Development, Testing and Health Effects of a Multilevel Family Planning Intervention

多层次计划生育干预措施的开发、测试和健康影响

基本信息

批准号：
9894336
负责人：
Susan Maria Kiene
金额：
$ 21.02万
依托单位：
UNIVERSITY OF TEXAS SAN ANTONIO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-01-01 至 2021-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9894336
关键词：
AIDS prevention Address Age Attention Attitude Behavior Therapy Cessation of life Child Collection Communication Communities Contraceptive Agents Contraceptive Distributions Contraceptive Usage Contraceptive methods Country Couples Data Decision Making Developing Countries Development Economics Family Family Planning Family Sizes Family health status Fertility Rates Focus Groups Fright Gender Role Goals Guidelines Health Health Benefit Health Personnel Health care facility Incidence Individual Infant Mortality Intervention Interview Knowledge Link Live Birth Maternal Mortality Measurement Misinformation Modernization Mother-to-child HIV transmission Outcome Partner Communications Perception Pilot Projects Population Study Postpartum Women Pregnancy Procedures Process Public Health Qualitative Research Randomized Research Resources Risk Rural Rural Community Services Shapes Side Structure Testing Time Translating Transportation Treatment Efficacy Uganda United States Woman Work abortion base community intervention condoms family influence feasibility trial follow-up gender equity improved infant morbidity/mortality informant innovation maternal morbidity member men peer influence pilot trial pregnancy prevention primary outcome recruit reproductive rural area scale up side effect therapy development unintended pregnancy uptake

AIDS prevention Address Age Attention Attitude Behavior Therapy Cessation of life Child Collection Communication Communities Contraceptive Agents Contraceptive Distributions Contraceptive Usage Contraceptive methods Country Couples Data Decision Making Developing Countries Development Economics Family Family Planning Family Sizes Family health status Fertility Rates Focus Groups Fright Gender Role Goals Guidelines Health Health Benefit Health Personnel Health care facility Incidence Individual Infant Mortality Intervention Interview Knowledge Link Live Birth Maternal Mortality Measurement Misinformation Modernization Mother-to-child HIV transmission Outcome Partner Communications Perception Pilot Projects Population Study Postpartum Women Pregnancy Procedures Process Public Health Qualitative Research Randomized Research Resources Risk Rural Rural Community Services Shapes Side Structure Testing Time Translating Transportation Treatment Efficacy Uganda United States Woman Work abortion base community intervention condoms family influence feasibility trial follow-up gender equity improved infant morbidity/mortality informant innovation maternal morbidity member men peer influence pilot trial pregnancy prevention primary outcome recruit reproductive rural area scale up side effect therapy development unintended pregnancy uptake

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项目摘要

Abstract In 2018, 32.6% of women of reproductive age had an unmet need for family planning in Uganda, meaning they wanted to avoid pregnancy but were not using a modern contraceptive method. Filling the unmet need for family planning has important public health implications, including reductions in pregnancy-related health risks and deaths, and infant mortality. While Uganda is scaling up efforts to reduce supply-side barriers in rural areas, such as community distribution of contraceptives, couples are still faced with multi-level demand-side barriers to contraceptive use. In addition to misinformation and fear of contraceptive side-effects, relationship dynamics, peer and family influence, and broader community norms promoting large family size and traditional gender roles influence family planning. We propose to develop and pilot test a multi-level, community-based intervention, which employs transformative community dialogues to alter individual attitudes and the perception of community norms that discourage family planning. Community dialogues are delivered to groups of couples over 4-sessions enhanced to simultaneously address individual and interpersonal-level determinants of family planning and link couples to family planning services. The aims of our project are to: Aim 1) Develop a multi- level intervention that engages couples in transformative community dialogues to reduce unintended pregnancy by increasing modern contraceptive use. We will develop the intervention through qualitative research with women and men with an unmet need and community stakeholders and through the formation of a community intervention steering committee; Aim 2) Conduct a pilot quasi-experimental controlled trial with 70 couples (intervention n=35, control n=35), randomizing one village to the multi-level intervention (n=35 couples) and one village to the control condition (n=35 couples, attention-matched control intervention). We will assess acceptability and feasibility of the trial procedures (Aim 2a) and intervention content (Aim 2b), with the exploratory aim (2c) of assessing the intervention's potential efficacy on contraceptive uptake and continuation and intermediate outcomes (knowledge, attitudes, perceived community norms, partner communication and equity) through 6-month follow up.

抽象的 2018年，有32.6％的生殖年龄妇女在乌干达对计划生育的需求未满足，这意味着她们想避免怀孕，但不使用现代避孕方法。满足未满足的需求计划生育具有重要的公共卫生影响，包括减少与怀孕有关的健康风险和死亡和婴儿死亡率。而乌干达正在扩大努力，以减少农村的供应方向区域，例如避孕药的社区分布，夫妻仍然面临多层需求方避孕药使用的障碍。除了错误的信息和对避孕副作用的恐惧之外，关系还动态，同伴和家庭影响力以及更广泛的社区规范，促进了庞大的家庭规模和传统性别角色影响计划生育。我们建议开发和试点测试多层，基于社区的干预措施，采用变革性的社区对话来改变个人态度和感知社区规范不鼓励计划生育。社区对话交付给夫妇团体超过4个课程可以同时解决家庭的个人和人际关系决定因素计划并将夫妇链接到计划生育服务。我们项目的目的是：目标1）与夫妻进行变革性社区对话以减少意外的水平干预措施通过增加现代避孕药的使用来怀孕。我们将通过定性发展干预措施与有未满足需求和社区利益相关者的男女研究，并通过形成社区干预指导委员会；目标2）进行70的试点准实验对照试验夫妻（干预n = 35，控制n = 35），将一个村庄随机化为多层干预（n = 35 夫妻）和一个村庄的控制条件（n = 35对夫妇，注意力匹配的控制干预措施）。我们将评估试验程序的可接受性和可行性（AIM 2A）和干预含量（AIM 2B），与评估干预措施对避孕药的潜在功效的探索目的（2C）以及中级结果（知识，态度，感知的社区规范，合作伙伴交流和股权）至6个月的随访。