Inequities in family engagement in the neonatal intensive care unit

新生儿重症监护病房中家庭参与的不平等

• 批准号: 10606766
• 负责人: Mary Quinn
• 金额: $ 6.95万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10606766
• 关键词: Address; Advisory Committees; Affect; Automobile Driving; Black race; Breast Feeding; Breastfed infant; California; Caring; Child; Child Care; Data; Development; Disparity; Ensure; Epidemiologist; Ethnic Origin; Exclusion; Face; Family; Family Leave; Foundations; Future; Goals; Health; Health Services Research; Hospitalization; Hospitals; Human Milk; Income; Inequity; Infant; Infant Care; Infant Development; Infant Health; Interruption; Intervention; Interview; Language; Latinx; Length of Stay; Mental Health; Methods; Modeling; Modification; Native Americans; Neonatal; Neonatal Intensive Care Units; Observational Study; Occupations; Outcome; Parents; Pattern; Perinatal; Policies; Population; Premature Infant; Prevalence; Qualitative Research; Race; Reduce health disparities; Reporting; Research; Research Personnel; Research Project Grants; Risk; Role; Series; Skin; Skin Care; Structure; Subgroup; Surveys; Time; Training; Transportation; Visit; barrier to care; career; cohort; design; disadvantaged background; evidence base; experience; extreme prematurity; falls; feeding; health inequalities; improved; infant outcome; informant; lower income families; marginalization; marginalized population; neonatal health; neonatal outcome; perinatal health; prevent; programs; racial disparity; social; socioeconomic disadvantage; socioeconomic disparity; sociologist; success; theories; therapy design; transportation access; trend

Families’ engagement in NICU care facilitates holding, skin-to-skin care, and human milk feeding, which improve neonatal survival and long-term infant development. However, there are many disproportionate structural barriers faced by marginalized families when visiting the NICU. Few studies have characterized these structural barriers and evaluated how they affect infant and parental disparities and outcomes. In this project, Dr. MK Quinn, hypothesizes that parents of children in the NICU from marginalized backgrounds are less likely to have access to paid family leave, childcare, transportation, and may encounter language barriers, and that this contributes racial, ethnic, and socioeconomic disparities in preterm infant health outcomes. This hypothesis will be addressed with two specific aims. First, to understand the barriers that families face to engaging in the care of their preterm infants in mixed methods study Dr. Quinn will identify barriers through key informant interviews of low-income families with preterm infants in the NICU. This rich qualitative data of parents’ experiences will inform the development of evidenced based theory of what is driving disparities in family visitation and engagement. This will be followed by a multicenter survey of parents with preterm infants in the NICU, in order to first understand the prevalence of these barriers and investigate how these barriers are experienced by marginalized groups. Second, Dr. Quinn will conduct an observational study of the health effects of the most salient barrier to care, paid family leave. For this analysis she will investigate how the implementation of California’s paid family leave policy contributed to racial and socioeconomic disparities in preterm infant care and outcomes. The results of this study will provide the groundwork for designing policy interventions to ensure families can engage in their preterm infant’s care, and ultimately, reduce inequities and improve preterm health outcomes. The sponsor for this research is Dr. Henry Lee, a neonatologist with expertise in health services research. The cosponsor, Dr. Jochen Profit, is a neonatologist with expertise in neonatal inequities. The advisory team includes Dr. Maya Rossin-Slater, an economist with expertise in family leave policy, Dr. Suzan Carmichael, an epidemiologist with expertise in perinatal health inequities, and Dr. Christine Morton, a sociologist with expertise in perinatal qualitative research. The research in this study in concert her training plan will provide Dr. Quinn a foundation in the study of neonatal health inequities and prepare her for a career continuing this research as an independent investigator.

家庭参与新生儿重症监护室护理有助于保持，皮肤护理和母乳 喂养，提高新生儿存活率和婴儿的长期发育。但有 边缘化家庭在访问新生儿重症监护室时面临许多不成比例的结构性障碍。 很少有研究描述这些结构性障碍，并评估它们如何影响婴儿 和父母的差异和结果。在这个项目中，MK奎因博士假设父母 来自边缘化背景的新生儿重症监护室的儿童不太可能获得有偿服务， 探亲假、儿童保育、交通，可能会遇到语言障碍，这 导致早产儿健康结果的种族，民族和社会经济差异。 这一假设将以两个具体目标来处理。首先，要了解 家庭面临着从事照顾他们的早产儿在混合方法研究奎因博士 将通过对早产儿低收入家庭的关键知情人访谈来确定障碍 在新生儿重症监护室这些丰富的父母经验定性数据将为发展提供信息， 基于证据的理论是什么驱动家庭探视和参与的差距。这 随后将对NICU中早产儿的父母进行多中心调查，以便 首先了解这些障碍的普遍性，并调查这些障碍是如何 被边缘化的群体。第二，奎因博士将进行一项观察性研究， 保健方面最突出的障碍-带薪家事假-对健康的影响。在这次分析中，她将 调查如何实施加州的带薪家庭假政策有助于种族歧视 以及早产儿护理和结果的社会经济差异。 这项研究的结果将为设计政策干预措施提供基础，以确保 家庭可以参与早产儿的护理，并最终减少不平等， 早产儿健康结果。这项研究的发起人是亨利李博士，他是一位神经病学家， 卫生服务研究的专业知识。共同发起人Jochen Profit博士是一位神经学家， 新生儿不平等的专业知识。顾问团队包括Maya Rossin-Slater博士， 在家庭休假政策方面具有专长的经济学家苏珊卡迈克尔博士， 专业知识在围产期健康不平等，和博士克莉丝汀莫顿，社会学家与专业知识， 围产期定性研究。本研究的研究将为她的训练计划提供参考 博士奎因在新生儿健康不公平的研究基础，并准备她的职业生涯 作为独立调查员继续这项研究。