A Measure for Shared Decision Making in Maternity Care through Communicating CHOICes, CHildbirth Options, Information, and person-Centered Explanation

项目总结/摘要（最多30行） 改善产妇保健，包括产妇之间发病率和死亡率的差异， 国家优先。美国专业围产期护理组织建议共同决策 (SDM)在产妇护理方面，为孕妇和产妇提供以人为本的高质量护理， 在围产期护理期间分娩的人;然而，没有有效和可靠的SDM测量方法， 患者为了解决SDM测量差距，需要一种可靠有效的措施， 可以确定SDM的影响。这项建议的主要目的是测试心理测量 属性的修订以前开发的措施SDM。该措施，分娩选择， 信息和以人为中心的解释（选择）评估SDM从分娩的人的 这包括产前和分娩期间的医院护理。提供初步试验数据 支持选择项的心理测量属性，但需要额外的项目， 综合衡量SDM。修改后的选择将被翻译成文化和 翻译成西班牙语为了达到具有代表性的全国样本，我们将招募505人， 在过去六个月内通过日常健康应用程序分娩：期待什么， 婴儿中心，和什么期待西班牙语。接触传统上不参与的人口， 研究，我们将使用社会网络招聘通过社区为基础，联邦资格 医疗中心，玛丽中心。将致力于实现以下目标： 围产期护理共同决策的英语心理测量学特征 和西班牙语.我们将确定修订后的评分信度、评分效度和可扩展性- 基于Rasch分析和Mokken非参数分析的产前和产时护理选择 可扩展性分析将使用Rasch分析的拟合指数进行有效性检验， 验证性因素分析目标2：确定共享决策项是否执行 在不同的临床情况（第一胎）和人口统计学群体（种族，民族， 年龄、教育、收入和保险类型）。我们将进行平均差异的统计检验， 组间评分和基于Rasch分析的差异项目功能（DIF）分析。后 完成拟议的项目，我们的预期成果是一个可靠和有效的修订选择 SDM的测量，用于围产期护理的一般用途，并说明评分的解释。 未来的研究将使用修订的选择工具，重点是使用的影响， 相关临床结果的衡量标准。这项研究与AHRQ的使命一致，即开发、 测试和评估有意义的以人为本的措施，解决不平等和健康结果。

PROJECT SUMMARY/ABSTRACT (30 lines maximum) Improving maternity care including the morbidity and mortality disparities amongst birthing people is a national priority. U.S. professional perinatal care organizations recommend shared decision-making (SDM) in maternity care as the way to provide person-centered, high-quality care to pregnant and birthing people during their perinatal care; yet there is no valid and reliable measure of SDM for use by patients. To address the SDM measurement gap, a reliable and valid measure is needed so that the impact of SDM can be determined. The main objective of this proposal is to test the psychometric properties of a revised previously developed measure of SDM. The measure, CHildbirth Options, Information, and person-Centered Explanation (CHOICEs) evaluates SDM from the birthing person's perspective and covers both prenatal and intrapartum hospital care. Pilot data provided preliminary support for the psychometric properties of the CHOICEs items, but additional items are needed to comprehensively measure SDM. The Revised-CHOICES and will be translated culturally and linguistically into Spanish. To reach a representative, national sample, we will recruit 505 people who have given birth within the previous six months through the Everyday Health apps: What to Expect, the Baby Center, and What to Expect Español. To reach populations that do not traditionally participate in research, we will use social networking recruitment through a community based, federally qualified healthcare center, Mary's Center. The following aims will be addressed: Aim 1: Establish the psychometric properties of a measure of shared decision-making in perinatal care in English and Spanish. We will determine the score reliability, score validity and scalability of the Revised- CHOICEs for prenatal and intrapartum care based on Rasch analysis and a Mokken non-parametric scalability analysis. Validity testing will be conducted using Fit Indices from a Rasch analysis and confirmatory factor analysis. Aim 2: Determine whether the shared decision-making items perform equally across different clinical situations (first birth) and demographic groups (race, ethnicity, age, education, income and insurance type). We will conduct statistical tests of mean differences in scores across groups and differential item functioning (DIF) analysis based on Rasch analysis. Upon completion of the proposed project, our expected outcome is a reliable and valid Revised-CHOICEs measure of SDM for general use in perinatal care with instructions for interpretation of the scores. Future research using the Revised-CHOICEs instrument will be done to focus on the impact of the use of the measure on relevant clinical outcomes. This research aligns with AHRQ's mission to develop, test, and evaluate meaningful person-centered measures addressing inequity and health outcomes.