Understanding Family Networks and Implications for Maternal Health

项目摘要 这项新颖的探索性研究将社交网络方法应用于概念化和测量 孕妇的家庭背景。我们将研究母亲自我定义的总体结构 家庭网络及其内部互动的质量通过两种途径影响孕产妇健康： 健康行为和社会心理健康。先前关于家庭和孕产妇健康的研究主要集中在 父母的关系状况或“家庭结构”，父母或父母与父母之间的二元关系质量 儿童或有关健康方面家庭支持的全球问题。我们的研究通过收集自我来创新 来自孕妇的有关其家庭的网络数据，以捕获其结构和交互特性 家庭。我们的两个具体目标是 (1) 收集 400 名家庭网络数据以及健康和出生结果数据 孕妇，以及 (2) 测试将家庭网络特征与孕产妇健康联系起来的概念模型 通过行为和心理社会途径得出的结果。为了实现这些目标，我们将制定配额 从一个医疗保健系统的电子病历中抽取 400 名女性样本 (n=400)，该系统是 主要分布在北卡罗来纳州的两个县。样本在种族/民族、社会阶层和城市方面具有多样性， 郊区或农村住宅。怀孕第四或第五个月的妇女自愿同意 研究将参加一次 45 分钟的访谈，其中包括一套结构化的问题来衡量他们的家庭 网络以及跨关系的支持、冲突和控制。我们还将包括结构较少的 了解我们是否忽视了对健康至关重要的家庭动态的问题。我们的网络数据 使用 EgoWeb 2.0 在平板电脑上收集的数据将进行定量分析，以检查家庭的多个维度 网络并调查这些差异与孕产妇和儿童健康结果的关系。我们还将 评估这些关联是否可以用女性的健康行为或社会心理健康来解释 存在。我们将把采访中结构性较差的部分转录成定性数据，以供分析发现 我们可能会遗漏或误解家庭背景的哪些方面。这项研究的结果将引发 新的研究和激励政策和计划关注更丰富的家庭动态及其 影响健康。此外，我们使用电子病历对孕妇进行抽样并收集健康和社会信息 数据将为人口健康研究建立新的、突破性的替代方案。

PROJECT ABSTRACT This novel, exploratory research applies a social network approach to the conceptualization and measurement of pregnant women's family contexts. We will examine how the overarching structure of mothers' self-defined family networks, and the quality of interactions within them, shape maternal health through two pathways: health behaviors and psychosocial well-being. Prior research on family and maternal health focuses primarily on parents' relationship status or “family structure,” dyadic relationship quality between parents or parent and child, or global questions about family support in relation to health. Our research innovates by collecting ego- network data from pregnant women about their families to capture the structural and interactive properties of families. Our two specific aims are to (1) collect family network data and health and birth outcome data for 400 pregnant women, and (2) test a conceptual model linking family network characteristics to maternal health outcomes through behavioral and psychosocial pathways. To accomplish these aims, we will develop a quota sample of 400 women (n=400) from the electronic medical records of one health care system that is predominant in two counties of NC. The sample will be diverse in race/ethnicity, social class, and urban, suburban, or rural residence. Women in their fourth or fifth month of pregnancy who voluntarily consent to the study will participate in a 45-minute interview that includes a structured set of questions to measure their family networks and the support, conflict, and control moving across ties. We will also include less-structured questions to understand if we are overlooking family dynamics that matter for health. The network data we collect on tablets using EgoWeb 2.0 will be analyzed quantitatively, to examine several dimensions of family networks and investigate how variance in those relates to maternal and child health outcomes. We will also assess whether any of these associations are explained by women's health behaviors or psychosocial well- being. We will transcribe the less-structured parts of the interview into qualitative data for analyses to uncover which aspects of family context we might be missing or misunderstanding. Findings from this study will spark new research and motivate policies and programs that are attentive to a richer set of family dynamics and their bearing on health. Moreover, our use of EMRs for sampling pregnant women and collecting health and social data will model new, groundbreaking alternatives for population health research.