Investigating the prevalence of medical mistrust amongst pregnant and perinatal women

家长助学金摘要/摘要 危机怀孕中心(CPC)是一家非营利性组织，其使命是在 不堕胎。为此，初级保健中心提供免费服务(例如，尿检、非诊断性 超声波检查，以及对有限的怀孕选择进行同伴咨询)，以及赚取婴儿的机会- 上课时的相关材料项目。公共资金在中共发挥着越来越重要的作用 功能正常。在俄亥俄州，州政府对CPC的资助从100万美元增加到2019年的750万美元。尽管 宣传提供健康程序并接受国家资助和支持，CPC通常会这样做 没有雇用医务人员，也没有获得医疗设施许可证。根据美国最高法院最近的一起案件， CPC不会被强制披露它们不是医疗设施。专业医疗机构 警告CPC可能的健康风险；然而，到目前为止，对其可能的研究还很少。 效果。我们进行了两项初步研究，为这个项目做准备。首先，在我们以人口为基础的 调查发现，参加CPC是很常见的，俄亥俄州18-45岁的女性中有14%报告说 参加过党代会。出席率在非西班牙裔黑人和低收入人群中更为常见 社会经济地位。第二，通过对CPC工作人员和客户的深入访谈，我们发现 客户经常去CPC确认怀孕，一些人认为CPC是一家医疗诊所 提供早孕护理的机构。该项目寻求量化与健康相关的结果 参加党代会的人，以及参加党代会的人在接受服务方面的差距。具体地说，我们将使用 调查数据旨在解决三个目标：1)评估延迟进入产前护理的时间是否更多 在以前参加过这次怀孕的CPC的人中常见，相对于非 与会者；2)评估CPCS提供的怀孕选择咨询是否因客户而异 控制客户怀孕后的人口统计数据(例如，种族/民族、婚姻状况和宗教) 在中共访问前的计划；以及3)评估医疗不信任的普遍性和模式 所有的产前患者和参加CPC的子组。为了达到这些目标，我们将 对400名新近进入产前护理的患者进行调查。样本将包括200名患有 在进入产前护理前参加了一次CPC，并与200名没有参加过产前护理的妇女进行了对照 在进入产前护理之前参加了一次CPC。我们将使用频率匹配进行注册(年龄和 种族/民族)，并在分析过程中与倾向分数相匹配，以减少偏见。此外，我们还将 对40名表示医疗不信任的参与者进行跟踪采访，以评估种族 医疗不信任的模式和类型的差异。在中共文学不断扩张的同时， 近年来，几乎没有关于CPC客户的量化数据发布。我们预计这个项目将取得成果。 孕妇参加CPC可能产生的后果的基本证据。

SUMMARY / ABSTRACT OF PARENT GRANT Crisis pregnancy centers (CPCs) are non-profit organizations with the mission of supporting pregnant people in not having an abortion. To this end, CPCs offer free services (e.g., urine pregnancy tests, non-diagnostic ultrasounds, and peer counseling on a limited range of pregnancy options) and the opportunity to earn infant- related material items by attending classes. Public funding increasingly plays an important role in CPC functioning. In Ohio, state funding of CPCs increased from $1 million to $7.5 million in 2019. Despite advertising the provision of health procedures and receiving state funding and endorsement, CPCs typically do not employ medical staff and are not licensed as medical facilities. Per a recent U.S. Supreme Court case, CPCs are not compelled to disclose that they are not medical facilities. Professional medical organizations warn of possible health risks of CPCs; however, to date, little research has been conducted on their possible effects. We conducted two preliminary studies in preparation for this project. First, in our population-based survey, we found that attending a CPC is common, with 14% of women 18-45 years of age in Ohio reporting ever CPC attendance. Attendance was more common among non-Hispanic Black people and those of low socioeconomic status. Second, by conducting in-depth interviews with CPC staff and clients, we found that clients often attend the CPC for pregnancy confirmation and some perceived the CPC to be a medical clinic that provides early pregnancy care. This project seeks to quantify health-related outcomes associated with attending a CPC and, among those attending a CPC, disparities in services received. Specifically, we will use survey data to address three aims: 1) To assess whether delayed entry into prenatal care is more common among people who had previously attended a CPC for the current pregnancy relative to non- attendees; 2) To assess whether the pregnancy options counseling provided at CPCs differs by client demographics (e.g., race/ethnicity, marital status, and religion) after controlling for client pregnancy plans before the CPC visit; and 3) To assess the prevalence and patterns of medical mistrust among prenatal patients overall and among the subset who attended a CPC. To address these aims, we will survey 400 patients who recently entered into prenatal care. The sample will include 200 women who had attended a CPC before entering into prenatal care and a comparison group of 200 women who had not attended a CPC before entering into prenatal care. We will use frequency matching for enrollment (age and race/ethnicity) and matching with propensity scores during the analysis to reduce bias. In addition, we will conduct follow-up interviews with 40 participants who express medical mistrust 4) To assess racial differences in the patterns and typology of medical mistrust. While CPC literature has been expanding in recent years, almost no quantitative data has been published on CPC clients. We expect this project will yield fundamental evidence on the possible consequences of CPC attendance among pregnant people.