Multilevel Barriers and Facilitators to Addressing Disparities in Perinatal Mental Health

解决围产期心理健康差异的多层次障碍和促进因素

• 批准号: 10559204
• 负责人: Marcia J Ash
• 金额: $ 4.32万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2024-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10559204
• 关键词: Multilevel; Barriers; Facilitators; Addressing; Disparities

ABSTRACT Black perinatal women face significant mental health disparities. In particular, Black women are at increased risk for trauma and stressor-related disorders, which have been shown to be associated with significantly increased risk for severe maternal morbidity. Few Obstetric departments screen patients for trauma and stressor-related disorders, and Black women are less likely to be insured and have access to perinatal care. To begin to address disparities in unmet trauma and stress needs among Black perinatal women, we propose a sequential mixed-method study with three aims: (1) utilizing data from the National Survey on Drug Use and Health (NSDUH), identify determinants of mental health treatment utilization and unmet mental health needs among a national sample of Black women of reproductive age (18-44 years) with serious psychological distress; (2) to contextualize findings from Aim 1, use the patient-centered access framework to analyze data from 5 focus groups with Black perinatal women living in two urban areas (n=40) to understand barriers and facilitators to accessing perinatal mental health supports and recommendations to improve access; and (3) conduct semi-structured interviews with 20 OB providers and administrators from two urban, safety-net hospital systems serving primarily Black patient populations to assess provider and systems-level barriers and facilitators to conducting trauma and stressor-related disorder screenings and referrals. Achieving the aims of this study will lead to the identification of multilevel barriers and facilitators to addressing unmet mental health needs among Black perinatal women who experience trauma and stress. By utilizing a mixed-methods approach that integrates national estimates with contextualized patient, provider, and administrator perspectives, this study will generate targeted policy and program-based recommendations to promote access to trauma and stressor-related disorder screenings and services for Black perinatal women in order to reduce disparities in maternal morbidity.

摘要 黑人围产期妇女面临着巨大的心理健康差距。尤其是黑人女性， 创伤和压力相关疾病的风险，已被证明与显著相关 严重孕产妇发病率的风险增加。很少有产科对病人进行创伤筛查， 与压力有关的疾病，黑人妇女不太可能得到保险和获得围产期护理。到 开始，以解决黑人围产期妇女未得到满足的创伤和压力需求的差距，我们提出了一个 序贯混合方法研究有三个目的：（1）利用全国药物使用调查的数据， 健康（NSDUH），确定心理健康治疗利用的决定因素和未满足的心理健康需求 在全国范围内对育龄期（18-44岁）黑人妇女进行抽样调查， （2）将目标1中的发现置于情境中，使用以患者为中心的访问框架来分析数据 来自5个焦点小组，黑人围产期妇女生活在两个城市地区（n=40），以了解障碍， 促进获得围产期心理健康支持和建议，以改善获得;和（3） 对来自两家城市安全网医院的20名产科医生和管理人员进行半结构化访谈 主要服务于黑人患者群体的系统，以评估提供者和系统级障碍， 协助进行创伤和压力相关的疾病筛查和转诊。实现 这项研究将导致识别多层次的障碍和促进因素，以解决未满足的心理健康 黑人围产期妇女谁经历创伤和压力的需求。通过使用混合方法， 一种将国家评估与患者、提供者和管理者情境化相结合的方法 本研究将提出有针对性的政策和方案建议，以促进获得 为黑人围产期妇女提供创伤和与压力有关的疾病筛查和服务， 产妇发病率的差异。