Racialized & Structurally Urbanized Risk Environments for Pregnant/Postpartum Women who Use Drugs: a longitudinal qualitative study
种族化
基本信息
- 批准号:10639425
- 负责人:
- 金额:$ 69.93万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-07-01 至 2027-04-30
- 项目状态:未结题
- 来源:
- 关键词:AddressAreaBlack raceCessation of lifeCollaborationsCommunitiesComplexDataDeveloped CountriesDimensionsDiseaseDisparityDrug usageDrug userEconomicsEnvironmentEquityEtiologyFosteringFoundationsFrequenciesGeneral PopulationGenerationsHarm ReductionHealthHealth PromotionHealthcareIndividualInequityInterventionInvestigationJournalsLearningLegal InterventionLinkLongitudinal StudiesMaternal HealthMaternal MortalityMethodsModelingNeedle-Exchange ProgramsPathway interactionsPerceptionPharmaceutical PreparationsPoliciesPostpartum PeriodPostpartum WomenPregnancyPregnant WomenPublic HealthPublishingQualitative MethodsRaceReproductive HealthResearchResearch MethodologyResistanceResourcesReview CommitteeRiskRuralSamplingScientistShapesSocial statusSocioeconomic StatusTestingTimeUrbanicityUrbanizationVariantWalkingWomanaddictionamphetamine useblack womencohortconstructivismdesigneffective interventionepidemiology studyexperiencehazardinsightneglectnovelopioid use disorderoverdose deathpregnantprenatalpreventreproductiverural arearuralityscale upsocialtheoriestherapy development
项目摘要
Abstract: For women who use drugs (WWUD) in the US, the months they are pregnant and postpartum are
among the most hazardous of their lives: the US has the highest maternal mortality rate of all industrialized na-
tions, and up to 26% of maternal deaths in multiple states are attributed to drug use. Disparities are complex.
Though all-cause maternal mortality rates are higher for Black women, rates of drug-related maternal mortal-
ity are far higher among White women. Rural/urban inequities are stark and widening. Public health scientists
have largely neglected this crisis. Since 2010, just 1.6% of articles in major addiction journals have addressed
pregnancy or the postpartum period; a parallel silence exists in maternal health research. The proposed 4-
year longitudinal qualitative study is thus designed to help lay the foundations for a new arena of mul-
tilevel epidemiologic research and interventions to help Black, White, urban, and rural WWUD survive
while pregnant and postpartum. Four pillars of the Intersectional Risk Environment Model (IREM) guide this
novel inquiry: harm reduction, intersectional equity, intersectional risk environments, and resistance.
Harm reduction principles invite us to recognize that pregnant/postpartum WWUD have vital insights into the
drug and sexual/reproductive (SR) harms that drugs can create for them, and may have crafted effective prac-
tices to prevent these harms (e.g., altering drug use frequency). Intersectional equity insists that pregnant/
postpartum WWUD’s drug and SR health concerns and practices may vary along intersecting dimensions of
their social position (e.g., race and rurality/urbanicity). IREM suggests that features of WWUD’s social, eco-
nomic, physical, policy, and healthcare/criminal legal intervention risk environments create these variations,
and that these environments are racialized and structurally urbanized–i.e., resources have been dispropor-
tionately allocated to urban and/or majority White areas, and hazards to rural and/or majority Black areas.
IREM posits that hazards can be resisted via individual and collective action. Guided by IREM and Advisory
Boards of WWUD, we will use Constructivist Grounded Theory and Qualitative Longitudinal Research
methods to “walk alongside” a cohort of Black, White, urban, and rural WWUD living in 4 racialized and struc-
turally urbanized regions of Georgia while they are pregnant and postpartum, gathering 5 waves of data, to:
Aim 1. Explore pregnant WWUDs’ (a) drug- and SR-related health concerns and practices, and how they vary
across pregnancy and by race, rurality/urbanicity, and socioeconomic status (SES); and (b) perceptions of their
racialized and structurally urbanized risk environments, how they evolve during pregnancy, and how these
evolving environments shape WWUD’s concerns and practices. Aim 2. Analyze postpartum WWUD’s (a)
drug- and SR-related concerns and practices, and how they vary in the postpartum months by race, rurality/ur-
banicity, and SES; and (b) perceptions of their racialized and structurally urbanized risk environments, how
they evolve postpartum, and how these evolving environments shape WWUD’s concerns and practices.
摘要:对于美国吸毒女性(WWUD)来说,她们怀孕和产后的月份是
其中最危险的国家之一:美国是所有工业化国家中孕产妇死亡率最高的国家
且多个州高达 26% 的孕产妇死亡归因于药物使用,差异十分复杂。
尽管黑人妇女的全因孕产妇死亡率较高,但与毒品相关的孕产妇死亡率
农村/城市的不平等现象在白人女性中要高得多,而且公共卫生科学家的不平等现象还在不断扩大。
自 2010 年以来,主要的成瘾期刊中只有 1.6% 的文章讨论了这一危机。
怀孕或产后期;孕产妇健康研究中也存在类似的沉默。 4-
因此,年度纵向定性研究旨在帮助为多元研究的新领域奠定基础。
旨在帮助黑人、白人、城市和农村 WWUD 生存的流行病学研究和干预措施
跨部门风险环境模型 (IREM) 的四大支柱指导这一点。
新颖的探究:减少危害、交叉公平、交叉风险环境和抵抗力。
减少危害原则让我们认识到,孕期/产后 WWUD 对于以下问题有着重要的见解:
毒品和毒品可能对他们造成的性/生殖(SR)伤害,并且可能已经制定了有效的实践
防止这些伤害的措施(例如,改变药物使用频率)坚持认为怀孕/
产后 WWUD 的药物和 SR 健康问题和实践可能会因交叉维度而异
他们的社会地位(例如种族和乡村/城市)表明 WWUD 的社会、生态特征。
经济、物理、政策和医疗保健/刑事法律干预风险环境造成这些变化,
而且这些环境是种族化的和结构城市化的——即资源不成比例
分配给城市和/或大多数白人地区,以及对农村和/或大多数黑人地区的危害。
IREM 认为,在 IREM 和咨询的指导下,可以通过个人和集体行动来抵御危险。
WWUD 董事会,我们将使用建构主义扎根理论和定性纵向研究
方法来“并肩”生活在 4 个种族化和结构化的黑人、白人、城市和乡村的 WWUD 群体中
格鲁吉亚的城市化地区在怀孕和产后期间收集了 5 波数据,以便:
目标 1. 探索怀孕 WWUD 的 (a) 药物和 SR 相关健康问题和做法,以及它们如何变化
不同怀孕期、不同种族、农村/城市和社会经济地位 (SES);以及 (b) 对她们的看法;
种族化和结构性城市化的风险环境,它们在怀孕期间如何演变,以及这些风险环境如何
不断变化的环境塑造了 WWUD 的关注点和实践 目标 2. 分析产后 WWUD 的 (a)。
与毒品和 SR 相关的问题和做法,以及它们在产后几个月如何因种族、农村/地区而异
厌烦性和社会经济地位;以及 (b) 对种族化和结构性城市化风险环境的看法,如何
它们在产后发生演变,以及这些不断变化的环境如何影响 WWUD 的关注点和实践。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Hannah LF Cooper其他文献
CARE-SD: Classifier-based analysis for recognizing and eliminating stigmatizing and doubt marker labels in electronic health records: model development and validation
CARE-SD:基于分类器的分析,用于识别和消除电子健康记录中的污名化和可疑标记标签:模型开发和验证
- DOI:
- 发表时间:
2024 - 期刊:
- 影响因子:0
- 作者:
Drew Walker;Annie Thorne;Sudeshna Das;Jennifer Love;Hannah LF Cooper;Melvin Livingston;Abeed Sarker - 通讯作者:
Abeed Sarker
Hannah LF Cooper的其他文献
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{{ truncateString('Hannah LF Cooper', 18)}}的其他基金
OVAL: Overdoses Among Black pregnant/Postpartum People and Laws Governing Drug Use in Pregnancy: A Mixed-Methods Project to Support Mobilization
OVAL:黑人怀孕/产后人群用药过量和妊娠期吸毒法律:支持动员的混合方法项目
- 批准号:
10755459 - 财政年份:2023
- 资助金额:
$ 69.93万 - 项目类别:
Center to Advance Reproductive Justice and Behavioral Health among Black Pregnant/Postpartum Women and Birthing People (CORAL).
促进黑人孕妇/产后妇女和分娩者生殖正义和行为健康中心 (CORAL)。
- 批准号:
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Training in Advanced Data Analytics to End Drug-Related Harms (TADA)
消除毒品相关危害的高级数据分析培训 (TADA)
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10618208 - 财政年份:2020
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$ 69.93万 - 项目类别:
Training in Advanced Data Analytics to End Drug-Related Harms (TADA)
消除毒品相关危害的高级数据分析培训 (TADA)
- 批准号:
10399449 - 财政年份:2020
- 资助金额:
$ 69.93万 - 项目类别:
Developing the evidence base for overdose policies: a multilevel analysis of NHBS
开发过量政策的证据基础:NHBS 的多层次分析
- 批准号:
10357754 - 财政年份:2018
- 资助金额:
$ 69.93万 - 项目类别:
Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE)
肯塔基州社区和研究人员致力于制止阿片类药物的流行 (CARE2HOPE)
- 批准号:
10241254 - 财政年份:2017
- 资助金额:
$ 69.93万 - 项目类别:
Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE)
肯塔基州社区和研究人员致力于制止阿片类药物的流行 (CARE2HOPE)
- 批准号:
9760236 - 财政年份:2017
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$ 69.93万 - 项目类别:
Kentucky Communities & Researchers Engaging to Halt the Opioid Epidemic-CARE2HOPE
肯塔基州社区
- 批准号:
9709969 - 财政年份:2017
- 资助金额:
$ 69.93万 - 项目类别:
Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE)
肯塔基州社区和研究人员致力于制止阿片类药物的流行 (CARE2HOPE)
- 批准号:
10644787 - 财政年份:2017
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$ 69.93万 - 项目类别:
Novel methods for research on young rural opioid users at risk of HIV, HCV & OD
研究面临艾滋病毒、丙肝病毒风险的农村年轻阿片类药物使用者的新方法
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