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.

项目摘要/摘要 为了回应特殊关注的通知（NOT-OD-22-031），以研究“研究 研究了，代表性不足且人口不足（U3）人口，“我们建议运用来自的资源 我们的父母R01项目旨在检查美国医院出院数据的伤害性暴力率 印度/阿拉斯加本地人（Aian）居住在美洲印第安人预订的妇女；评估这些费率 在Covid-19-19的大流行条件下；并利用与主要部落的访谈结果 领导者以对部落决策者有效且有用的方式来解释结果。带有越来越多的报告 失踪和被谋杀的土著妇女，迫切需要扩大研究能力 基于性别的暴力行为，以解决私密伴侣暴力的背景，风险和服务， 家庭暴力和性侵犯。家长项目使用医疗保健成本和利用项目（HCUP） 数据以在与美洲印第安人相处的多个州进行地理空间分析 至少有2,000名居民的预订。拟议的补充剂将调查伤害 与专门针对代理和需求的亚洲妇女的基于性别的暴力有关 在研究中，历史，不断地理解，代表性不足和研究不足。指导 研究表明HCUP实用的研究以解决亲密伴侣的暴力和国内 其他妇女群体中的暴力行为，这项补充研究与 妇女健康研究办公室，涉及与土著妇女的暴力有关的差异。 我们采用多方法和交叉方法来实现以下目的：目标1：评估类型 和医院出院记录的频率编码为暴力行为，例如攻击和炮台。 亲密的合作伙伴和未知的刺客，适用于居住在部落司法管辖区的艾亚妇女 使用亚利桑那州使用2006年至2019年的HCUP数据（在Covid-19大流行之前）。目标2：比较 这些关于使用HCUP数据来自于19 COVID-19的大流行状况范围内寻求护理的报告 2020年。目标3：确定部落社区条件和部落服务如何告知我们对 与暴力相关的报告和共同199大流行控制措施的影响，使用访谈数据 主要领导者。在这样做的过程中，这项补充研究解决了在文化和上下文上创建的呼吁 将地理和结构性因素的景观视为主要和 预防性护理并以艾安妇女的现场经验为中心 需要。