Developing and Testing a Smart Phone Based Contraceptive Use Educational Intervention for African Immigrant Women with Low Literacy

为识字率低的非洲移民妇女开发和测试基于智能手机的避孕药具使用教育干预

• 批准号: 10667872
• 负责人: Kafuli Agbemenu
• 金额: $ 24.85万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-19 至 2025-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10667872
• 关键词: Access to Information; Address; Adverse effects; African; Age; Belief; Birth; Birth Intervals; COVID-19 pandemic; Cause of Death; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Child; Communities; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; Data; Development; Education; Educational Intervention; Educational Status; Environment; Family; Family Planning; Family Planning Education; Family member; Fertility; Fright; Future; Goals; Health; Health Personnel; Healthcare; Healthcare Systems; Hormonal; Immigrant; Immigrant community; Incidence; Infant Mortality; Intervention; Knowledge; Language; Length; Low Birth Weight Infant; Low income; Maternal Mortality; Maternal and Child Health; Measures; Methods; Misinformation; Modality; Modification; Mothers; Neonatal Mortality; Online Systems; Outcome; Participant; Persons; Population; Population Control; Pregnancy; Pregnancy Rate; Premature Birth; Prenatal care; Preparation; Process; Proliferating; Reaction; Refugees; Reporting; Reproductive Health; Research; Resources; Sampling; Science; Self Efficacy; Services; System; Target Populations; Testing; Text; Time; Underserved Population; United States; Voice; Vulnerable Populations; Woman; Work; Writing; birth control; black women; career; child bearing; cost; design; empowerment; evidence base; experience; health care availability; health disparity; hormonal contraception; human centered design; implementation trial; improved; information gathering; innovation; literacy; low socioeconomic status; marginalization; marginalized population; obstetrical complication; pregnancy prevention; programs; racial minority; recruit; reproductive; smartphone application; social; social culture; sociocultural determinant; unintended pregnancy; uptake; usability; video chat; women of color

Project Summary/Abstract Maternal mortality continues to be the second leading cause of death for women of reproductive age around the world. Maternal mortality is contributed to by unplanned, or mistimed pregnancies, that is, pregnancies that occur at a time the mother is not prepared for, or too soon after a previous birth. Unplanned pregnancies are associated with low birth weight, delayed access to prenatal care, and other health concerns for women and babies. Unplanned pregnancy occurs disproportionately among low-income women, women of color, and immigrant women. Rates of unplanned pregnancy can be reduced through the use of family planning, which include natural methods, and use of contraceptives, whether hormonal or otherwise. Contraception use allows women to decide whether, and when to have children. In addition, planning, postponing and spacing births, allows women to achieve educational and career goals. Family planning access is influenced by factors such as access to health care, fear of adverse effects, proliferation of misinformation about family planning methods, and fear of a partner or family member’s reaction to use. These concerns are amplified in vulnerable and underserved populations, such as in immigrant communities, where social ties, and connections with the larger healthcare system may not be as strong. In the U.S., a particularly marginalized group is that of African immigrant women (including African refugee women), a steadily increasing population, who have been reported to have overall poorer reproductive health outcomes due to decreased access to health care, language barriers, low socioeconomic status, and potentially lower education levels. Therefore, the objective of this R21 application is to address important gaps in the healthcare environment by providing salient and meaningful contraceptive information for African refugee women who may not speak English, and have low literacy levels. The specific aims are to: 1) adapt an existing web-based family planning intervention into a culturally congruent family planning smartphone-based intervention, and 2) assess the feasibility, acceptability, and preliminary efficacy of the developed smart-phone based intervention. This intervention will be designed to increase access to information by providing self-paced, science-based education. Findings from the feasibility and usability study will allow the research team to gather information on the processes, resources, and scientific feasibility of the approach. This preliminary assessment will provide formative data that will inform the development of a well-designed future R01 implementation trial. It is also anticipated that this intervention could be trialed in in a larger sample of the population. The use of a cellphone application is an innovative method that allows for self-paced, yet wide spread dissemination of the intervention.

项目概要/摘要 孕产妇死亡率仍然是育龄妇女的第二大死因 世界各地的孕产妇死亡率是由计划外或不合时宜的怀孕造成的。 意外怀孕发生在母亲没有做好准备的时候，或者是在上次分娩后不久。 与低出生体重、延迟获得产前护理以及妇女和儿童的其他健康问题有关 意外怀孕发生在低收入女性、有色人种女性和白人中的比例不成比例。 移民妇女的意外怀孕率可以通过计划生育来降低。 包括自然方法和避孕药具的使用，无论是否使用激素避孕药。 妇女决定是否以及何时生育此外，计划、推迟和间隔生育， 使女性能够实现教育和职业目标。 计划生育的获得受到以下因素的影响：获得医疗保健、对不利影响的恐惧、 关于计划生育方法的错误信息泛滥，以及对伴侣或家庭成员的恐惧 对使用的反应在弱势和服务不足的人群中更加严重，例如移民。 社区，那里的社会联系以及与更大的医疗保健系统的联系可能不那么牢固。 在美国，一个特别边缘化的群体是非洲移民妇女（包括非洲难民妇女）， 人口稳步增长，据报道，他们的生殖健康状况总体较差 由于获得医疗保健的机会减少、语言障碍、社会经济地位低下以及潜在的较低收入 因此，此 R21 应用程序的目标是解决教育水平方面的重要差距。 通过为非洲难民提供显着且有意义的避孕信息来改善医疗保健环境 可能不会说英语且识字水平较低的女性。 具体目标是： 1) 将现有的基于网络的计划生育干预措施调整为文化上一致的措施。 基于智能手机的计划生育干预措施，2) 评估可行性、可接受性和初步 所开发的基于智能手机的干预措施的有效性。 该干预措施旨在通过提供自定进度的、基于科学的方法来增加获取信息的机会 可行性和可用性研究的结果将使研究团队能够收集有关教育的信息。 该初步评估将提供该方法的流程、资源和科学可行性。 形成性数据将为精心设计的未来 R01 实施试验的开发提供信息。 预计这种干预措施可以在更大的人群样本中进行试验。 应用程序是一种创新方法，允许自定进度，但广泛传播 干涉。