Adolescent Wellness Visits in Tanzania

坦桑尼亚青少年健康访问

基本信息

批准号：
10433988
负责人：
Joy Noel Baumgartner
金额：
$ 60.96万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-04-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10433988
关键词：
Adherence Adolescence Adolescent Adolescent Health Services Adult Age Allied Health Sciences Area Bundling Caring Child Clinic Clinic Visits Clinical Collaborations Consent Consolidated Framework for Implementation Research Contraceptive Agents Contraceptive Usage Contraceptive methods Counseling Coupling Diagnostic Education Evidence based intervention Evidence based practice Focus Groups Future HIV HIV-infected adolescents Health Health Promotion Health Services Health Services Accessibility Health Status Health care facility Health education Health system Human immunodeficiency virus test Individual Information Services Intervention Interview Letters Mental Health Modeling National Institute of Child Health and Human Development Nurses Oral health Outcome Persons Policies Population Prevention Preventive Health Services Preventive service Primary Schools Provider Puberty Public Health Randomized Controlled Trials Reproductive Health Reproductive Health Services Research Resource-limited setting Risk Risk Assessment Role School-Age Population Schools Science Services Sexual Health Sexually Transmitted Diseases Shoulder Site Structure Students Tanzania Testing Time Training Universities Ursidae Family Vision Visit Youth base behavioral health behavioral outcome cost effectiveness cost-effectiveness evaluation critical developmental period design dissemination research evidence base health seeking behavior health service use high risk sexual behavior implementation research implementation trial improved informant low and middle-income countries neglect nutrition pilot test pragmatic implementation prevent prevention service primary outcome response screening screening services secondary outcome service delivery service utilization sexually active sexually active adolescent unintended pregnancy uptake

项目摘要

PROJECT ABSTRACT Adolescent Wellness Visits in Tanzania Getting adolescents in the door of a health facility is an entrenched health system problem, particularly for HIV and sexual and reproductive health (SRH) services. Adolescents in low-resource settings need a preventative health service platform applicable for all young people that promotes a culture of health-seeking behavior. In response to PAR- impact of Adolescent Wellness Visits (AWVs), a 19-274 [Dissemination & Implementation Research in Health], this R01 will evaluate the new health service platform, for reaching young adolescents with HTC and other evidence-based prevention services which are clinic-based and school-facilitated. We posit that by coupling sexual and reproductive health (SRH) and non-SRH information and services, issues of self- risk assessment, and access to services may be circumvented. AWVs could meet the SRH needs of at-risk adolescents, and have a larger public health impact for all adolescents on access to traditionally neglected and untreated non-SRH issues such as poor nutrition, vision, dental, and mental health problems at the time of delivery as well as in the future as adolescents continue with more timely service utilization. The AWV is designed to be delivered during the last year of primary school when school attendance is high and adolescents are on the cusp of puberty (mean age 13). This project is a collaboration between Duke University and Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania. Specific Aims are: 1) To assess the impact of the Adolescent Wellness Visit model on HTC (primary outcome for all adolescents) and contraceptive uptake (secondary outcome for sexually active adolescents) up to two years post-primary school via a cluster randomized controlled trial (24 school-clinic pairs: 12 intervention + 12 control; n=552 adolescents); 2) To evaluate factors that support or limit implementation of the AWV model and fidelity/adherence to implementation of the proposed package of evidence-based practices included in the AWV; and 3) To determine the cost-effectiveness of the AWV model for increased HIV testing, reaching PEPFAR diagnostic targets, and reductions in unmet need for contraception. This D&I proposal creates and leverages a new population level health service for adolescents that aligns with NICHD’s Research Theme #5: Improving Health during the Transition from Adolescence to Adulthood (NOT-HD-18-031), and as a nurse- delivered intervention, it also aligns with NINR’s strategic focus area—Wellness: Promoting Health and Preventing Illness (16-NR-778). A prevention-focused adolescent health service in LMICs can set the tone for a ‘culture of health and wellness’ during this critical developmental period.

项目摘要坦桑尼亚的青少年健康访问让青少年进入医疗机构的门是一个根深蒂固的卫生系统问题，尤其是对于艾滋病毒以及性和生殖健康（SRH）服务。低资源设置中的青少年需要预防健康服务平台适用于所有促进寻求健康行为文化的年轻人。在对par的回应青少年访问的影响（AWVS），一个 19-274 [卫生传播与实施研究]，该R01将评估新的卫生服务平台，用于吸引年轻的青少年使用HTC和其他基于诊所的预防服务，这些服务是基于诊所的，并具有学校为基础的。我们的位置通过结合性和生殖健康（SRH）以及非SRH信息和服务，自我的问题风险评估和获得服务的访问可能会得到规避。 AWV可以满足高危的SRH需求青少年，对所有青少年的公共卫生影响更大未经治疗的非SRH问题，例如营养不良，视力，牙齿和心理健康问题随着青少年的及时服务，交付以及将来继续使用更及时的服务利用。 AWV是旨在在小学的最后一年上学时交付青少年在青春期的风口浪尖（平均年龄13岁）。这个项目是杜克大学之间的合作以及坦桑尼亚达累斯萨拉姆的卫生大学和盟军科学大学。具体目的是：1）评估青少年健康访问模型对HTC（所有青少年的主要结果）和长达两年后学校的避孕药摄取（性活跃青少年的次要结果）通过群集随机对照试验（24个学校链接对：12干预 + 12控制； n = 552 青少年）； 2）评估支持或限制AWV模型的实施或限制的因素和忠诚/坚持实施所提出的一套基于证据的做法的包裹 awv; 3）确定AWV模型的成本效益以增加HIV测试，以达到 PEPFAR诊断靶标和避孕不需要的需求减少。这个D＆I提出创建的，利用与NICHD的研究主题5一致的青少年的新人口卫生服务：从青春期到成年期（非HD-18-031）的过渡期间的健康状况，作为护士提供干预措施，它也与尼尔的战略重点领域保持一致 - 环境：促进健康和预防疾病（16-NR-778）。 LMICS中以预防为重点的青少年健康服务可以为在这个关键的发展时期，一种“健康与保健文化”。