The training plan outlined will enable the PI to develop the necessary knowledge and skills to be an independent investigator in global mental and sexual health. The research plan aims to investigate and develop an evidence-based, sustainable, and culturally relevant intervention to address the mental and sexual health needs of young pregnant women. This work builds upon ongoing pilot research being conducted by the PI. Following 14 years of civil war in Liberia, war-exposure, gender-based violence, and extreme poverty have been identified as key challenges to the mental and sexual health of young pregnant women, and the health of their unborn children. Despite ongoing efforts to rebuild the country's healthcare infrastructure, empirical research and interventions focused on addressing the consequences of war on the mental and sexual health of young pregnant women in Liberia are severely limited. To address this, the proposed research aims to: (1) Develop a group-based mental and sexual health intervention~ and (2) Conduct a pilot randomized control trial of this group-based intervention with 80 pregnant young women in Liberia. An intervention manual will be developed, informed by data from 20 key informants and 20 pregnant young women. Further, focus groups will be conducted with young pregnant women (n=20) and health care workers (n=20) to ensure the developmental and cultural relevance of the intervention manual. A pilot trial will then be conducted, randomly assigning 80 pregnant Liberian young women to either the group intervention condition or the standard care condition. A detailed process evaluation will be completed to establish feasibility, cultural acceptability, and preliminary evidence of efficacy in decreasing traumatic stress and HIV risk behavior among war-exposed, pregnant young women. Future research will continue to develop evidence-based, sustainable, and culturally relevant interventions for at-risk young women in post-conflict, West African countries. To pursue this long-term research agenda, the PI will work with an international and interdisciplinary team of mentors to refine and develop four areas of expertise: (1) Pregnancy/perinatal epidemiology~ (2) Qualitative research methods, including the design and implementation of focus groups, qualitative data analyses, and the use of qualitative data to inform the development and evaluation of behavioral and psychotherapeutic interventions~(3) Cultural adaptation methods to ensure cultural and developmental relevance of interventional content~ and (4) Quantitative research methods and analytic techniques to independently design and implement a Randomized Control Trial. This International Research Scientist Development Award addresses a key priority in global mental and sexual health research and will provide the PI the opportunity to become a leading independent investigator.
War-exposure, gender-based violence, and extreme poverty following 14 years of civil war in Liberia has resulted in mental and sexual health challenges place young pregnant women and their unborn children at risk. Sustainable, culturally-relevant interventions focused on addressing the consequences of trauma and war on the mental and sexual health of young pregnant women in Liberia are non-existent. In partnership with the Liberian Ministry of Health and Social Welfare and the University of Liberia, this project will (1) develop a group-based mental and sexual health intervention and (2) conduct a pilot RCT with 80 pregnant young Liberian women.