Patient navigation to improve outcomes among low-income women in the postpartum period

患者导航可改善低收入女性产后的结局

• 批准号: 10331608
• 负责人: Lynn M Yee
• 金额: $ 23.41万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10331608
• 关键词: 2019-nCoV; Academic advising; Address; Adherence; American College of Obstetricians and Gynecologists; Attitude; Automobile Driving; Belief; COVID-19 disparity; COVID-19 mortality; COVID-19 pandemic; COVID-19 vaccination; COVID-19 vaccine; Centers for Disease Control and Prevention (U.S.); Communicable Diseases; Counseling; Data; Diphtheria; Evaluation; Failure; Fetal health; Funding; Future; Goals; HIV; HIV Seronegativity; Health; Health Campaign; Healthcare; Hospitals; Immunocompromised Host; Individual; Influenza; Intervention; Interview; Investigation; Knowledge; Low income; Maternal Health; Maternal-fetal medicine; Minority; Morbidity - disease rate; Motivation; National Institute of Child Health and Human Development; Neonatal; Patients; Perception; Pertussis; Population; Population Heterogeneity; Postpartum Period; Postpartum Women; Pregnancy; Pregnant Women; Preventive; Preventive care; Provider; Public Health; Recommendation; Research; Risk; Safety; Sampling; Services; Societies; Strategic Planning; Structure; Tetanus; Time; Trust; Underrepresented Populations; United States; United States National Institutes of Health; Vaccination; Vaccine Research; Vaccines; Vulnerable Populations; Woman; Women' s Health; Work; World Health Organization; antenatal; ethnic minority population; experience; global health; health care availability; health disparity; implementation strategy; improved outcome; influenza virus vaccine; mortality; motherhood; novel; novel vaccines; obstetric care; patient oriented; preference; pregnant; programs; racial minority; recruit; shared decision making; social culture; social health determinants; social structure; standard of care; uptake; vaccine acceptance; vaccine access; vaccine hesitancy; vaccine safety

PROJECT SUMMARY Pregnancy is a critical window of opportunity for preventive health interventions, including vaccines. Yet, vaccine hesitancy is a known global phenomenon. Uptake of the currently recommended vaccines in pregnancy (influenza and tetanus, diphtheria, and pertussis [TDaP]) is suboptimal, with only 50% of individuals receiving recommended vaccines. Disparities in vaccine uptake exist, yet this issue has not been thoroughly investigated from the patient perspective. Little is known about the perspectives of pregnant women who identify as racial or ethnic minorities or pregnant women living with HIV (WLHIV), both of whom are underrepresented and understudied populations who are at greater risk of complications from conditions such as influenza. Additionally, the COVID-19 pandemic and introduction of a novel vaccine to health care presents an urgent need to understand factors driving vaccination uptake, particularly in vulnerable populations such as racial and ethnic minority pregnant and postpartum women and WLHIV. Early data suggest that pregnant women and immunocompromised people – such as those living with HIV - are at increased risk of morbidity and mortality from COVID-19. Understanding the evolving perspectives of these populations will inform educational and counseling strategies to enhance vaccination uptake in pregnancy and reduce vaccination disparities. Aim 1 will assess the experiences and preferences of racial and ethnic minority pregnant and postpartum WLHIV and HIV-seronegative women with regard to standard of care vaccines during pregnancy. Individual interviews will address perceptions, experiences, and decisions surrounding routine vaccinations during pregnancy, including issues of trust, access, and knowledge. Analyses will additionally compare perspectives on routine vaccines that may differ by HIV status. Aim 2 will examine the perspectives of this population on the novel COVID-19 vaccine. We will explore motivations and sociocultural underpinnings that may clarify the concerns, beliefs, and experiences surrounding COVID-19 vaccination in pregnancy. We will additionally compare the perspectives of women with and without HIV, and we will analyze differences in attitudes for the COVID-19 vaccine versus standard of care vaccines. To accomplish these aims, we will recruit 40 pregnant or recently postpartum women in partnership with the NICHD-funded Navigating New Motherhood 2 study and the Northwestern Memorial Hospital Women’s Infectious Diseases Program. Women with and without HIV will be demographically similar in order to focus on a diverse population of understudied women who are largely low- income and from a racial or ethnic minority. This proposal aims to fill an unmet need for a systematic, in-depth, and unbiased evaluation of the attitudes and preferences of understudied populations of women regarding routine and novel vaccinations during pregnancy. This project directly aligns with the Trans-NIH Strategic Plan for Women’s Health Research goals and the aims will address intersections of social determinants of health in diverse populations of women.

项目摘要 怀孕是预防健康干预措施（包括疫苗）的关键机会。但是，疫苗 犹豫是一种已知的全球现象。目前推荐的疫苗在怀孕中的摄取 （流感和破伤风，白喉和百日咳[TDAP]）是次优的，只有50％的人接受 推荐的疫苗。疫苗摄取的差异存在，但该问题尚未得到彻底调查 从病人的角度来看。关于识别为种族或种族或 少数族裔或艾滋病毒（WLHIV）的孕妇，她们的人数不足，并且 研究的人群受到影响力诸如影响力的并发症的风险更大。 此外，Covid-19的大流行和新型卫生疫苗的引入迫切需要 了解推动疫苗接种吸收的因素，特别是在诸如种族和种族之类的脆弱人群中 少数孕妇和产后妇女和WLHIV。早期数据表明孕妇和 免疫功能低下的人（例如患有艾滋病毒的人）的发病率和死亡风险增加 从Covid-19。了解这些人群的不断发展的观点将为教育提供信息， 咨询策略，以增强怀孕的疫苗接种并减少疫苗接种差异。 AIM 1将评估种族和少数民族怀孕和产后的经历和偏好 以及怀孕期间的护理疫苗标准妇女和艾滋病毒的妇女。个人访谈 将解决怀孕期间常规疫苗接种的看法，经历和决策， 包括信任，访问和知识的问题。分析还将比较有关例程的观点 可能因艾滋病毒状况而有所不同的疫苗。 AIM 2将在小说中检查该人群的观点 2019冠状病毒病疫苗。我们将探索动机和社会文化的基础，这些基础可能会阐明担忧， 信念以及围绕Covid-19怀孕疫苗接种的经验。我们还将比较 患有和没有艾滋病毒的妇女的观点，我们将分析COVID-19的出勤差异 疫苗与护理标准疫苗。为了实现这些目标，我们将招募40个怀孕或最近 产后妇女与NICHD资助的新母亲2研究和 西北纪念医院女性传染病计划。患有和没有艾滋病毒的妇女将是 人口统计学相似 收入以及种族或少数民族。 该建议旨在满足对对待和对待的系统，深入和无偏评估的未满足的需求 在怀孕期间，知识妇女对常规和新型疫苗接种的偏好。 该项目与妇女健康研究目标的Trans-NIH战略计划直接相吻合和目标 将解决妇女潜水员人群中卫生社会决定者的交叉点。