Couples Advancing Together for Safer Conception (CAT-SC): A couples’-based intervention to improve engagement in sexual and reproductive health services for mobile fisherfolk in Kenya

夫妻共同推进安全受孕 (CAT-SC)：基于夫妻的干预措施，旨在提高肯尼亚流动渔民对性健康和生殖健康服务的参与度

• 批准号: 10618411
• 负责人: Sarah A Gutin
• 金额: $ 18.18万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10618411
• 关键词: AIDS prevention; Address; Affect; Africa South of the Sahara; Age; Attention; Behavior; Behavior Therapy; Behavioral; Caring; Child; Clinic; Collaborations; Communication; Complement; Conceptions; Counseling; Couples; Data; Dedications; Educational workshop; Epidemic; Evaluation; Face; Feedback; Female; Fertility; Fishes; Gender; Geography; Goals; HIV; HIV Infections; HIV/AIDS; Health; Health Personnel; Household; Human; Incidence; Infant; Infrastructure; Insemination; Internal Migrations; International Migrations; Interpersonal Relations; Intervention; Interview; Kenya; Knowledge; Link; Location; Manuals; Marital Relationships; Measures; Mentorship; Methods; Motivation; National Institute of Mental Health; Outcome; Participant; Periodicals; Population; Prevalence; Prevention; Prevention strategy; Preventive; Protocols documentation; Provider; Psychology; Public Health; Reproductive Health; Reproductive Health Services; Reproductive Rights; Research; Research Personnel; Research Priority; Risk; Scientist; Services; Sexual Health; Stretching; Surveys; Techniques; Testing; Training; Transact; Vagina; Vulnerable Populations; Woman; acceptability and feasibility; care outcomes; career; child bearing; cohort; design; flexibility; high risk; high risk sexual behavior; implementation intervention; improved; innovation; insight; intervention delivery; male; men; men' s group; neglect; neonatal health; pharmacologic; pre-exposure prophylaxis; preference; pregnant; prevent; prevention service; preventive intervention; randomized trial; recruit; reproductive; residence; self testing; sex; sexually active; skills; social; social stigma; theories; therapy design; transmission process; uptake; AIDS prevention; Address; Affect; Africa South of the Sahara; Age; Attention; Behavior; Behavior Therapy; Behavioral; Caring; Child; Clinic; Collaborations; Communication; Complement; Conceptions; Counseling; Couples; Data; Dedications; Educational workshop; Epidemic; Evaluation; Face; Feedback; Female; Fertility; Fishes; Gender; Geography; Goals; HIV; HIV Infections; HIV/AIDS; Health; Health Personnel; Household; Human; Incidence; Infant; Infrastructure; Insemination; Internal Migrations; International Migrations; Interpersonal Relations; Intervention; Interview; Kenya; Knowledge; Link; Location; Manuals; Marital Relationships; Measures; Mentorship; Methods; Motivation; National Institute of Mental Health; Outcome; Participant; Periodicals; Population; Prevalence; Prevention; Prevention strategy; Preventive; Protocols documentation; Provider; Psychology; Public Health; Reproductive Health; Reproductive Health Services; Reproductive Rights; Research; Research Personnel; Research Priority; Risk; Scientist; Services; Sexual Health; Stretching; Surveys; Techniques; Testing; Training; Transact; Vagina; Vulnerable Populations; Woman; acceptability and feasibility; care outcomes; career; child bearing; cohort; design; flexibility; high risk; high risk sexual behavior; implementation intervention; improved; innovation; insight; intervention delivery; male; men; men' s group; neglect; neonatal health; pharmacologic; pre-exposure prophylaxis; preference; pregnant; prevent; prevention service; preventive intervention; randomized trial; recruit; reproductive; residence; self testing; sex; sexually active; skills; social; social stigma; theories; therapy design; transmission process; uptake

PROJECT SUMMARY / ABSTRACT Mobile fishermen and their partners along Lake Victoria in western Kenya are a vulnerable population in need of improved sexual and reproductive health (SRH)/HIV prevention efforts because of their high mobility, high HIV prevalence, poor HIV care engagement, and high-risk sexual behaviors such as relationship concurrency and a local transactional sex economy. Safer conception (SC) is a strategy to prevent HIV transmission and is an entry point for life-long HIV prevention efforts, but current interventions to improve SC uptake have neglected to address couple relationship dynamics (e.g. communication skills). This K01 proposal is to support Dr. Sarah Gutin’s long-term career goal to become an independent social-behavioral scientist conducting innovative research on engaging couples and promoting male engagement in SRH/HIV prevention services. To achieve this career goal, and in collaboration with a dedicated mentorship team, Dr. Gutin proposes training to: 1) gain knowledge of theories and research on the psychology of interpersonal relationships in mobile populations; 2) develop mixed methods skills to collect, analyze, and integrate dyadic qualitative and quantitative data; and 3) acquire couples-based behavioral intervention adaptation, implementation, and analytic skills. The overall research objective is to adapt an innovative couples-based HIV prevention intervention, ‘Jamii Bora’ and assess the interventions’ potential to promote male engagement for SC among mobile couples. The specific aims are to: 1) identify dyadic-level barriers and facilitators to male engagement in SC; 2) adapt the Jamii Bora intervention to improve male engagement in SC among Kenyan fisherfolk; and 3) assess intervention feasibility, acceptability, and implementation. Dyadic mixed methods will be used in Aim 1 including qualitative in-depth interviews, survey piloting, and a quantitative survey. In Aim 2, Dr. Gutin will adapt the Jamii Bora couples’ intervention for fishermen and their primary female partners with feedback from mobile couples and healthcare providers who will take part in separate intervention design workshops. In Aim 3, Dr. Gutin will conduct a preliminary assessment of the adapted intervention to evaluate feasibility and acceptability. The proposed research will employ an innovative couples-based intervention approach to improve relationship dynamics (e.g., communication) that are urgently needed to impact mobile couples’ SC uptake and retention in SRH/HIV services. This integrated training and research plan will prepare Dr. Gutin to launch an independent research career conducting couples research with varied populations and health outcomes, and provide preliminary data for a pilot to test the couples’ intervention, followed by a randomized trial with mobile couples. By focusing on research to improve the relationship context for couples disproportionately burdened by HIV, it is possible to limit HIV transmission risks and improve long-term uptake of SRH/HIV preventive behaviors and services.

项目摘要 /摘要 肯尼亚西部维多利亚湖的移动渔民及其伴侣是有需要的人口 改善性和生殖健康（SRH）/HIV预防措施，因为它们的流动性很高，高 艾滋病毒患病率，不良的艾滋病毒护理参与和高风险的性行为，例如关系并发 以及当地的交易性经济。更安全的概念（SC）是预防艾滋病毒传播的策略，是 终身艾滋病毒预防工作的切入点，但是当前改善SC吸收的干预措施已 被忽略以解决夫妻关系动态（例如沟通技巧）。这个K01的建议是支持 莎拉·古丁（Sarah Gutin）博士的长期职业目标是成为一名独立的社会行为科学家 关于吸引夫妇并促进男性参与SRH/HIV预防服务的创新研究。 为了实现这一职业目标，并与专门的Mentalship团队合作，Gutin博士提案培训 TO：1）了解移动中人际关系心理学的理论和研究 人口； 2）开发混合方法技巧来收集，分析和整合二元定性和 定量数据； 3）获得基于夫妻的行为干预适应，实施和 分析技能。总体研究目标是调整创新夫妇的艾滋病毒预防 干预措施，“ Jamii Bora”，并评估干预措施的潜力，以促进男性参与SC的潜力 移动夫妇。具体目的是：1）确定男性参与的二元级障碍和促进者 SC; 2）调整Jamii Bora干预以改善肯尼亚渔民中SC的男性参与； 3） 评估干预可行性，可接受性和实施。二元混合方法将用于AIM 1 包括定性的深入访谈，调查试验和定量调查。在AIM 2中，Gutin博士将 适应Jamii Bora夫妇对渔民及其主要女伴侣的干预，并通过 将参加单独的干预设计研讨会的移动夫妇和医疗保健提供者。目标 3，古丁博士将对改编干预措施进行初步评估，以评估可行性和 可接受性。拟议的研究将采用创新的夫妻干预方法来 迫切需要影响移动夫妇的SC所需的改进关系动态（例如，沟通） SRH/HIV服务的吸收和保留。该集成的培训和研究计划将为Gutin博士做好准备 启动独立的研究职业，从事夫妻研究的研究 结果，并提供初步数据以测试夫妻干预的试验，然后是随机的 与移动夫妇的审判。通过关注研究以改善夫妻的关系环境 艾滋病毒不成比例地燃烧，可能会限制艾滋病毒传播风险并改善长期吸收 SRH/HIV预防行为和服务。