Training for Health Professionals

卫生专业人员培训

• 批准号: 10452706
• 负责人: Dickson Ally Mkoka
• 金额: $ 51.42万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-15 至 2023-09-19
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10452706
• 关键词: Address; Adopted; Advocate; Africa; Africa South of the Sahara; African; Allied Health Sciences; Attitude; Blinded; Child; Christianity; Clinic; Clinical Skills; Communication; Communities; Community Health; Counseling; Country; Development; Diagnosis; Discipline; Discipline of Nursing; Discrimination; Education; Educational Curriculum; Educational process of instructing; Ensure; Environment; Epidemic; Evaluation; Faculty; Focus Groups; Forcible intercourse; Functional disorder; Government; HIV/STD; Health; Health Occupations; Health Personnel; Health Professional; Health Services; Health education; Healthcare; Homosexuality; Indigenous; Individual; Intervention; Intervention Trial; Interview; Knowledge; Language; Lesbian Gay Bisexual Transgender; Marriage; Masturbation; Measures; Medical; Midwife; Midwifery; Modeling; Morbidity - disease rate; Muslim religion; Needs Assessment; Nurse Midwives; Nurses; Outcome; Pan American Health Organization; Participant; Patients; Persons; Plant Roots; Policies; Population; Pre-Post Tests; Pregnancy in Adolescence; Primary Health Care; Randomized; Randomized Controlled Trials; Recording of previous events; Religion; Reproductive Health; Research; Risk Reduction; Safe Sex; Science; Sex Education; Sexual Dysfunction; Sexual Health; Sexuality; Standardization; Stigmatization; Students; Surgeon; Tanzania; Teenagers; Testing; Trainers Training; Training; Training Programs; Training and Education; Tribes; Universities; Unwanted pregnancy; Waiting Lists; Wife; Woman; Writing; Youth; abortion; arm; base; boys; care delivery; effectiveness evaluation; evidence base; female genital cutting; follow-up; girls; health care delivery; health communication; health knowledge; health training; high risk; improved; informant; intervention effect; men; men who have sex with men; mortality; pilot test; provider behavior; reproductive; routine care; secondary analysis; sex; sexual assault; sexual minority; sexual violence; single-blind trial; skill acquisition; skills; skills training; social; statistics; unintended pregnancy

ABSTRACT As documented in the US Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior, training of health providers in sexual health care is critical to addressing a broad array of the nation's sexual and reproductive health concerns. Yet rigorous trials evaluating the effects of sexual health curricula on provider behavior are rare. In sub-Saharan Africa, an environment which has the highest rates of HIV, STI, teen pregnancy, unwanted pregnancy, unsafe abortion, child marriage of girls and sexual assault of boys in the world, and where female genital cutting, wife-beating, marital rape, criminalization of homosexuality, stigmatization of Lesbian, Gay, Bisexual and Transgender (LGBT) persons, myths about masturbation leading to dysfunction, and rates of sexual dysfunction in both men and women are common, we could find no formalized training of health providers in sexual health care. Sexual health education, even of health providers, is a sensitive issue in Africa. Consequently, a rigorous study of its effects is needed, if such education is to be widely adopted. Recently, at Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, we adapted a PAHO/WHO sexual health curriculum training for healthcare providers for implementation in Tanzania. Participants were 87 nursing, midwifery, and allied health science students. Pre-post evaluations show the curriculum to be highly acceptable, needed, and desired by students, feasible in implementation, and effective in improving student knowledge, attitudes, and skills in providing sexual health care to patients. The logical next step in this line of research is to conduct the first rigorous trial of a comprehensive sexual health training curriculum for health professionals in Tanzania. There are three specific aims. Aim 1 is to conduct a social ecological needs assessment of sexual health care delivery in Tanzania. To determine whether midwifery, nursing, medical, and allied health science students would benefit from one curriculum or separate curricula tailored by discipline, we will conduct focus groups (3 from each discipline). We will also conduct individual interviews with key informants to address structural and cultural issues. 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 African-based, culturally-appropriate, sexual health curriculum. We will conduct a randomized, controlled, single blinded trial of the curriculum against a waitlist control assessing effects on sexual health knowledge, attitudes, and counseling skills (n=206 students per arm; 412 in total). Hypotheses will test if the curriculum is effective, and whether it is more effective for one discipline than another. If effective, MUHAS has committed to implement the curriculum for all their 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.

抽象的 正如美国卫生局局长呼吁采取行动促进性健康和负责任的性行为所记录的那样 性保健方面的行为和卫生服务提供者的培训对于解决一系列国家性问题至关重要 性健康和生殖健康问题。然而，严格的试验评估了性健康课程对性健康的影响 提供者的行为很少见。在撒哈拉以南非洲地区，艾滋病毒、性传播感染发病率最高， 青少年怀孕、意外怀孕、不安全堕胎、女孩童婚和男孩性侵犯 世界上，女性生殖器切割、殴打妻子、婚内强奸、同性恋定罪、 对女同性恋、男同性恋、双性恋和跨性别者 (LGBT) 的污名化、关于手淫的神话导致 性功能障碍的发生率在男性和女性中都很常见，我们发现没有 对卫生服务提供者进行性保健方面的正规培训。性健康教育，甚至是对医疗服务提供者的性健康教育， 在非洲是一个敏感问题。因此，如果要进行这种教育，就需要对其影响进行严格的研究。 被广泛采用。最近，在达累斯萨拉姆穆希姆比利健康与相关科学大学 (MUHAS)， 我们为医疗保健提供者改编了泛美卫生组织/世界卫生组织性健康课程培训，以便在 坦桑尼亚。参与者是 87 名护理、助产和联合健康科学专业的学生。事前事后评估 表明课程是学生高度接受、需要和渴望的，实施起来可行，并且 有效提高学生向患者提供性保健的知识、态度和技能。这 这一研究领域合乎逻辑的下一步是对全面的性健康进行首次严格试验 坦桑尼亚卫生专业人员培训课程。具体目标有三个。目标 1 是进行 坦桑尼亚性保健服务的社会生态需求评估。判断是否 助产学、护理学、医学和联合健康科学专业的学生将从一门课程或单独的课程中受益 根据学科定制课程，我们将进行焦点小组（每个学科 3 名）。我们还将进行 与主要知情人进行个人访谈，以解决结构和文化问题。在目标2中，我们将进一步 调整我们的课程，确保其在文化上适合坦桑尼亚/撒哈拉以南地区的背景，并进行试点测试。目的 三是评估基于非洲、适合文化的性健康课程的有效性。我们将 根据候补名单控制评估对课程进行随机、对照、单盲试验 对性健康知识、态度和咨询技能的影响（每组 206 名学生；总共 412 名）。 假设将检验课程是否有效，以及它对于某一学科是否比课程更有效 其他。如果有效，MUHAS 已承诺为所有健康学生实施该课程。给定 MUHAS 在整个非洲的健康学生教育方面表现出色，本研究评估的课程 被广泛采用作为非洲卫生专业人员培训新标准的巨大潜力。