Health risks and disparities in services for pregnant individuals

项目总结 危机怀孕中心(CPC)是一家非营利性组织，其使命是在 不堕胎。为此，初级保健中心向孕妇提供免费服务(例如尿液验孕、 非诊断性超声波，以及对有限范围的怀孕选择进行同伴咨询)和机会 通过上课来赚取与婴儿有关的材料。公共资金在以下方面发挥着越来越重要的作用 CPC的功能。在俄亥俄州，州政府对CPC的资助从100万美元增加到2019年的750万美元。 尽管宣传提供医疗程序，并得到国家资助和支持，但CPC 通常不雇用医务人员，也没有作为医疗机构的许可证。根据美国最近的一份报告。 在最高法院的案件中，CPC没有被强迫披露它们不是医疗设施。专业人士 医疗组织警告CPC可能存在的健康风险；然而，到目前为止，几乎没有研究 对它们可能产生的影响进行了研究。我们进行了两项初步研究，为这个项目做准备。第一, 在我们对俄亥俄州成年育龄妇女进行的基于人口的调查中，我们发现参加CPC是 很常见，有14%的女性报告曾参加过CPC。出席率在这些人中更常见 世卫组织报告说，他是非西班牙裔黑人，社会经济地位较低。第二，在一项研究中，我们发现 通过对CPC工作人员和客户的深入访谈，我们发现客户经常参加CPC 怀孕确认和一些人认为CPC是提供早孕的医疗诊所 关心。该项目寻求量化与参加CPC相关的健康结果，以及 参加CPC的人，在得到的服务方面存在差异。具体地说，我们将使用调查数据来解决两个问题 目标：1)评估延迟进入产前护理是否在患有以下疾病的人中更常见 与未出席者相比，之前参加过本次怀孕的CPC；以及2)评估 在CPC处提供的怀孕选项咨询是否因客户人口统计而不同(例如， 种族/民族、婚姻状况和宗教)在CPC之前控制客户怀孕计划 参观。为了达到这些目标，我们将对400名最近进入产前护理的患者进行调查。样品将会 包括200名在进入产前护理前参加过CPC的妇女和一组 200名参加产前护理前未参加过初级保健的妇女。我们将使用频率匹配 用于登记(年龄和种族/民族)，并在分析期间与倾向分数匹配，以减少偏见。 虽然近年来关于CPC的文献一直在扩大，但几乎没有定量的数据 在CPC客户端上发布。我们预计这项研究将为可能的后果提供基本证据。 孕妇参加CPC的情况。

PROJECT SUMMARY Crisis pregnancy centers (CPCs) are non-profit organizations with the mission of supporting pregnant people in not having an abortion. To this end, CPCs offer pregnant people free services (e.g., urine pregnancy tests, non-diagnostic ultrasounds, and peer counseling on a limited range of pregnancy options) and the opportunity to earn infant-related material items by attending classes. Public funding increasingly plays an important role in the functioning of CPCs. In Ohio, state funding of CPCs increased from $1 million to $7.5 million in 2019. Despite advertising the provision of health procedures and receiving state funding and endorsement, CPCs typically do not employ medical staff and are not licensed as medical facilities. According to a recent U.S. Supreme Court case, CPCs are not compelled to disclose that they are not medical facilities. Professional medical organizations warn of possible health risks of CPCs; however, to date, little research has been conducted on their possible effects. We conducted two preliminary studies in preparation for this project. First, in our population-based survey of adult, reproductive-age women in Ohio, we found that attending a CPC is common, with 14% of women reporting ever CPC attendance. Attendance was more common among those who reported being non-Hispanic Black and of low socioeconomic status. Second, in a study in which we conducted in-depth interviews with CPC staff and clients, we found that clients often attend the CPC for pregnancy confirmation and some perceived the CPC to be a medical clinic that provides early pregnancy care. This project seeks to quantify health-related outcomes associated with attending a CPC and, among those attending a CPC, disparities in services received. Specifically, we will use survey data to address two aims: 1) To assess whether delayed entry into prenatal care is more common among people who had previously attended a CPC for the current pregnancy relative to non-attendees; and 2) To assess whether the pregnancy options counseling provided at CPCs differs by client demographics (e.g., race/ethnicity, marital status, and religion) after controlling for client pregnancy plans before the CPC visit. To address the aims, we will survey 400 patients who recently entered into prenatal care. The sample will include 200 women who had attended a CPC before entering into prenatal care and a comparison group of 200 women who had not attended a CPC before entering into prenatal care. We will use frequency matching for enrollment (age and race/ethnicity) and matching with propensity scores during the analysis to reduce bias. While the literature on CPCs has been expanding in recent years, almost no quantitative data has been published on CPC clients. We expect the study will yield fundamental evidence on the possible consequences of CPC attendance among pregnant people.