Doctoral Dissertation Research: Navigating reproductive care in times of uncertainty

该奖项全部或部分由《2021年美国救援计划法案》（公法117-2）资助。众所周知，社会和经济不平等会对幸福感产生影响。然而，导致这种关系的途径仍然知之甚少。这个博士论文项目研究了不平等如何与个人属性相交，影响获得护理和生殖决策。它这样做的背景是，形成生殖保健的政策正在迅速变化，不仅影响到在特定时间内可获得的支助类型，而且影响到对这些变化的了解，以及获得知识和提供支助的渠道。利用这一背景提供了政策、生育保健和经济不平等理论的新综合，以更好地理解这些因素如何影响妇女的生育决定。这项研究支持博士生的训练。结果将广泛传播，包括传播给学术和非学术受众、生殖健康从业人员和参与卫生政策的组织。具体而言，该项目考察了各种利益相关者如何解释和驾驭影响生殖保健的不断变化的景观。它有三个主要目的：(1)描述社会和经济不平等与寻求生殖保健的妇女经历之间的联系；(2)政策如何塑造女性理解和选择护理方案的方式；(3)妇女的经历如何影响对与提供生殖保健相关的伦理维度的理解。为了实现这些目标，研究人员使用了一套混合方法，如参与者观察、政策和话语分析、半结构化访谈和生活史，这些方法都是在塑造生殖保健的政策迅速变化的背景下进行的。这些结果有助于科学地理解社会和经济不平等与医疗保健获取和政策之间的关系，以及为适应政策变化而产生的创新解决方案。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

This award is funded in whole or in part under the American Rescue Plan Act of 2021 (Public Law 117-2).Social and economic inequality are known to have impacts on well-being. Yet, the pathways leading to this relationship remain poorly understood. This doctoral dissertation project examines how inequality intersects with individual attributes to affect access to care and reproductive decision-making. It does so in a context in which policies shaping reproductive care are changing rapidly, affecting not only what types of support are available at a given time, but knowledge of these changes, and the channels through which knowledge is gained and support offered. Leveraging this context offers a new synthesis of theories of policy, reproductive care, and economic inequality to better understand how these factors shape women’s reproductive decisions. The research supports a doctoral student’s training. Results will be disseminated widely, including to academic and non-academic audiences, reproductive health practitioners, and organizations involved in health policy. Specifically, this project examines how a variety of stakeholders interpret and navigate the changing landscapes affecting reproductive care. It has three primary aims: (1) characterizing the association between social and economic inequality and the experiences of women seeking reproductive care; (2) how policies shape the ways that women understand and navigate care options; and (3) how women’s experiences affect understanding of the ethical dimensions associated with the provision of reproductive care. To achieve these aims, the investigators use a suite of mixed methods such as participant-observation, policy and discourse analysis, semi-structured interviews, and life histories in a context where policies shaping reproductive care are changing rapidly. The results contribute to scientific understandings about the relationships between social and economic inequality and healthcare access and policy, and innovative solutions that arise to adapt to policy changes.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.