Patterns in Women's Unmet Sexual and Reproductive Healthcare Needs Over the Life Course

女性一生中未满足的性和生殖保健需求的模式

• 批准号: 10677345
• 负责人: Elizabeth Marie Anderson
• 金额: $ 4.77万
• 依托单位: TRUSTEES OF INDIANA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-05 至 2026-06-04
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677345
• 关键词: Acute; Address; Age; Caring; Characteristics; Child; Classification; Clinical; Contraceptive Agents; Contraceptive methods; Data; Data Collection; Data Set; Development; Diagnosis; Disparity; Economics; Electronic Health Record; Elements; Emotional; Event; Female; Future; Guidelines; Health; Health Services Accessibility; Healthcare; Healthcare Systems; Household; Inequality; Intervention; Interview; Life Cycle Stages; Link; Logistic Regressions; Maternal and Child Health; Measures; Methods; Modeling; Outcome; Participant; Patient Recruitments; Pattern; Patterns of Care; Perception; Personal Satisfaction; Persons; Predisposing Factor; Preventive care; Probability; Probability Samples; Public Health; Public Policy; Recording of previous events; Reporting; Reproductive Health; Research; Research Personnel; Resources; Respondent; Risk; Sampling; Sequence Analysis; Sexual Health; Social Environment; Social support; Source; Specific qualifier value; Structure; Surveys; Time; Trust; Typology; United States; Woman; acute care; aged; demographic disparity; disparity elimination; experience; geographic disparity; health care availability; health care service utilization; health inequalities; improved; innovation; intergenerational; member; physical conditioning; predictive modeling; racial disparity; racism; recruit; reproductive; social; social disparities; sociodemographic disparity; sociodemographics; socioeconomic disparity; time use; transmission process

ABSTRACT Unmet sexual and reproductive healthcare (SRH) needs are a significant problem in the United States and are associated with a broad spectrum of negative sexual and reproductive health outcomes. Consequently, it is essential to understand the factors associated with unmet SRH needs and the characteristics of women who are most vulnerable to unmet SRH needs. Existing research has been limited in two ways. First, quantitative research on unmet SRH needs is often constrained by a lack of available information on women who do not receive care, by virtue of their absence from care. Second, the paucity of robust, longitudinal data has prohibited researchers’ ability to specify how SRH experiences (and unmet needs) are connected throughout women’s lives. The objective of this project is to elucidate the connection between unmet SRH needs over time and to identify the factors associated with and disparities in levels of unmet SRH needs over time. To do so, this project will leverage an innovative mixed-methods dataset from the Person to Person (P2P) Health Interview study, a large omnibus health study, including: (1) new in-depth interviews with reproductive-aged women in the P2P sample (N=40), (2) linked electronic health records (EHR) of women in the P2P sample (N=1,462), and (3) associated P2P survey data. To achieve the overall objective, the proposed project addresses two specific aims. Aim 1: Identify women’s perceptions of unmet SRH needs across their lives and the conditions that contribute to those unmet needs using in-depth interviews guided by participant’s EHR. These interviews will elicit women’s narratives of their experiences with SRH over time and contextualize SRH events in their EHR with information about their social circumstances and the connections between each experience and subsequent SRH utilization decisions. Furthermore, these interviews will identify instances of unmet need and utilization not included in the EHR. Aim 2: Classify patterns in SRH usage over time using sequence analysis to compare (2a) factors and resources associated with unmet SRH needs and (2b) sociodemographic disparities in patterns of SRH utilization. I will evaluate the elements in each pattern against standards of preventative and acute care and women’s accounts of their unmet needs (gathered in Aim 1) to assess the level of unmet need. I will use multinomial logistic regression to examine the association between (a) measures of predisposing factors and enabling resources (healthcare access, racism, trust in doctors, and social support), (b) sociodemographic characteristics and patterns of SRH utilization with differing levels of unmet SRH need. Results from this study will generate valuable information that can be used to develop targeted interventions to reduce unmet SRH needs, eliminate racial and socioeconomic disparities in SRH utilization, and improve sexual and reproductive health outcomes over women’s lives.

抽象的 未满足的性和生殖医疗保健（SRH）需求在美国和 与广泛的负面性和生殖健康结果有关。因此，是 了解与未满足的SRH需求以及女性特征相关的因素至关重要 最容易受到未满足的SRH需求。现有研究通过两种方式受到限制。首先，定量研究 根据未满足的SRH需求，通常会受到缺乏有关不接受护理的女性的可用信息的限制， 由于他们缺乏护理。其次，坚强的纵向数据的匮乏禁止研究人员的 能够在妇女的生活中指定SRH体验（以及未满足的需求）的联系。 该项目的目的是阐明未满足的SRH随着时间的时间和与 确定随着时间的流逝，未满足SRH需求水平的因素和差异。为此，这个项目 将利用从个人到人（P2P）健康访谈研究的创新混合方法数据集， 大型综合健康研究，包括：（1）P2P中对生殖老年妇女的新深度访谈 P2P样本中女性的样本（n = 40），（2）链接的电子健康记录（EHR）（n = 1,462）和（3） 相关的P2P调查数据。 为了实现总体目标，拟议的项目解决了两个具体目标。目标1：确定妇女 对未满足的SRH需求的看法以及导致未满足需求的条件 使用由参与者的EHR指导的深入访谈。这些访谈将引起妇女的叙述 随着时间的流逝，SRH的经验并将其在EHR中的SRH事件进行背景化，并提供有关其社会的信息 环境以及每种经验与随后的SRH利用决策之间的联系。 此外，这些访谈将确定EHR中未包含未满足需求和利用的实例。目的 2：使用序列分析对SRH使用的模式进行分类，以比较（2a）因素和资源 与未满足的SRH需求和（2B）SRH利用模式的社会人口统计学差异相关。我会 根据预防和急性护理和妇女帐户的标准评估每种模式中的元素 他们未满足的需求（聚集在目标1）以评估未满足需求的水平。我将使用多项式逻辑 回归以检查（a）易感性因素和启用资源之间的关联 （医疗保健访问，种族主义，对医生的信任和社会支持），（b）社会人口统计学特征和 SRH利用的模式，具有不同水平的未满足SRH需求的模式。这项研究的结果将产生价值 可用于制定有针对性干预措施的信息，以减少未满足的SRH需求，消除种族和 SRH利用中的社会经济分布，改善性和生殖健康结果 妇女的生活。