Understanding Barriers to Reproductive Health Care among Women with Autism Spectrum Disorder (ASD)

了解患有自闭症谱系障碍 (ASD) 的女性的生殖保健障碍

基本信息

批准号：
10195839
负责人：
Jennifer Lisa Ames
金额：
$ 8万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-04-01 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10195839
关键词：
Address Adult Advocacy Age Anxiety Area Attention deficit hyperactivity disorder Back Behavior Behavioral Biological COVID-19 California Caring Case-Control Studies Cervical Cancer Screening Characteristics Child Complications of Diabetes Mellitus Computerized Medical Record Data Databases Development Developmental Disabilities Diagnosis Discipline of obstetrics Eating Disorders Emotions Epidemiology Epilepsy Ethnic Origin Etiology Face Feeling Frequencies Future Gestational Diabetes Gynecologic Gynecology Health Health Services Health Status Healthcare Hypersensitivity Improve Access Incidence Integrated Delivery of Health Care Integrated Health Care Systems Intellectual functioning disability Investigation Knowledge Literature Logistic Regressions Longevity Medical Menstruation Mental Depression Mental Health Mothers Outcome Outpatients Pain Patient Self-Report Patients Pharmaceutical Preparations Population Pre-Eclampsia Pregnancy Pregnancy Complications Pregnancy Histories Premature Birth Premature Labor Prenatal care Prevalence Preventive healthcare Procedures Provider Race Registries Regulation Reproductive Health Research Research Design Risk Sampling Sensory Services Sex Behavior Sexual Health Sexual abuse Social Change Surveys Sweden Symptoms System Telemedicine Ultrasonography United States Visit Woman Women&apos s Health Services autism spectrum disorder autistic care delivery delivery complications epidemiology study experience gender dysphoria health care delivery health care disparity health care service utilization health disparity high risk improved individuals with autism spectrum disorder male neurodevelopment obstetric care physical conditioning public health relevance screening screening guidelines sex sexually active social social communication sociodemographics

项目摘要

ABSTRACT Early evidence suggests that women with autism spectrum disorder (ASD) experience unique challenges around reproductive and sexual health. Exacerbating these problems, autistic women face health care disparities in accessing women’s health services. At Kaiser Permanente Northern California (KPNC), a large integrated healthcare system, we found that women with ASD utilize gynecological care and cervical cancer screenings at nearly half the rate of women with ADHD or typical neurodevelopment. Aim 1 examines which factors, including sociodemographic characteristics, medical and psychiatric conditions, and other types of healthcare utilization may contribute to autistic women underutilizing different types of gynecologic care. Aim 2 will examine the epidemiology of pregnancy in women with ASD and whether autistic women also experience gaps in obstetric care, an area that has been largely understudied. We will sample women with and without autism using a case-control study design. There are currently 2600 adult women in the KPNC autism registry with 350 pregnancies enumerated among them. This population is growing dramatically as the wave of children diagnosed with ASD reaches adulthood. We will examine differences in obstetrics/gynecology utilization, including frequency and counts of visits, procedures, and prescriptions, in the period of January 2016 to December 2020. We will examine pregnancy history extending back to 1995, the year KPNC’s outpatient databases were established. Using multivariate logistic regression, we will examine whether factors such as race/ethnicity, age at ASD diagnosis, and mental and physical health status are associated with utilization of gynecologic care among women with ASD compared with controls. We will also describe the epidemiology of pregnancy and obstetric care utilization, including ultrasounds and screenings for gestational diabetes, among autistic women compared to controls. Given the impact of COVID-19 on health care, we will conduct an analysis focused on care delivery in 2020 to explore how the shift to telemedicine may have be impacting OB/GYN care disparities between women with and without ASD. Study findings will inform the development of strategies to improve provider knowledge, care practices, and effective obstetrics/gynecology health care delivery for adult women with ASD.

抽象的早期证据表明，患有自闭症谱系障碍 (ASD) 的女性面临着独特的挑战自闭症妇女面临的医疗保健问题加剧了这些问题。在北加州凯撒医疗机构 (KPNC)，女性在获得医疗服务方面存在巨大差异。综合医疗保健系统，我们发现患有自闭症谱系障碍的女性利用妇科护理和宫颈癌目标 1 检查的注意力缺陷多动症或典型神经发育女性的筛查率接近一半。因素，包括社会人口特征、医疗和精神状况以及其他类型医疗保健的利用可能会导致自闭症女性未充分利用不同类型的妇科护理目标 2。将检查患有自闭症谱系障碍的女性怀孕的流行病学以及自闭症女性是否也会经历产科护理方面的差距，这一领域在很大程度上尚未得到充分研究，我们将对有或没有产科的妇女进行抽样调查。使用病例对照研究设计的自闭症目前 KPNC 自闭症登记处有 2600 名成年女性。其中有 350 名怀孕者，随着怀孕的浪潮，这一人口正在急剧增长。被诊断患有自闭症谱系障碍的儿童成年后，我们将检查妇产科的差异。一月份期间的使用情况，包括就诊、手术和处方的频率和次数 2016年至2020年12月。我们将检查追溯到1995年的怀孕史，即KPNC的那一年使用多元逻辑回归建立门诊数据库，我们将检查是否存在因素。例如种族/族裔、自闭症谱系障碍 (ASD) 诊断时的年龄以及精神和身体健康状况与我们还将描述自闭症谱系障碍 (ASD) 女性与对照组女性对妇科护理的利用情况。妊娠流行病学和产科护理利用，包括超声检查和妊娠筛查考虑到 COVID-19 对医疗保健的影响，我们将在自闭症女性中与对照组进行比较。对 2020 年的护理服务进行分析，探讨向远程医疗的转变可能会发生什么研究结果将影响患有自闭症谱系障碍 (ASD) 和非自闭症谱系障碍 (ASD) 的女性之间的妇产科护理差异。制定战略以提高提供者的知识、护理实践和有效的妇产科为患有 ASD 的成年女性提供医疗保健。