A multimedia, group-based clinical care and support model to increase dual protec

多媒体、基于团体的临床护理和支持模式，以增强双重保护

• 批准号: 8449542
• 负责人: Melissa Kottke
• 金额: $ 30万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2017-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8449542
• 关键词: multimedia; group; based; clinical; care

DESCRIPTION (provided by applicant): Young African American women carry a disproportionate burden of both unintended pregnancy and STDs. Dual protection strategies offer concurrent prevention of both unintended pregnancy and STDs. Previous efforts to develop clinic-based interventions to promote dual protection have met with limited success. Efforts have been hampered by a poor understanding of the strategies young women employ to protect themselves, the interplay among individual, partner and provider influences on young women's dual protection practices, and provider practices around dual protection. The proposed intervention seeks to build motivation for dual protection use, a multi-layered (self, peers, care team, partners, etc.) culture of support around dual protection use, a social norms shift towards expectation of dual protection use, and an acknowledgement of the influences and challenges of dual protection use as well as management suggestions for these challenges. Methods: This is a randomized controlled trial testing group-based educational and clinical care to encourage dual protection use among young African American women. We will recruit African American females aged 15- 19 who are attending the Grady Memorial Teen Services Clinic for reproductive health care. Young women who consent to enrollment will be randomized to one of two groups. Clinic day will be the unit of randomization. Those randomized to the control arm will receive individual-based clinical care consistent with standard care protocols at the Grady Memorial Teen Services Clinic. Those randomized to the intervention arm will receive the same clinical care, however, participants will access clinic as a group. These participants will receive individual clinical care as needed as well as group-based education with a focus on dual protection with the following approaches: Use of an interactive multimedia platform focused on dual protection strategies and selection of a strategy of Five group based educational sessions focusing on issues relevant to dual protection use (Importance of dual protection, Relationships, Sexual decision-making, Partner communication) A consistent care team (Nursing, Health Educator, Healthcare Provider) providing support and care to individuals attending the group sessions as needed Intercession communication via Facebook This intervention will span 18 months from recruitment to final follow-up. We will test the following hypotheses: H1: Participants in this multi-component intervention will experience lower incidence of biologic outcomes (unintended pregnancy, Chlamydia and/or gonorrhea) than participants in the control group. H2: Participants in this multi-component intervention will report higher adoption and adherence to proven dual protection strategies than participants in the control group.

描述（由申请人提供）：年轻的非裔美国女性承受着不成比例的意外怀孕和性病负担。双重保护策略可同时预防意外怀孕和性病。此前为促进双重保护而制定基于临床的干预措施的努力取得了有限的成功。由于对年轻女性用来保护自己的策略、个人、伴侣和提供者之间的相互作用对年轻女性双重保护实践的影响以及提供者围绕双重保护的实践缺乏了解，这些努力受到了阻碍。拟议的干预措施旨在建立双重保护使用的动力，围绕双重保护使用的多层次（自我、同伴、护理团队、合作伙伴等）支持文化，社会规范转向双重保护使用的期望，以及承认双重保护使用的影响和挑战以及针对这些挑战的管理建议。方法：这是一项随机对照试验，测试基于小组的教育和临床护理，以鼓励年轻的非裔美国女性使用双重保护。我们将招募 15-19 岁的非裔美国女性到格雷迪纪念青少年服务诊所接受生殖健康护理。同意加入的年轻女性将被随机分入两组中的一组。门诊日将是随机化的单位。那些随机分配到对照组的人将在格雷迪纪念青少年服务诊所接受符合标准护理方案的基于个人的临床护理。那些随机分配到干预组的人将接受相同的临床护理，但是参与者将作为一个小组进入诊所。这些参与者将获得 根据需要进行个人临床护理以及以双重保护为重点的小组教育，采用以下方法： 使用以双重保护策略为重点的交互式多媒体平台，并选择策略 五个以小组为基础的教育课程，重点关注与以下问题相关的问题：双重保护的使用（双重保护的重要性、关系、性决策、伴侣沟通） 一致的护理团队（护理、健康教育者、医疗保健提供者）根据需要为参加小组会议的个人提供支持和护理 通过 Facebook 进行代祷沟通 这种干预将跨越18从招募到最终随访需要几个月的时间。我们将检验以下假设： H1：这种多成分干预的参与者的生物学结果（意外怀孕、衣原体和/或淋病）的发生率低于对照组的参与者。 H2：与对照组的参与者相比，这种多成分干预措施的参与者将报告更高的采用率和对经过验证的双重保护策略的遵守率。