Inequities in family engagement in the neonatal intensive care unit

家庭对NICU护理的参与促进了抱抱、皮肤对皮肤护理和母乳 喂养，可提高新生儿存活率和婴儿的长期发育。然而，有一些 在NICU就诊时，边缘化家庭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对婴儿的影响。 以及父母的差异和结果。在这个项目中，MK Quinn博士假设父母 NICU中来自边缘背景的儿童不太可能获得付费 探亲假，育儿，交通，可能会遇到语言障碍，而这 导致早产儿健康结局中的种族、民族和社会经济差异。 这一假设将有两个具体的目标。首先，要了解 Quinn博士的研究表明，家庭面临着在混合方法中照顾早产儿 将通过对有早产儿的低收入家庭的关键线人访谈来确定障碍 在NICU里。这一丰富的父母经验的定性数据将为发展 基于证据的理论，即是什么导致了家庭探访和接触的差异。这 之后将对NICU中有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 被边缘化群体所经历的。其次，奎恩博士将进行一项关于 对健康影响最突出的护理障碍是带薪探亲假。对于这一分析，她将 调查加州带薪探亲假政策的实施如何促成种族 早产儿护理和结局方面的社会经济差距。 这项研究的结果将为设计政策干预措施提供基础，以确保 家庭可以参与对早产儿的护理，最终减少不平等并改善 早产健康结局。这项研究的发起人是亨利·李博士，他是一位患有 在卫生服务研究方面的专业知识。共同发起人Jochen Proof博士是一名新生儿专家，患有 在新生儿不平等方面的专业知识。顾问团队包括玛雅·罗辛-斯莱特博士， 拥有家庭假政策专业知识的经济学家Suzan Carmichael博士，流行病学家 围产期健康不平等方面的专门知识，以及克里斯汀·莫顿博士，她是一位在以下方面有专长的社会学家 围产期质化研究。这项研究中的研究与她的训练计划将提供 奎恩博士奠定了研究新生儿健康不平等的基础，并为她的职业生涯做好了准备 以独立调查员的身份继续这项研究。

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.