Vaginal Douching in Latina Women and Adolescents

拉丁妇女和青少年的阴道冲洗

• 批准号: 6965956
• 负责人: MELISSA DIANE MCKEE
• 金额: $ 8.25万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6965956
• 关键词: Hispanic Americans; adolescence (12-20); behavior therapy; belief; clinical research; counseling; culture; disease /disorder prevention /control; female; health behavior; human subject; human therapy evaluation; lavage therapy; vagina; young adult human (21-34)

DESCRIPTION (provided by applicant): The health risks of vaginal douching are well documented, including increased risk of pelvic inflammatory disease, ectopic pregnancy, Chlamydia infection, reduced fecundity, and preterm delivery. However, for reasons that are not well understood, douching remains a common practice, especially among ethnic minority women in the United States. Douching practices are likely to be shaped by social norms regarding feminine hygiene and sexuality, and by folk models of vaginal and reproductive anatomy. Yet there has been little research taking a qualitative, ethnographic approach to understanding the cultural and social context of douching; none have explored the potentially unique beliefs and practices of Latinas. The overall goal of this study is to design a primary care practice-based intervention to reduce or eliminate vaginal douching among Latina women and adolescents. This intervention will be culturally sensitive, practical to deliver in busy primary care settings, and grounded in the Transtheoretical Model and Motivational Interviewing. We propose 2 phases. In Phase I, ethnographic investigation will describe the socially and culturally shaped beliefs and attitudes that influence douching practices from the perspective of adolescent and young adult Latinas, and Hispanic men. We will also describe the contexts (e.g. postmenstrual, post-coital, or prophylactic), products, and practices associated with douching. In Phase II, we will design a culturally sensitive practice-based behavioral counseling intervention to reduce douching, informed by the qualitative findings. We will create and evaluate patient education materials to be used as an adjunct to the counseling intervention. The investigators will be trained in Behavior Change Counseling, and pilot test the behavioral intervention with 20 adolescents and 20 young adult women to assess feasibility and acceptability of the intervention in anticipation of a larger efficacy trial.

描述（由申请人提供）：阴道冲洗的健康风险已得到充分证明，包括增加骨盆炎性疾病的风险，异位妊娠，衣原体感染，育肥力降低和早产。但是，出于不太了解的原因，灌肠仍然是一种普遍的做法，尤其是在美国少数民族妇女中。对女性卫生和性行为的社会规范以及阴道和生殖解剖结构的民间模型可能会塑造灌肠习惯。然而，几乎没有采用定性的民族志方法来理解奉献的文化和社会背景。没有人探索了拉丁裔的潜在独特信念和实践。这项研究的总体目的是设计基于初级保健实践的干预措施，以减少或消除拉丁裔妇女和青少年的阴道冲洗。这种干预将对文化敏感，可在繁忙的初级保健环境中进行实用，并以跨理论模型和动机访谈为基础。我们提出了2个阶段。在第一阶段，民族志调查将描述从青少年和年轻的成年拉丁裔和西班牙裔男人的角度影响灌肠实践的社会和文化形状的信念和态度。我们还将描述上下文（例如月经后，后毛状或预防性），产品和与灌注相关的实践。在第二阶段，我们将设计一种基于文化敏感的行为咨询干预措施，以减少定性发现的启发。我们将创建和评估患者教育材料，以用作咨询干预的辅助手段。研究人员将接受行为变更咨询的培训，并试点对20名青少年和20名年轻妇女进行行为干预，以评估干预措施的可行性和可接受性，以期预期更大的疗效试验。