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）：六分之一的美国女性一生中都会被强奸，这可能导致怀孕、受伤、性传播感染、创伤后应激障碍、需要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）。然而，关于 Plan B(R) 的非处方 (OTC) 状态如何影响与医疗保健提供者的联系，文献中存在空白，因为这种限制有可能影响强奸幸存者将获得的全面护理。这项混合方法研究的目的是检验 OTC Plan B(R) 对幸存者的影响，否则他们可能会接受黄金标准综合护理。女权主义的视角将构成这项研究的框架。数据收集和分析计划由 PI 的护理模型、客户健康行为交互模型和适合公共卫生现象的理论（布朗芬布伦纳的生态系统理论）的具体内容整合提供信息。该模型将指导使用并行混合方法来实现以下具体目标：1）使用匿名调查来量化错过的所需护理机会；2）使用参与性行动框架和开放式问题来评估概念模型和袭击后 Plan B(R) 用户希望采取干预措施，以促进获得全面护理的所有要素。我们将从密歇根大学药房招募参与者，同时他们正在获得 Plan B(R)。所有参与者都将被要求回答匿名调查问卷。具体来说，所有访问 Plan B(R) 的参与者都将完成一份标有“黄色问卷”的调查问卷，其中包括与取自妇女健康问题调查的研究概念框架相关的问题。那些被确定为已完成强奸幸存者的人将用性经历调查中的问题回答“蓝色问卷”。这项跨学科研究的结果将深入了解 PI 模式在评估错过的护理机会方面的用途，并将有助于为使用 Plan B(R) 的强奸幸存者提供干预措施，这些幸存者有可能无法接受全面护理。该项目是博士生长期研究轨迹的第一步，重点关注已完成的强奸幸存者、B(R) 计划和有效的综合护理干预措施。公共健康相关性：既然无需处方即可在药房购买紧急避孕药（Plan B(R)），强奸案幸存者可以通过自我治疗来预防怀孕，并放弃综合护理的其他五个要素：伤害护理、性传播疾病感染预防、心理健康转诊、法医和受害者服务以及司法系统参与。这项混合方法研究将量化潜在错失的护理机会，深入了解 PI 模型在评估错失的护理机会时的使用情况，并将引发幸存者对获得综合护理的替代方式的渴望。