Developing a Primary Care Intervention to Support Reproductive Decision-Making among Black and Latina Women of Reproductive Age with Type 2 Diabetes

制定初级保健干预措施以支持患有 2 型糖尿病的育龄黑人和拉丁裔女性的生殖决策

基本信息

批准号：
10558484
负责人：
Cassondra Marshall
金额：
$ 13.71万
依托单位：
UNIVERSITY OF CALIFORNIA BERKELEY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-08 至 2026-04-30
项目状态：
未结题

项目摘要

Project Summary/Abstract Candidate: The goal of this K01 Award is to support the training and research of Dr. Cassondra Marshall, who's long-term goal is to advance reproductive and maternal health equity through the translation of evidence into practice using tailored interventions that address the needs of racial/ethnic minority women with chronic medical conditions. Her research has examined young women's contraceptive decision-making and has explored the ways in which health care providers and systems can deliver patient-centered contraceptive care. Research Plan: Women with diabetes prior to pregnancy have elevated rates of maternal and neonatal morbidity and mortality. Type 2 diabetes is increasingly prevalent among women during their childbearing years, disproportionately impacting Black and Latina women. To prevent maternal and infant health complications, there is an urgent need for enhanced efforts to improve reproductive health outcomes among reproductive-aged women with type 2 diabetes, particularly racial/ethnic minorities. However, there are currently no evidence-based strategies to implement clinical guidelines for improving reproductive outcomes among adult women with type 2 diabetes. Patient decision support tools in primary care represent a promising implementation strategy. The research aims are: Aim 1: Elucidate reproductive decision-making processes and reproductive health care preferences among Black and Latina women of reproductive age with type 2 diabetes, using person-centered and structural competency frameworks. Aim 2: Adapt an existing patient decision support intervention to support reproductive decision-making and reproductive health counseling delivery in primary care to meet the needs of Black and Latina reproductive-aged women with type 2 diabetes. Aim 3: Assess acceptability and feasibility of the adapted intervention among patients and providers and examine the implementation context for the intervention. Career Development and Training Plan: The candidate's training plan capitalizes on an interdisciplinary mentoring team with expertise in person-centered family planning care, diabetes care, implementation science, and organizational research in primary care. Through coursework, workshops, apprenticeships, and mentored research experiences, Dr. Marshall will receive training in Person- Centered and Structurally Competent Reproductive Health Interventions, Advanced Mixed Methods, Implementation Science and Stakeholder Engagement, and Designing and Implementing Trials in the Primary Care Setting. UC Berkeley and close partners UCSF and Kaiser Permanente Northern California provide an excellent research infrastructure and training environment for Dr. Marshall. Summary: The training and research proposed in this application position Dr. Marshall to be competitive for R01 funding to support a multisite effectiveness-implementation trial of the adapted intervention and facilitate her transition to independence as a researcher.

项目概要/摘要候选人：K01 奖的目标是支持 Cassondra Marshall 博士的培训和研究，世卫组织的长期目标是通过证据转化促进生殖和孕产妇健康公平将针对性的干预措施付诸实践，以满足患有慢性病的种族/族裔少数妇女的需求医疗条件。她的研究调查了年轻女性的避孕决策，并已探索医疗保健提供者和系统提供以患者为中心的避孕护理的方式。研究计划：怀孕前患有糖尿病的女性孕产妇和新生儿的发病率较高发病率和死亡率。 2 型糖尿病在育龄妇女中越来越普遍多年来，对黑人和拉丁裔女性的影响尤为严重。预防母婴健康并发症，迫切需要加强努力改善生殖健康结果患有 2 型糖尿病的育龄妇女，尤其是少数种族/族裔。然而，有目前没有基于证据的策略来实施改善生殖结果的临床指南患有 2 型糖尿病的成年女性。初级保健中的患者决策支持工具代表着一个有前途的工具实施策略。研究目标是：目标 1：阐明生殖决策过程和患有 2 型糖尿病的黑人和拉丁裔育龄妇女的生殖保健偏好，使用以人为本的结构性能力框架。目标 2：调整现有的患者决策支持干预措施，以支持生殖决策和生殖健康咨询服务初级保健，以满足患有 2 型糖尿病的黑人和拉丁裔育龄妇女的需求。目标 3：评估患者和提供者之间调整后的干预措施的可接受性和可行性，并检查干预措施的实施背景。职业发展和培训计划：候选人的培训该计划利用了跨学科指导团队，他们在以人为本的计划生育护理方面拥有专业知识，糖尿病护理、实施科学和初级保健的组织研究。通过课程作业，马歇尔博士将接受讲习班、学徒和指导研究经验方面的培训以中心和结构为中心的生殖健康干预措施、先进的混合方法、实施科学和利益相关者参与，以及设计和实施初级试验护理设置。加州大学伯克利分校以及密切的合作伙伴加州大学旧金山分校和北加州凯撒医疗机构提供马歇尔博士拥有良好的研究基础设施和培训环境。总结：培训和本申请中提出的研究使马歇尔博士能够在 R01 资金方面具有竞争力，以支持对经过调整的干预措施进行多地点有效性实施试验，并促进她过渡到作为研究员的独立性。