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 未满足的性与生殖保健 (SRH) 需求是美国的一个重大问题， 经测试，它们与广泛的负面性和生殖健康结果有关。 了解与未满足的性健康和生殖健康需求相关的因素以及性健康和生殖健康需求不足的妇女的特征至关重要 最容易受到未满足的性健康和生殖健康需求的影响 现有研究在两个方面受到限制。 对未满足的性健康和生殖健康需求的认识常常因缺乏关于未接受护理的妇女的可用信息而受到限制， 其次，由于缺乏可靠的纵向数据，研究人员无法进行研究。 能够明确性健康和生殖健康经历（和未满足的需求）如何与女性的一生联系起来。 该项目的目标是阐明随着时间的推移未满足的性健康和生殖健康需求之间的联系，并 确定随着时间的推移与未满足的性健康和生殖健康需求水平相关的因素和差异。 将利用来自人对人 (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中新的对育龄妇女的深度访谈 样本 (N=40)，(2) P2P 样本 (N=1,462) 中女性的关联电子健康记录 (EHR)，以及 (3) 相关的 P2P 调查数据。 为了实现总体目标，拟议项目涉及两个具体目标 1：确定女性的目标。 对一生中未满足的性健康和生殖健康需求的看法以及导致这些需求未得到满足的条件 在参与者的电子病历指导下进行深度访谈，这些访谈将引出女性对其的叙述。 随着时间的推移，性与生殖健康方面的经验，并将其 EHR 中的性与生殖健康事件与他们的社会信息联系起来 情况以及每次经历与随后的性健康和生殖健康利用决策之间的联系。 此外，这些访谈将确定 EHR 目标中未满足的需求和利用情况。 2：使用序列分析对 SRH 使用随时间变化的模式进行分类，以比较 (2a) 因素和资源 与未满足的性健康和生殖健康需求以及 (2b) 性健康和生殖健康利用模式中的社会人口差异有关。 根据预防性和急性护理标准以及妇女账户评估每种模式中的要素 我将使用多项逻辑来评估未满足需求的水平（在目标 1 中收集）。 回归分析以检验 (a) 诱发因素和有利资源的衡量标准之间的关联 （医疗保健获取、种族主义、对医生的信任和社会支持），(b) 社会人口特征和 不同程度的性健康和生殖健康需求未得到满足的情况下的性健康和生殖健康利用模式 本研究的结果将产生有价值的结果。 可用于制定有针对性的干预措施的信息，以减少未满足的性健康和生殖健康需求，消除种族和 性健康和生殖健康利用方面的殖民差异，并改善性健康和生殖健康结果 妇女的生活。