Emergency Contraception to Prevent Pregnancy: Missed Opportunities for Care.

紧急避孕以防止怀孕：错过护理机会。

基本信息

批准号：
8253850
负责人：
Michelle Lynne Munro-Kramer
金额：
$ 3.4万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-01 至 2013-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8253850
关键词：
Address Affect American Caring Client Comprehensive Health Care Data Analyses Data Collection Ecosystem Elements Forcible intercourse Forensic Medicine Future Gold Health Personnel Health behavior Healthy People 2010 Injury Intention Interdisciplinary Study Intervention Justice Knowledge Label Legal system Literature Mental Health Methods Michigan Modeling Nursing Models Participant Pharmacy facility Plan B Post-Traumatic Stress Disorders Pregnancy Prophylactic treatment Public Health Questionnaires Recruitment Activity Research Risk Safety Services Sexually Transmitted Diseases Surveys Survivors System Systems Theory United States Dept. of Health and Human Services Universities Violent injury Woman Women&apos s Health assault base doctoral student emergency contraception experience health care delivery insight meetings prevent programs research study theories therapy development

项目摘要

DESCRIPTION (provided by applicant): One in six American women will be raped in her lifetime, which can result in pregnancy, injury, sexually transmitted infections, post-traumatic stress disorder, a need to seek forensic and victim services, and potential legal system involvement for safety and prosecution (Tjaden & Thoennes, 2006). However, there is a gap in the literature on how the over-the-counter (OTC) status of Plan B(R) may impact contact with a healthcare provider because such limitation has the potential to affect the comprehensive care completed rape survivors will receive. The purpose of this mixed method study is to examine the impact of OTC Plan B(R) on survivors who might otherwise receive gold standard comprehensive care. A feminist perspective will frame this study. The data collection and analysis plan are informed by the PI's content specific integration of a nursing model, the Interaction Model of Client Health Behavior and a theory suited to public health phenomena, Bronfenbrenner's Ecological Systems Theory. This model will guide the use of a concurrent mixed method approach to meet the specific aims of 1) using an anonymous survey to quantify missed opportunities for desired care and 2) using a participatory action framework and open-ended questions to assess the conceptual model and post-assault Plan B(R) users' desire for interventions to facilitate access to all elements of comprehensive care. We will recruit participants from university based pharmacies in Michigan while they are obtaining Plan B(R). All participants will be asked to answer an anonymous questionnaire. Specifically, all participants accessing Plan B(R) will complete a questionnaire labeled the "Yellow Questionnaire" which will include questions related to the study's conceptual framework taken from the Survey on Women's Health Issues. Those identifying as completed rape survivors will answer the "Blue Questionnaire" with questions from the Sexual Experiences Survey. The results of this interdisciplinary research study will provide insight into the use of the PI's mode in evaluating missed opportunities for care and will help inform interventions for completed rape survivors using Plan B(R) who are at risk of not receiving comprehensive care. This project is the initial step for a doctoral student in a long-term research trajectory focused on completed rape survivors, Plan B(R), and efficacious interventions for comprehensive care. PUBLIC HEALTH RELEVANCE: Now that emergency contraception (Plan B(R)) is available at the pharmacy without prescription, survivors of completed rape may self-treat to prevent pregnancy and forego the other five elements of comprehensive care: care for injuries, sexually transmitted infection prophylaxis, mental health referrals, forensic and victim services, and justice system involvement. This mixed method study will quantify potential missed opportunities for care, will provide insight into the use of the PI's model in evaluating missed opportunities fo care, and will elicit survivors' desires for alternative access to comprehensive care.

描述（由申请人提供）：一生中将强奸六分之一的美国妇女，这可能导致怀孕，伤害，性传播感染，创伤后应激障碍，寻求法医和受害者服务以及潜在的法律制度参与安全和起诉（Tjaden＆Thoennes，2006年）。但是，文献上存在差距，即计划B（R）的非处方（OTC）状态如何影响与医疗保健提供者的接触，因为这种限制有可能影响综合护理完整的强奸幸存者。这项混合方法研究的目的是检查OTC计划B（R）对可能获得黄金标准综合护理的幸存者的影响。女权主义的观点将构成这项研究。 Bronfenbrenner的生态系统理论，通过PI的内容特定整合，客户健康行为的相互作用模型以及适合公共卫生现象的理论来告知数据收集和分析计划。该模型将指导使用一种并发的混合方法来满足1）使用匿名调查来量化所需护理的错失机会的具体目的，以及2）使用参与式动作框架和开放式问题来评估概念模型和攻击后计划B（R）用户的愿望，以促进所有综合护理元素的干预措施。我们将在获得B（R）计划的同时，招募来自密歇根州大学药房的参与者。所有参与者将被要求回答匿名问卷。具体来说，所有访问B（R）计划的参与者将填写标有“黄色问卷”的问卷，其中将包括与研究有关妇女健康问题调查的研究概念框架有关的问题。那些确定为完整的强奸幸存者的人会回答“蓝色问卷”，并通过性经历调查中的问题。这项跨学科研究的结果将提供有关使用PI模式在评估错过的护理机会时使用的洞察力，并将有助于使用有没有接受综合护理的风险的B（R）为完整的强奸幸存者提供干预措施。该项目是长期研究轨迹中的博士生的第一步，该研究轨迹着重于完整的强奸幸存者，计划B（R）和有效的综合护理干预措施。公共卫生相关性：现在，在药房就可以在没有处方的情况下获得紧急避孕（B（R）计划），已完成强奸的幸存者可能会自我治疗以防止怀孕，并放弃其他综合护理的其他五个要素：对伤害，性传播的感染预防，心理健康，精神健康，及受害者的服务，征服和受害者服务，以及司法服务和正义系统。这项混合方法研究将量化潜在的缺失护理机会，将提供有关使用PI模型在评估失踪机会的洞察力，并将引起幸存者对获得综合护理的替代访问的愿望。