Training Healthcare Professionals to Address Reproductive Health for Persons with Disabilities in Tanzania

培训医疗保健专业人员以解决坦桑尼亚残疾人的生殖健康问题

基本信息

批准号：
10596703
负责人：
Kristen Patricia Mark
金额：
$ 75.66万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-07-05 至 2028-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10596703
关键词：
Address Adopted Africa Africa South of the Sahara African Age Ally Attitude Blinded Caregivers Caring Christianity Clinic Communities Community Health Consult Counseling Country Development Disabled Persons Discipline Discipline of Nursing Discrimination Education Educational Curriculum Ensure Environment Epidemic Evaluation Exclusion Face Faculty Focus Groups Funding Future Government HIV Health Health Personnel Health Professional Health Services Health education Healthcare Indigenous Individual Intervention Trial Interview Knowledge Language Learning Medical Students Medicine Midwifery Modeling Morbidity - disease rate Muslim religion Needs Assessment Nursing Students Outcome Pan American Health Organization Participant Patients Persons Policies Population Pregnancy in Adolescence Professional Education Randomized Randomized, Controlled Trials Recording of previous events Religion Reproductive Health Research Research Personnel Science Sexual Health Sexually Transmitted Diseases Structure Students Taboo Tanzania Testing Trainers Training Training Training Programs Tribes United States National Institutes of Health Universities Waiting Lists Writing acceptability and feasibility arm comparison control design disability leave effectiveness evaluation efficacy testing evidence base experience follow-up health care delivery health communication health knowledge health training high risk improved informant intervention effect low income country mortality neglect patient population pilot test professional students provider behavior routine care secondary analysis sex sexual violence single-blind trial skill acquisition skills social social stigma statistics treatment arm unintended pregnancy

项目摘要

PROJECT SUMMARY Training of healthcare providers in the reproductive and sexual health (RSH) needs of persons with disabilities (PWD) is critical to addressing a broad array of RSH concerns. Rigorous trials evaluating the effects of curricula on provider behavior are rare. Specifically, we could find no formalized training of healthcare providers in RSH for PWD in sub-Saharan Africa, an environment with the highest rates of human immunodeficiency virus (HIV), sexually transmitted infection (STI), and unintended pregnancy in the world; and where RSH challenges are common and particularly dire for PWD. Reproductive healthcare is a sensitive issue in Africa and PWD are often excluded from consideration. Consequently, a rigorous study of PWD RSH education for healthcare providers is needed if such education is to be widely adopted. Currently, at Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, we are conducting a rigorous randomized controlled trial (RCT) of an Afrocentric RSH curriculum training for healthcare providers which was partly adapted from PAHO/WHO for implementation in Tanzania. When we assessed the need for training in RSH needs of PWD in our participants in this trial, nursing, midwifery, and medical students indicated RSH curriculum for PWD to be highly acceptable, needed, and desired by students, and our current NIH-funded RCT has clearly indicated the feasibility of implementation. The next logical step is to create a culturally relevant RSH curriculum to improve student knowledge, attitudes, and skills in providing RSH care for PWD. There are three specific aims. Aim 1 is to conduct a social ecological needs assessment of RSH care delivery for PWD in Tanzania. To determine the most important content when accessing RSH care, we will interview ~20 PWD and ~20 PWD caregivers (total of ~40 interviews) on their experience accessing RSH care. To determine the needs from the perspective of the healthcare workers, we will conduct focus groups of midwifery, nursing, and medical students (3 from each discipline). We will also conduct individual interviews with 12 key informants. In Aim 2, we will further adapt our curriculum, ensure it is culturally tailored to the Tanzanian/sub-Saharan context, and pilot test it. Aim 3 is to evaluate the effectiveness of an Afrocentric, culturally appropriate RSH curriculum for health providers focused on caring for PWD. We will conduct a randomized, controlled, single blinded trial of the curriculum against a waitlist control assessing effects on RSH for PWD knowledge, attitudes, and counseling skills (n=206 students per arm; 412 in total). Hypotheses will test efficacy of the curriculum. We will consult an advisory board of PWD in Tanzania to address structural and cultural issues throughout and use Universal Design (UD)/Universal Design for Learning (UDL) consultant for all study materials. If effective, MUHAS has committed to implement the curriculum for all health students. Given MUHAS is preeminent in health student education across Africa, the curriculum assessed in this study has high potential to be widely adopted as a new standard of training for health professionals across Africa.

项目摘要在残疾人的生殖和性健康（RSH）需求中培训医疗保健提供者（PWD）对于解决广泛的RSH问题至关重要。严格的试验评估提供者行为的课程很少见。具体来说，我们找不到对医疗保健的正式培训撒哈拉以南非洲的PWD的RSH提供商，人类的率最高的环境世界范围内的免疫缺陷病毒（HIV），性传播感染（STI）和意外怀孕；和 RSH挑战很常见，特别是PWD的挑战。生殖医疗保健是一个敏感的问题在非洲和PWD中，通常被排除在考虑之外。因此，对PWD RSH进行了严格研究如果要广泛采用此类教育，则需要为医疗保健提供者进行教育。目前，在Muhimbili 卫生与盟友大学（MUHAS）在达累斯萨拉姆，我们正在进行严格的随机分析对医疗保健提供者的非洲为中心RSH课程培训的对照试验（RCT）部分是部分改编自Paho/WHO在坦桑尼亚实施。当我们评估RSH培训的需求时 PWD在我们的试验，护理，助产士和医学生的参与者中的需求表示RSH PWD的课程是高度可接受的，需要和需要的，我们当前的NIH资助 RCT清楚地表明了实施的可行性。下一个逻辑步骤是在文化上创建一个相关的RSH课程，以提高学生知识，态度和技能，以提供PWD的RSH护理。有三个特定的目标。目标1是对RSH护理交付的社会生态需求评估用于坦桑尼亚的PWD。为了确定访问RSH护理时最重要的内容，我们将采访〜20个PWD和〜20个PWD护理人员（总共约40次访谈）在他们访问RSH护理方面的经验。到从医护人员的角度来确定需求，我们将进行焦点小组助产士，护理和医学生（每个学科的3个）。我们还将进行个人面试有12位关键线人。在AIM 2中，我们将进一步适应我们的课程，确保其在文化上量身定制坦桑尼亚/撒哈拉以下环境，并试点对其进行测试。目标3是评估以非洲为中心的有效性，针对健康提供者的文化上适合的RSH课程，专注于照顾PWD。我们将进行课程的随机，受控，单盲试验，以评估对RSH的效果的候补控制列表为了获得PWD知识，态度和咨询技能（n = 206名学生；总共412名）。假设会测试课程的功效。我们将咨询坦桑尼亚PWD咨询委员会，以解决结构和整个文化问题，并使用通用设计（UD）/通用学习（UDL）顾问所有研究材料。如果有效，Muhas已致力于为所有卫生学生实施课程。鉴于Muhas在整个非洲的卫生学生教育方面都是杰出的，因此该课程在本研究中评估有很高的潜力被广泛采用作为非洲卫生专业人员的新培训标准。