Mitigating the Impact of Implicit Bias on Maternal Morbidity and Mortality for African American Women

减轻隐性偏见对非裔美国妇女孕产妇发病率和死亡率的影响

• 批准号: 10199204
• 负责人: Charles James Barone
• 金额: $ 24.55万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-21 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10199204
• 关键词: Administrative Supplement; African American; Caring; Cessation of life; Child Health; Childbirth; Communities; Development; Effectiveness; Enrollment; Environmental Exposure; Focus Groups; Goals; Group Practice; Health; Health Personnel; Healthcare; Interview; Justice; Link; Maternal Health; Maternal Health Services; Maternal Mortality; Morbidity - disease rate; Mothers; Outcome; Pregnancy; Pregnancy Outcome; Provider; Quality of Care; Risk; Site; Time; Voice; Woman; Work; base; cohort; disparity reduction; experience; health care service; health care service utilization; health care settings; health equity; implicit bias; improved; informant; innovation; lens; maternal morbidity; mortality; parent grant; patient oriented; perinatal period; postnatal; racism; reproductive; unconscious bias

Project Summary/Abstract African American (AA) women are 2-4 times more likely to experience pregnancy-related severe morbidity and mortality than are white mothers in the US. Half of pregnancy-related maternal mortality is judged to be preventable, but access to quality care is problematic for AA women. Implicit bias, perceived racism and culturally inappropriate interactions with health care providers have all been linked to a lack of health care utilization. The amplification of AA women's voices and the support of AA women-led solutions are critical to achieving maternal health equity. The work proposed in this 1-yr Administrative Supplement builds on the aims of the Environmental influences on Child Health Outcomes (ECHO) parent grant (UG3/UH3OD023285, Paneth Contact PI), which are to assess environmental exposures during pregnancy and the perinatal period in relation to later child health outcomes. We will enroll AA women from our Detroit ECHO site and work closely with the Atlanta ECHO pregnancy cohort (Dunlop & Brennan, UG3/UH3OD023318), which enrolls US-born Black women. The hypothesis for this study is that eliciting guidance from AA women and their health care providers through the lens of reproductive justice, respectful care, and health equity, can offer critically important information useful in improving AA women's treatment in the health care setting and their utilization and participation in health care, thereby reducing disparities in adverse maternal health outcomes. Through interviews and focus groups with AA mothers, health care providers, and community groups, the aims are to 1) identify facilitators and barriers for mitigating the impact of implicit bias and racism on AA women in the health care setting, based on input from key informants, including both AA women at risk and health care providers; and 2) develop strategies that will optimize utilization and effectiveness of healthcare services for AA mothers. This ECHO-wide study is innovative in eliciting guidance from AA women and their health care providers through the lens of reproductive justice, respectful care, and health equity and it will contribute to better understanding of ECHO's Pre, Peri, and Postnatal health outcomes. It is significant in discovering critically important information for improving AA women's treatment in health care settings that will improve participation in health care, thereby reducing disparities in adverse maternal health outcomes. The result will be the development of a toolkit of specific strategies for mothers to counter negative interactions and obtain patient centered, respectful care. The goal is to empower women by discovering mechanisms women and providers can employ to lessen the impact of unconscious or implicit bias in the health care setting and thus reduce the risk of severe morbidity and mortality.

项目概要/摘要 非裔美国 (AA) 女性患妊娠相关严重疾病的可能性是其他女性的 2-4 倍 死亡率高于美国白人母亲。一半与妊娠有关的孕产妇死亡率被认为是 可以预防，但对于 AA 女性来说，获得优质护理是有问题的。隐性偏见、明显的种族主义和 与医疗保健提供者在文化上不适当的互动都与缺乏医疗保健有关 利用率。扩大 AA 女性的声音以及支持 AA 女性主导的解决方案对于 实现孕产妇健康公平。本一年期行政补充文件中提议的工作建立在以下目标之上 环境对儿童健康结果的影响 (ECHO) 家长补助金 (UG3/UH3OD023285，Paneth 联系PI），用于评估怀孕期间和围产期的环境暴露 与以后儿童健康结果的关系。我们将从底特律 ECHO 站点招募 AA 女性并密切合作 与亚特兰大 ECHO 妊娠队列（Dunlop & Brennan，UG3/UH3OD023318）一起，该队列招募了美国出生的人 黑人女性。这项研究的假设是，从 AA 女性及其医疗保健中获取指导 提供者通过生殖正义、尊重护理和健康公平的视角，可以提供批判性的 对于改善 AA 妇女在医疗保健机构中的治疗及其利用有用的重要信息 和参与卫生保健，从而减少不良孕产妇健康结果的差异。通过 与 AA 母亲、医疗保健提供者和社区团体进行访谈和焦点小组讨论，目的是 1) 确定减轻隐性偏见和种族主义对 AA 妇女健康影响的促进因素和障碍 护理环境，基于关键信息提供者的意见，包括处于危险中的 AA 妇女和医疗保健提供者； 2) 制定战略，优化 AA 母亲医疗保健服务的利用和有效性。 这项 ECHO 范围内的研究在征求 AA 女性及其医疗保健提供者的指导方面具有创新性 通过生殖正义、尊重护理和健康公平的视角，它将有助于更好地 了解 ECHO 的产前、围产期和产后健康结果。批判性地发现具有重要意义 改善 AA 妇女在医疗保健机构中的治疗的重要信息，从而提高参与度 保健领域，从而减少不良孕产妇健康结果的差异。结果将是 开发一套具体策略工具包，供母亲对抗负面互动并获得患者的帮助 集中、尊重的关怀。目标是通过发现女性和提供者的机制来赋予女性权力 可以用来减轻医疗保健环境中无意识或隐性偏见的影响，从而减少 严重发病和死亡的风险。