Doctoral Dissertation Research: Effecting Changes While Providing Reproductive Health Care in Diverse Organizational Contexts

该奖项全部或部分由《2021年美国救援计划法案》（公法117-2）资助。本博士论文项目考察了护理态度和实践的差异，对妊娠结果的影响，以及护理人员在导航不同制度惯例的同时改善总体结果的尝试。护理人员面临着个性化护理和更广泛的组织优先事项之间的权衡，本研究探讨了护理人员如何在影响组织变革的同时平衡这些权衡。这项研究对在不同的经济、伦理和制度挑战下的医疗保健实践做出了宝贵的贡献。通过关注多个可比较的机构，该研究有助于描述个人对组织变革的贡献。研究结果有助于指导在不同情况下实施卫生保健。本研究有助于培养研究生的科学方法论和分析方法。本项目研究护理人员如何在基础设施和资源有限的各种组织环境中，特别是在监狱中，为孕妇和产后妇女提供支助和保健。调查的重点是权衡强加的照顾者的同时试图影响积极的组织变革，同时保持高标准的卫生保健。研究人员采用多种方法，包括观察方法、对不同利益相关者样本的访谈、焦点小组和对社交媒体内容的分析，研究了护理人员如何在多种组织环境中进行权衡。这种比较的方法有助于学术对多方面的因素，塑造医疗服务提供者如何推进和实施改进，他们的工作系统。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

This award is funded in whole or in part under the American Rescue Plan Act of 2021 (Public Law 117-2). This doctoral dissertation project examines variation in caregiving attitudes and practices, the resulting impacts on pregnancy outcomes, and caregivers’ attempts to improve outcomes in general while navigating differential institutional conventions. Caregivers face tradeoffs between individualized care and broader organizational priorities, and this research investigates how caregivers balance those tradeoffs while effecting organizational change. This research valuably contributes to scholarship on the practice of health care amid divergent economic, ethical, and institutional challenges. By focusing on multiple comparable institutions, the research helps to characterize individuals’ contributions to organizational change. The results from the study help to guide the implementation of health care in diverse contexts. This study contributes to the training of a graduate student in scientific methodology and analytical approaches. This project examines how caregivers provide support and healthcare for pregnant and post-partum women in diverse organizational settings with limited infrastructure and access to resources, particularly prisons. The investigation focuses on tradeoffs imposed by the caregivers’ concurrent attempts to effect positive organizational change while maintaining high standards of health care. Using a combination of methods, including observational approaches, interviews with a diverse sample of stakeholders, focus groups, and an analysis of social media content, the investigators examine how caregivers navigate these tradeoffs in multiple organizational settings. This comparative approach contributes to scholarship on the multifaceted factors that shape how healthcare providers advance and implement improvements to the systems in which they work.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.