Healthcare-Seeking and Violence against American Indian and Alaska Native Women: Examining the Impact of the COVID-19 Pandemic

针对美洲印第安人和阿拉斯加原住民妇女的求医和暴力行为：审视 COVID-19 大流行的影响

• 批准号: 10559049
• 负责人: JULIET P LEE
• 金额: $ 23.19万
• 依托单位: PACIFIC INSTITUTE FOR RES AND EVALUATION
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-05 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10559049
• 关键词: Accident and Emergency department; Address; Administrative Supplement; Adopted; Alaska Native; American Indians; Arizona; Attention; Behavioral; COVID-19; COVID-19 impact; COVID-19 pandemic; COVID-19 pandemic effects; Characteristics; Code; Conditioned Reflex; Crime; Data; Data Set; Databases; Domestic Violence; Emotional; Ethnic Origin; Evaluation; Frequencies; Gender; Geography; Goals; Government; Health; Health Care Costs; Health Services; Health care facility; Healthcare; Hospitals; Improve Access; Indian reservation; Indigenous; Injury; Inpatients; Interview; Law Enforcement; Life Cycle Stages; Measures; Methods; Murder; Muslim religion; Outcome; Outpatients; Parents; Pathway interactions; Patients; Personal Satisfaction; Persons; Population; Prevention Research; Preventive care; Preventive service; Primary Health Care; Public Health; Race; Records; Reporting; Research; Research Institute; Research Methodology; Research Personnel; Resources; Risk; Risk Behaviors; Safety; Sampling; Senior Scientist; Services; Shelter facility; Social Work; System; Tribes; Universities; Variant; Violence; Washington; Well in self; Woman; Women' s Group; Women' s Health; Work; assault; care seeking; cost; evidence base; experience; gender-based violence; health care availability; health care service utilization; help-seeking behavior; hospital analysis; improved; interest; intimate partner violence; lens; parent grant; parent project; perpetrators; post-COVID-19; prevent; public policy on alcohol; residence; response; sexual assault; social; social health determinants; social structure; tribal Nation; tribal community; tribal health; tribal lands; tribal leader; violence against women; violence prevention; violence victimization

PROJECT SUMMARY/ABSTRACT In response to the Notice of Special Interest (NOT-OD-22-031) for “Research on the Health of Women of Understudied, Underrepresented, and Underreported (U3) Populations,” we propose to apply resources from our parent R01 project to examine rates of injurious violence from hospital discharge data for American Indian/Alaska Native (AIAN) women residing on and off American Indian reservations; assess these rates within the context of the COVID-19 pandemic conditions; and utilize results of interviews with key Tribal leaders to interpret results in ways that are valid and useful for Tribal policymakers. With mounting reports of Missing and Murdered Indigenous Women, there is a profound need to expand the capacity of research on gender-based violence to account for the contexts, risks, and services underlying intimate partner violence, domestic violence, and sexual assault. The parent project uses Healthcare Cost and Utilization Project (HCUP) data to perform geospatial analyses across multiple states that are collocated with American Indian reservations populated with at least 2,000 residents. The proposed supplement will investigate injuries associated with gender-based violence specifically for AIAN women whose agency and needs have been historically and continually understudied, underrepresented, and underreported in research. Guided by research that has demonstrated the utility of the HCUP to address intimate partner violence and domestic violence among other groups of women, this supplemental study aligns with the priorities established by the Office of Research on Women's Health regarding disparities related to violence against Indigenous women. We adopt a multi-methods and intersectional approach to achieve the following aims: AIM 1: Assess the type and frequency of hospital discharge records coded for violence, such as assault and battery committed by intimate partners and unknown assailants, for AIAN women residing on versus off Tribal jurisdictions collocated with Arizona by using HCUP data from 2006-2019 (preceding the COVID-19 pandemic). AIM 2: Compare these reports of care-seeking within the scope of the COVID-19 pandemic conditions using HCUP data from 2020. AIM 3: Identify how Tribal community conditions and Tribal services may inform our understanding of the violence-related reporting and impacts of the COVID-19 pandemic control measures using interview data from key leaders. In doing so, this supplemental research addresses the call for creating culturally and contextually relevant evidence that considers the landscape of geographic and structural factors to primary and preventative care and centers the lived experiences of AIAN women to meet group- and population-level needs.

项目总结/摘要 为响应特别关注的通知（NOT-OD-22-031）， 研究不足、代表性不足和报告不足（U3）的人群，”我们建议从以下方面申请资源 我们的父R 01项目从美国人的出院数据中检查伤害性暴力的发生率， 居住在美洲印第安人保留地内外的印第安人/阿拉斯加土著妇女;评估这些比率 在COVID-19大流行的情况下;并利用与关键部落的访谈结果 领导人以有效和对部落决策者有用的方式解释结果。随着越来越多的报告， 关于失踪和被谋杀的土著妇女问题，极有必要扩大关于以下问题的研究能力： 基于性别的暴力，以说明造成亲密伴侣暴力的背景、风险和服务， 家庭暴力和性侵犯父项目使用医疗保健成本和利用项目（HCUP） 数据以跨与美洲印第安人并置的多个州执行地理空间分析 至少有2,000名居民的保留地。拟议的补充将调查伤害 特别针对土著民族和土著民族妇女的暴力行为， 历史上和持续的研究不足，代表性不足，在研究中报告不足。指导 研究表明，《最高刑事法院和刑事诉讼法》在处理亲密伴侣暴力和家庭暴力方面具有效用; 关于其他妇女群体中的暴力问题，本补充研究报告符合《消除对妇女一切形式歧视公约》 妇女健康研究办公室，涉及与暴力侵害土著妇女有关的不平等问题。 我们采用多方法交叉的方法来实现以下目标：目标1：评估类型 和频率的出院记录编码的暴力，如攻击和殴打犯下的 亲密伴侣和身份不明的攻击者，分别针对居住在部落管辖区内和部落管辖区外的AIAN妇女 使用2006-2019年（COVID-19大流行之前）的HCUP数据与亚利桑那州进行比较。目标2：比较 这些在COVID-19大流行条件范围内寻求护理的报告使用HCUP数据， 2020.目标3：确定部落社区条件和部落服务如何告知我们对 暴力相关的报告和COVID-19大流行控制措施的影响，使用来自 关键领导人。在这样做的时候，这个补充研究解决了在文化和背景上创造的要求。 相关的证据，认为地理和结构因素的景观，以主要和 预防性护理，并将AIAN妇女的生活经历集中在一起，以满足群体和人口的需要。 需求