Health risks and disparities in services for pregnant individuals

项目摘要 危机怀孕中心（CPC）是非营利性组织，其使命是在以下方面支持孕妇： 不堕胎。为此，中心为孕妇提供免费服务（例如，尿妊娠试验， 非诊断性超声波检查，以及关于有限范围的怀孕选择的同伴咨询）和机会 通过上课赚取与婴儿有关的物质项目。公共资金越来越发挥重要作用， CPC的功能。在俄亥俄州，2019年，州政府对CPC的资助从100万美元增加到750万美元。 尽管宣传提供健康程序并获得国家资助和认可， 通常不雇用医务人员，也没有医疗设施的许可证。根据美国最近的一项 在最高法院的案件中，CPC没有义务披露他们不是医疗设施。专业 医学组织警告CPC可能存在的健康风险;然而，迄今为止，很少有研究 根据其可能的影响进行。我们为准备这个项目进行了两项初步研究。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 普遍，14%的妇女报告曾经参加过CPC。出席会议的人更多的是 他们是非西班牙裔黑人，社会经济地位低下。其次，在一项研究中，我们 我们对CPC工作人员和客户进行了深入访谈，发现客户经常参加CPC， 怀孕确认和一些人认为CPC是一个医疗诊所，提供早孕 在乎该项目旨在量化与参加CPC相关的健康相关结果， 参加CPC的人，得到的服务不平等。具体而言，我们将使用调查数据来解决两个问题 目的：1）评估是否延迟进入产前护理的人更常见， 以前参加过当前妊娠的CPC（相对于未参加者）;以及2）评估 在CPC提供的妊娠选择咨询是否因客户人口统计数据而异（例如， 种族/民族、婚姻状况和宗教），在CPC前控制客户妊娠计划后 访问为了解决的目标，我们将调查400例患者谁最近进入产前护理。样品将 包括200名在产前护理前参加过CPC妇女， 200名妇女在接受产前护理之前没有参加过产前护理。我们将使用频率匹配 入组（年龄和人种/种族），并在分析期间与倾向评分匹配，以减少偏倚。 虽然近年来关于CPC的文献不断增加，但几乎没有定量数据。 发布在CPC客户端上。我们希望这项研究将为可能的后果提供基本证据 孕妇参加CPC的比例。

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.