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

该奖项的全部或部分资金来自《2021年美国救援计划法案》(公法117-2)。这篇博士论文项目考察了照看态度和做法的变化，由此对怀孕结果的影响，以及照顾者试图在遵循不同的机构惯例的同时总体上改善结果的尝试。护理者面临着个性化护理和更广泛的组织优先事项之间的权衡，本研究调查了护理者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卫生保健实践做出了有价值的学术贡献。通过关注多个可比较的机构，这项研究有助于确定个人对组织变革的贡献。这项研究的结果有助于指导在不同情况下实施保健。这项研究有助于培养研究生的科学方法论和分析方法。该项目考察了在基础设施和资源有限的不同组织环境中，特别是在监狱中，照顾者如何为孕妇和产后妇女提供支持和保健。调查的重点是照顾者同时试图在保持高标准的医疗保健的同时实现积极的组织变革所造成的权衡。调查人员使用观察法、对利益相关者、焦点小组的不同样本的采访以及对社交媒体内容的分析等多种方法，研究照顾者如何在多个组织环境中进行权衡。这种比较方法有助于多方面因素的学术研究，这些因素塑造了医疗保健提供者如何推进和实施对其工作系统的改进。该奖项反映了NSF的法定使命，并通过使用基金会的智力优势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.