Respectful Communication and Patient Portal Usage in Pregnant People of Color

项目摘要 怀孕的有色人种一直报告沟通不畅，被解雇，忽视，歧视 反对和不尊重。基于种族的虐待导致更糟糕的体验和更多的劳动力 干预措施。在产前护理中，迫切需要改善医患沟通（PPC）。与 随着数字模式（如患者门户网站）数量的不断增加，必须检查 这些数字化工具在PPC上。患者门户网站已成为改善PPC的有效和有价值的策略 供应商在普通人群中。关于一般人群中患者门户网站使用情况的研究，包括 怀孕的人，表明较低的门户网站的使用在社区的颜色创造数字鸿沟。一个方面 数字健康素养（DHL）。在美国，很少有研究调查DHL在怀孕期间的作用。 研究了有色人种孕妇PPC、患者门户网站使用和DHL之间的关系。与 持续存在的围产期健康不平等和数字健康工具的快速整合，现在是时候改善 了解孕妇的医患沟通、患者门户网站使用情况和数字健康素养 颜色。拟议研究的长期目标是通过以下措施提高围产期护理的尊重和质量 创建一个包容性的，与文化相关的数字健康干预措施，以解决孕妇的PPC， 颜色.具体目标是：目标1 -量化患者-提供者沟通，患者 有色人种孕妇的门户网站使用和数字健康素养;目标2 -确定促进因素和障碍 有色人种孕妇的最佳数字交流这项多方法研究将招募130名自认为 来自城市安全网医院的有色人种孕妇调查数据将根据人口统计和 临床信息，以及参与者对妊娠期PPC的看法，患者门户网站的使用和数字 健康素养。调查结束时将提出探索性定性问题，以询问辅导员 以及最佳数字医患沟通的障碍。对于目标1，回归分析将检查 尊重患者-提供者沟通，数字健康素养和患者门户网站使用之间的关联， 有色人种的孕妇，在控制协变量后。在目标2中，主题分析将被应用于理解 如何通过患者门户网站的使用，通过患者的个人经验， 参与者这项研究意义重大，因为它提出了一个潜在的可修改的影响， PPC，公共卫生优先事项。这项研究涉及NINR的研究镜头，以促进健康公平， 健康研究的社会决定因素。如果没有患者与提供者之间如何沟通的数据， 门户网站和利用障碍所面临的怀孕的人的颜色，这种数字形式的好处将是 不公平和差距加剧。

Project Summary Pregnant people of color consistently report poor communication, being dismissed, ignored, discriminated against and disrespected. Racially-based mistreatment contributes to worse experiences and increased labor interventions. Improvements in patient-provider communication (PPC) are urgently needed in prenatal care. With the increasing numbers of digital modalities, such as the patient portal, it is essential to examine the impact of these digital tools on PPC. Patient portals have emerged as an effective and valuable strategy to improve PPC providers in the general population. Research on patient portal usage in the general population, including in pregnant people, demonstrates lower portal usage in communities of color creating the digital divide. One aspect of this divide is digital health literacy (DHL). Few studies have examined DHL in pregnancy in the U.S. No study has examined the relationship between PPC, patient portal usage and DHL in pregnant people of color. With the persistent perinatal health inequities and the rapid integration of digital health tools, the time is now to better understand patient-provider communication, patient portal usage and digital health literacy in pregnant people of color. The long-term goal of the proposed research is to improve respect and quality in perinatal care through the creation of an inclusive, culturally relevant digital health intervention to address PPC for pregnant people of color. The specific aims are: Aim 1 - quantify the relationships between patient-provider communication, patient portal usage and digital health literacy in pregnant people of color; and Aim 2 - identify the facilitators and barriers to optimal digital communication in pregnant people of color. This multimethod study will recruit 130 self-identified pregnant people of color from an urban safety net hospital. Survey data will be collected on demographic and clinical information, as well as participant perceptions of PPC in pregnancy, patient portal usage and digital health literacy. Exploratory qualitative questions will be posed at the end of the survey to inquire about facilitators and barriers to optimal digital patient-provider communication. For Aim 1, regression analysis will examine the associations among respectful patient-provider communication, digital health literacy and patient portal usage in pregnant people of color, after controlling for covariates. In Aim 2, thematic analysis will be applied to understand how optimal communication develops through patient portal utilization by individual experiences of the participants. This research is significant because it proposes to examine a potentially modifiable influence on PPC, a public health priority. This study addresses the NINR’s research lenses to advance health equity and social determinants of health research. Without data on how patient-provider communication within the patient portal and utilization barriers faced by pregnant people of color, the benefit of this digital modality will be inequitable and disparities exacerbated.