Reducing Disparities among African American Women Seeking Infertility Treatment

减少寻求不孕症治疗的非裔美国女性之间的差异

• 批准号: 9910757
• 负责人: Morine Cebert
• 金额: $ 3.61万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9910757
• 关键词: Address; Adopted; Affect; African American; Age; Anxiety; Area; Attitude; Award; Behavior Therapy; Biological; Caring; Clinic; Clinical; Data; Data Sources; Diagnosis; Disease; Distress; Economics; Education; Elements; Employment; Employment Status; Environment; Family; Fertility; Foundations; Future; Gender Identity; Goals; Gynecology; Health; Health Promotion; Health Services Accessibility; Income; Individual; Infertility; Institution; Insurance; Insurance Coverage; Intervention; Interview; Knowledge; Literature; Marital Status; Maryland; Medical; Mental Depression; Methods; Not Hispanic or Latino; Nurses; Operative Surgical Procedures; Outcome; Patients; Perception; Policy Developments; Population; Predictive Factor; Prevalence; Privatization; Provider; Public Health; Quality of life; Recording of previous events; Religion; Research; Research Personnel; Resources; Sampling; Self Management; Social support; Socioeconomic Status; Structure; Time; Training; Universities; Well in self; Woman; Women' s Health; child bearing; clinical diagnostics; disparity reduction; experience; health belief; health disparity; help-seeking behavior; improved; infertility treatment; programs; psychologic; racial disparity; reproductive; social; subfertility; therapy development; treatment center; treatment disparity; treatment planning

Abstract Black women are two times more likely to experience infertility, yet twice less likely to seek treatment than non- Hispanic White women. Research on treatment decisions among Black women with infertility is scarce and provide incomplete understanding of their reproductive experiences. Black women with untreated infertility experience issues such as high levels of isolation, silence, and negative medical experiences, yet little is known about what factors influences decisions to initiate and complete care. The purpose of this study is to understand what influences Black women with infertility to initiate and complete treatment. The specific aims of this study are to: 1) Identify biological, clinical, and sociocultural factors that predict completion of infertility treatment plans among Black women who have initiated treatment; and 2) Generate a multidimensional description and conceptualization of Black women’s perceptions of biological, clinical, socio-cultural influences on decisions to initiate and complete treatment for infertility. This study will utilize a convergent mixed methods approach combining data from a retrospective chart review and individual semi-structured interviews. Biological (age, BMI, past medical/surgical/gynecological history, type of infertility), clinical (diagnostic results and proposed treatment plan), and sociocultural (insurance, employment status, marital status) data of Black women with infertility from a large infertility clinic will be extracted through a retrospective chart review. Concurrently, a purposive sample of Black women who have initiated care at the same clinic will be interviewed regarding their perspectives of how biological (perceptions/attitudes/beliefs of health and infertility and impact of infertility), clinical (perceptions of clinical encounter, patient-provider relationship, and perceptions of treatment plan), and sociocultural (religion, education, employment, marital status, racial identify, culture significance of infertility, and social support) elements influenced their decisions to initiate and complete care. The knowledge generated from this proposed study will identify currently unknown influences on clinical experiences among Black women with infertility. Moreover, results will help inform self-management interventions for modifiable factors, target sub-populations of Black women who are in most need of these interventions, and policy development addressing social determinants aimed at improving health disparities affecting Black women with infertility. The training proposed under this award will satisfy future goals to develop a thoughtful program of research focused on improving the family building experience of Black women as a health disparities nurse researcher using mixed methods approaches. Duke University and other public and private institutions will provide a rich environment with unique resources to complete this study.

摘要 黑人女性不孕不育的可能性是非黑人女性的两倍，但寻求治疗的可能性却是非黑人女性的两倍 西班牙裔白人女性。关于黑人不孕不育妇女治疗决策的研究很少 对他们的生育经历提供不完整的理解。患有未经治疗的不孕症的黑人妇女 经历过诸如高度孤立、沉默和消极的医疗经历等问题，但很少有 了解哪些因素会影响启动和完成护理的决策。这项研究的目的是 了解是什么影响了患有不孕症的黑人妇女开始并完成治疗。的具体目标 这项研究的目的是：1)确定预测完全不孕症的生物学、临床和社会文化因素 已经开始治疗的黑人妇女的治疗计划；和2)产生多方面的 描述和概念化黑人妇女对生物、临床、社会文化影响的看法 关于开始和完成不孕不育治疗的决定。本研究将采用一种收敛的混合方法 方法结合回溯性图表回顾和个人半结构化访谈的数据。 生物学(年龄、体重指数、既往内科/外科/妇科病史、不孕症类型)、临床(诊断结果 和建议的治疗计划)和社会文化(保险、就业状况、婚姻状况)数据 来自一家大型不孕症诊所的不孕不育妇女将通过回顾图表进行提取。 同时，在同一家诊所开始护理的有目的的黑人妇女样本将是 就他们的生物学观点(对健康和不孕不育的看法/态度/信念)进行了采访 和不孕不育的影响)、临床(对临床遭遇的看法、患者与提供者的关系以及 对治疗计划的看法)和社会文化(宗教、教育、就业、婚姻状况、种族 识别、不孕不育的文化意义和社会支持)因素影响了他们发起和 万无一失。这项拟议研究产生的知识将确定目前未知的影响 关于黑人女性不孕症的临床经验。此外，结果将有助于自我管理。 对可改变因素的干预，目标是最需要这些因素的黑人妇女亚群体 针对旨在改善健康差距的社会决定因素的干预措施和政策制定 影响患有不孕症的黑人妇女。根据该奖项建议的培训将满足未来的目标 制定一项深思熟虑的研究计划，重点是改善黑人妇女的家庭建设体验 作为一名健康差距的护士研究员，使用混合方法进行研究。杜克大学和其他公共机构 私营机构将为完成这项研究提供丰富的环境和独特的资源。