Time-Sensitive Research to Assess the Effects of Reproductive Health Policy on the Health Outcomes of People with Chronic Diseases

评估生殖健康政策对慢性病患者健康结果影响的时间敏感研究

• 批准号: 10768227
• 负责人: Mehret Birru Talabi
• 金额: $ 68.17万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10768227
• 关键词: Advertising; Affect; Age; Birth; Cardiovascular Diseases; Caring; Chronic; Chronic Disease; Clinical; Complex; Contraceptive methods; Dangerousness; Data; Decision Making; Disabled Persons; Discipline of obstetrics; Disease; Drug Prescriptions; Eligibility Determination; Epidemiology; Equity; Family Planning; Female; Health; Health Policy; Health Services; Healthcare; Individual; Interview; Legal; Life; Low income; Malignant Neoplasms; Maternal Mortality; Medicaid; Medical; Medicine; Outcome; Outcome Assessment; Patient Outcomes Assessments; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pharmacy facility; Physicians; Policies; Population; Pregnancy; Pregnancy Outcome; Primary Care; Procedures; Public Health; Recommendation; Recording of previous events; Regulation; Reporting; Reproductive Health; Research; Respondent; Risk; Sampling; Surveys; Systemic Lupus Erythematosus; Teratogens; Time; Travel; Women' s Health; abortion; adverse pregnancy outcome; child bearing; clinical center; clinical practice; court; experience; fetal; health equity; health practice; healthy pregnancy; high risk; indexing; multidisciplinary; person centered; population based; pregnant; recruit; search engine; severe maternal morbidity; social; socioeconomics; unintended pregnancy

ABSTRACT In June 2022, the U.S. Supreme Court’s ruling in Dobbs v. Jackson Women’s Health overturned Roe v. Wade, eliminating federal protections for abortion access nationwide. The Dobbs decision rapidly upended fifty years of legal precedent and health policy. Fourteen states have banned abortion, state legislatures have introduced 85 bills to protect or restrict abortion access, and courts in eight states have temporarily blocked the passage of abortion bans. Over 33.6 million people with childbearing capacity now live in states where abortion is banned or likely to be heavily restricted. The effect of these rapidly changing policies on abortion access will be profound, yet the consequences of these policies on public health indices are unknown. People with chronic and complex medical conditions are particularly vulnerable to adverse health consequences as a result of abortion policy. At baseline, these individuals are at high risk for severe maternal morbidity and maternal mortality as compared to other birthing people. Prior to the Dobbs decision, abortion care allowed for life- altering care among people whose underlying health conditions complicated healthy pregnancy. However, few studies had described the impact of abortion on the health and well-being of individuals with chronic diseases; thus, it is unclear how the Dobbs decision will impact their clinical outcomes. Our study, Investigating Time- sensitive Reproductive Health Equity Post-Dobbs for Patients with ChronIc Disease (INTREPID), will evaluate the time-sensitive impact of evolving abortion policies on the health and well-being of patients, particularly those with chronic diseases that increase the risk of severe maternal morbidity and maternal mortality (e.g., cardiovascular disease, cancer, systemic lupus erythematosus); the clinical practice of physicians who care for people with chronic diseases; and downstream clinical outcomes at a population level. We will use survey- based, qualitative, and epidemiologic approaches to realize our Specific Aims, which are to: 1) Evaluate, among people who are seeking abortion, who is able or not able to obtain a wanted abortion, and to assess their longitudinal outcomes related to health and well-being; 2) Assess, among physicians, the impact of abortion policy on medical decision-making and practice; and 3) Generate new evidence about the impact of abortion policy on population-based pregnancy outcomes (e.g., severe maternal morbidity, maternal mortality) and healthcare-related outcomes (e.g., contraception and teratogenic medication prescribing). The INTREPID research team has multidisciplinary expertise in medicine, obstetrics, family planning research, health equity, health policy, and epidemiology. Our project seeks to inform health policy that will optimize reproductive healthcare and clinical outcomes in the post-Dobbs era.

摘要