SELF-CARE TO PREVENT BIRTH-RELATED UI IN DIVERSE WOMEN: FOCUS GROUP

这个子项目是许多利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 骨盆底肌肉训练（PFMT）可将分娩相关性尿失禁（UI）的风险降低39- 59%。PFMT被推荐用于妊娠/产后UI预防，但只有20-47%的人报告使用它。PFMT是一种非侵入性的自我护理实践，非常适合育龄妇女。 我们在老年女性中进行的随机对照试验（RCT）测试了强化课程预防UI的有效性，该课程提供了一系列自我护理策略- PFMT（骨盆底肌肉的重复自主收缩和放松）;膀胱训练（BT）（一种具有渐进性排尿间隔的计划排尿）;以及Knack操作（故意收缩骨盆底以避免UI）。这些自我护理实践已经证明了UI治疗的有效性，但我们的RCT是第一个证明其预防UI的综合能力的RCT。PFMT的依从性在术后3个月为82%，1年为68%。通过自我效能、并发BT和PFMT常规方法预测依从性。我们认为，这些战略之间存在协同效应。结合策略的课堂教学将可能促进育龄妇女PFMT的实践。 虽然非裔美国人（AA）和西班牙裔女性的UI风险较低，但其UI症状的心理困扰超过白人女性（AA女性高1.26倍，西班牙裔女性高5.7倍）。以前的PFMT预防UI的试验主要包括白人女性，引起了对非裔美国人和西班牙裔美国人预防性卫生服务率低的健康差异的关注。增加的痛苦加上缺乏证据的UI自我保健的功效，在颜色的妇女，保证测试的有效性产前膀胱健康类（BH类）在未来的随机对照试验。早些时候的NIH申请受到好评，但建议BH类，泄漏指数问卷，招聘/保留策略的文化适当性进行了讨论与目标样本的成员。拟议的试点将通过以下具体目标产生证据： 目标1：制定文化上适当的方式来介绍BH类AA和西班牙裔育龄妇女。 目标二：确保泄漏指数调查问卷和BH类中使用的印刷材料是在5年级阅读水平，这是适合我们的目标人群。 目标3：确定文化上适当的招聘和保留战略，AA和西班牙裔育龄妇女在密歇根州东南部。 为了实现这些目标，我们将与AA和西班牙裔妇女进行重点小组讨论。结果将告知未来的NIH拨款申请。'

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Pelvic floor muscle training (PFMT) reduces childbearing women's risk of birth-related urinary incontinence (UI) by 39-59%. PFMT is recommended for UI prevention in pregnancy/postpartum but only 20-47% report its use. PFMT is a non-invasive self-care practice well-suited for childbearing women. Our randomized controlled trial (RCT) with older women tested the effectiveness for UI prevention of an intensive class presenting an array of self-care strategies - PFMT, (repetitive voluntary contraction and relaxation of pelvic floor muscles); bladder training (BT) (a program of scheduled voiding with progressive voiding intervals); and the Knack maneuver (intentional contraction of the pelvic floor to avoid UI). These self-care practices have demonstrated efficacy in UI treatment but our RCT was the first to demonstrate their combined capacity for UI prevention. Adherence to PFMT was 82% at three months and 68% one year post-class. Adherence was predicted by self-efficacy, concurrent BT, and routine approach to PFMT. We believe synergy exists across the strategies. The class with combined strategies will likely enhance childbearing women's practice of PFMT. Although the risk of UI is lower among African American (AA) and Hispanic women, their psychological distress with UI symptoms exceeds that of Caucasian women (1.26 times higher in AA women, 5.7 times higher in Hispanic women). Previous trials of PFMT to prevent UI included predominantly Caucasian women raising a health disparities concern of low rates for preventive health services among African Americans and Hispanics. Increased distress plus lack of evidence for UI self-care efficacy in women of color, warrant testing the effectiveness of an antenatal bladder health class (BH Class) in a future RCT. An earlier NIH application was well received but recommended that cultural appropriateness of the BH Class, the Leakage Index questionnaire, and recruitment/retention strategies be discussed with members of the target sample. The pilot proposed will generate that evidence through the following specific aims: Aim 1: Develop culturally appropriate ways to present the BH class to AA and Hispanic childbearing women. Aim 2: Assure that the Leakage Index questionnaire and the print materials used in the BH Class are at a 5th grade reading level, which is appropriate for our target population. Aim 3: Identify culturally appropriate recruitment and retention strategies for AA and Hispanic childbearing women in Southeast Michigan. To accomplish these aims, we will conduct focus groups with AA and Hispanic women. Results will inform a future NIH grant application.'