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Disparities in Perinatal Care and Outcomes among Black Women and Latinas with Physical Disabilities

身体残疾的黑人妇女和拉丁裔妇女围产期护理和结果的差异

基本信息

批准号：
10278113
负责人：
Willi HORNER-JOHNSON
金额：
$ 74.94万
依托单位：
BRANDEIS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-21 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10278113
关键词：
1 year old Achievement Address Adverse event Affect Apgar Score Birth California Cesarean section Characteristics Data Development Disabled Persons Discipline of obstetrics Discrimination Emergency Situation Ethnic Origin Focus Groups Foundations Future Gestational Diabetes Goals Health Health Care Costs Healthcare Hospitals Infant Infant Health Inpatients Intervention Interview Knowledge Latina Link Massachusetts Methods Minority Groups Monitor Mothers National Health Services Outcome Perinatal Perinatal Care Pre-Eclampsia Pregnancy Pregnancy Complications Pregnancy Outcome Premature Infant Prenatal care Provider Public Health Race Recommendation Reproductive Health Research Research Personnel Risk Risk Assessment Small for Gestational Age Infant Source System Testing Time Woman adverse birth outcomes adverse outcome adverse pregnancy outcome base black women care costs care outcomes care providers cohort cost disability experience health care disparity health care service utilization health data health service use improved improved outcome infant outcome maternal outcome obstetric care perinatal health physically handicapped postpartum care pregnancy health pregnancy hypertension pregnant prenatal racial and ethnic social exclusion social stigma

项目摘要

Project Summary/Abstract Women with physical disabilities experience stark disparities in pregnancy care, complications, and outcomes, compared to women without disabilities. Black women and Latinas also experience substantial disparities related to perinatal care and outcomes, compared to White women. Black women and Latinas with physical disabilities, thus, are presumably at heightened risk of adverse experiences and outcomes. Nonetheless, no known studies have investigated the intersection of disability and race/ethnicity in relation to perinatal care and disparities. Preliminary findings from the investigator team demonstrate that Black women and Latinas with physical disabilities are at substantial risk for adverse pregnancy outcomes. Efforts to improve their pregnancy care and experiences while reducing costs require a definitive assessment of these women’s pregnancy risks and outcomes. The overarching goal of this study is to use a mixed-methods approach to understand pregnancy experiences, maternal and infant outcomes, related healthcare costs, and unmet perinatal healthcare needs of Black women and Latinas with physical disabilities and their infants, and examine the intersecting impacts of disparities from two avenues of marginalization (race or ethnicity, and physical disability). The specific aims of this study are: 1) Compare perinatal care receipt, pregnancy-related complications, health outcomes, inpatient healthcare utilization and costs among cohorts of women based on race, ethnicity, and physical disability status, and determine if the combined effects of being a Black woman or Latina with physical disabilities are additive or multiplicative; 2) Use linked data from Georgia, California, and Massachusetts to examine first year health outcomes, healthcare utilization and costs for cohorts of women based on race, ethnicity, and physical disability and their infants (<1 year old), and determine if the combined effect of being a Black woman or Latina with physical disabilities is additive or multiplicative; and 3) Identify unmet needs and barriers to perinatal care for Black women and Latinas with physical disabilities through: (a) interviews with Black women and Latinas with physical disabilities who are currently pregnant or have recently given birth, and (b) focus groups with obstetric care providers. This study will lead to a first-ever systematic understanding of pregnancy and infant health outcomes and pregnancy care costs for Black women and Latinas with physical disabilities, thus establishing a foundation for development and testing of future interventions to improve outcomes. This study will fill a critical knowledge gap in understanding of the pregnancy-related experiences among Black women and Latinas with physical disabilities before, during and after pregnancy.

项目概要/摘要身体残疾的妇女在怀孕护理、并发症和结果方面经历着巨大的差异，与没有残疾的妇女相比。黑人女性和拉丁裔女性也经历着巨大的差异与白人女性相比，与围产期护理和结果相关。黑人女性和拉丁裔女性有身体问题因此，残疾人遭受不良经历和后果的风险可能更高。尽管如此，没有已知的研究调查了残疾与种族/族裔在围产期护理和差异。研究小组的初步调查结果表明，黑人女性和拉丁裔女性身体残疾会给不良妊娠结局带来很大风险。努力改善怀孕状况护理和经验，同时降低成本，需要对这些妇女的怀孕风险进行明确的评估和结果。本研究的总体目标是使用混合方法来理解怀孕经历、母婴结局、相关医疗费用以及未满足的围产期身体残疾的黑人妇女和拉丁裔妇女及其婴儿的医疗保健需求，并检查两种边缘化途径（种族或族裔以及身体状况）差异的交叉影响残疾）。本研究的具体目的是： 1) 比较围产期保健收据、妊娠相关的情况女性群体的并发症、健康结果、住院医疗保健利用率和费用基于种族、民族和身体残疾状况，并确定作为黑人女性或身体残疾的拉丁裔可以加法或乘法； 2) 使用来自佐治亚州、加利福尼亚州和马萨诸塞州将检查女性群体第一年的健康结果、医疗保健利用率和成本根据种族、民族和身体残疾及其婴儿（<1 岁），并确定综合是否作为身体残疾的黑人女性或拉丁裔女性的影响是加法或乘法； 3) 识别身体残疾的黑人妇女和拉丁裔妇女的围产期护理未得到满足的需求和障碍：(a) 对目前怀孕或最近怀孕的身体残疾的黑人妇女和拉丁裔妇女的采访分娩，以及 (b) 与产科护理人员进行焦点小组讨论。这项研究将导致有史以来第一个系统的了解黑人妇女的怀孕和婴儿健康结果以及怀孕护理费用患有身体残疾的拉丁裔，从而为未来的开发和测试奠定了基础改善结果的干预措施。这项研究将填补理解这一问题的关键知识空白身体残疾的黑人妇女和拉丁裔妇女在怀孕前、怀孕期间和怀孕期间的相关经历怀孕后。