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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：
10491748
负责人：
Willi HORNER-JOHNSON
金额：
$ 66.65万
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/10491748
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 Latina Population Link Massachusetts Methods 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 ethnic minority population 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.

项目总结/摘要身体残疾的妇女在怀孕护理、并发症和结果方面存在明显差异，与无残疾的女性相比。黑人妇女和拉丁裔妇女也经历着巨大的差异与白色妇女相比，黑人女性和拉丁裔有身体因此，残疾人可能面临更大的不良经历和后果风险。不过，没有已知的研究调查了残疾和种族/民族在围产期护理方面的交叉点，差距。调查小组的初步调查结果表明，身体残疾对不良妊娠结果的风险很大。努力改善她们的怀孕状况护理和经验，同时降低成本，需要明确评估这些妇女的怀孕风险和结果。本研究的总体目标是使用混合方法来了解妊娠经历、母婴结局、相关医疗保健费用和未满足的围产期黑人妇女和拉丁美洲人的身体残疾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，残疾）。本研究的具体目的是：1）比较围产期保健收据，妊娠相关并发症，健康结果，住院医疗利用和费用的妇女队列的基础上，种族，民族和身体残疾状况，并确定是否是一个黑人妇女或身体残疾的拉丁裔是加法或乘法; 2）使用来自格鲁吉亚、加州和马萨诸塞州研究第一年的健康结果，医疗保健利用和成本的妇女队列根据种族，民族和身体残疾及其婴儿（<1岁），并确定是否结合作为一个黑人妇女或拉丁美洲人与身体残疾的影响是加法或乘法;和3）确定身体残疾的黑人妇女和拉丁裔妇女在围产期护理方面的需求得不到满足和遇到障碍，具体做法是：采访目前怀孕或最近怀孕的黑人妇女和拉丁裔身体残疾者（B）与产科护理提供者的重点小组。这项研究将导致有史以来第一次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，身体残疾的拉丁人，从而为未来的发展和测试奠定了基础干预措施，以改善结果。这项研究将填补一个关键的知识差距，了解身体残疾的黑人妇女和拉丁裔妇女在怀孕之前、期间和怀孕后。