Disparities in Perinatal Care and Outcomes among Black Women and Latinas with Physical Disabilities

身体残疾的黑人妇女和拉丁裔妇女围产期护理和结果的差异

基本信息

批准号：
10680584
负责人：
Willi HORNER-JOHNSON
金额：
$ 63.79万
依托单位：
BRANDEIS UNIVERSITY
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：
2021-09-21 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10680584
关键词：
1 year old Achievement Address Adverse event Affect Apgar Score Birth California Cesarean section Characteristics Data Development Disabled Persons Discipline of obstetrics Discrimination Disparity Emergency Situation Ethnic Origin Focus Groups Foundations Future Gestational Diabetes Goals Health Health Care Costs Healthcare Hospitals Infant Infant Health Inpatients Intervention Interview Knowledge Latina Latina Population Link Massachusetts Methods Monitor Mothers National Health Services Outcome Perinatal Perinatal Care Pre-Eclampsia Pregnancy Pregnancy Complications Pregnancy Outcome Premature Infant Prenatal care Provider Public Health Race Recommendation Reproductive Health Research Research Personnel Risk Risk Assessment Small for Gestational Age Infant Source System Testing Woman adverse birth outcomes adverse outcome adverse pregnancy outcome black women care costs care providers cohort cost disability ethnic minority experience health care disparity health care service utilization health data health service use improved improved outcome infant outcome marginalization maternal outcome obstetric care outcome disparities perinatal health physically handicapped poor health outcome post pregnancy postpartum care pregnancy health pregnancy hypertension pregnant prenatal racial minority social stigma

项目摘要

Project Summary/Abstract Women with physical disabilities experience stark disparities in pregnancy care, complications, and outcomes, compared to women without disabilities. Black women and Latinas also experience substantial disparities related to perinatal care and outcomes, compared to White women. Black women and Latinas with physical disabilities, thus, are presumably at heightened risk of adverse experiences and outcomes. Nonetheless, no known studies have investigated the intersection of disability and race/ethnicity in relation to perinatal care and disparities. Preliminary findings from the investigator team demonstrate that Black women and Latinas with physical disabilities are at substantial risk for adverse pregnancy outcomes. Efforts to improve their pregnancy care and experiences while reducing costs require a definitive assessment of these women’s pregnancy risks and outcomes. The overarching goal of this study is to use a mixed-methods approach to understand pregnancy experiences, maternal and infant outcomes, related healthcare costs, and unmet perinatal healthcare needs of Black women and Latinas with physical disabilities and their infants, and examine the intersecting impacts of disparities from two avenues of marginalization (race or ethnicity, and physical disability). The specific aims of this study are: 1) Compare perinatal care receipt, pregnancy-related complications, health outcomes, inpatient healthcare utilization and costs among cohorts of women based on race, ethnicity, and physical disability status, and determine if the combined effects of being a Black woman or Latina with physical disabilities are additive or multiplicative; 2) Use linked data from Georgia, California, and Massachusetts to examine first year health outcomes, healthcare utilization and costs for cohorts of women based on race, ethnicity, and physical disability and their infants (<1 year old), and determine if the combined effect of being a Black woman or Latina with physical disabilities is additive or multiplicative; and 3) Identify unmet needs and barriers to perinatal care for Black women and Latinas with physical disabilities through: (a) interviews with Black women and Latinas with physical disabilities who are currently pregnant or have recently given birth, and (b) focus groups with obstetric care providers. This study will lead to a first-ever systematic understanding of pregnancy and infant health outcomes and pregnancy care costs for Black women and Latinas with physical disabilities, thus establishing a foundation for development and testing of future interventions to improve outcomes. This study will fill a critical knowledge gap in understanding of the pregnancy-related experiences among Black women and Latinas with physical disabilities before, during and after pregnancy.

项目摘要/摘要身体残疾的妇女在怀孕，并发症和结局中经历明显的差异，与没有残疾的妇女相比。黑人妇女和拉丁裔也经历了很大的差距与白人妇女相比，与围产期护理和结果有关。黑人妇女和拉丁裔与身体因此，残疾大概是处于不利经历和结果的风险上。尽管如此，不已知的研究调查了残疾与种族/种族与围产期护理有关的交集差异。调查员团队的初步发现表明，黑人妇女和拉丁裔与身体疾病面临不良妊娠结局的重大风险。改善怀孕的努力降低成本的护理和经验需要对这些妇女怀孕风险进行明确评估和结果。这项研究的总体目标是使用混合方法来理解怀孕经历，母亲和婴儿的结果，相关的医疗保健费用以及未满足的围产期黑人妇女和拉丁裔的医疗保健需求及其婴儿，并检查从边缘化的两个途径（种族或种族和身体残疾）。这项研究的具体目的是：1）比较围产期护理收据，与妊娠有关并发症，健康结果，住院医疗保健利用以及基于妇女的同类成本种族，种族和身体残疾状况，并确定是黑人妇女还是具有物理疾病的拉丁裔是加性的或乘法的； 2）使用来自加利福尼亚佐治亚州的链接数据和马萨诸塞州检查一年级的健康成果，医疗保健利用和成本基于种族，种族和身体残疾及其婴儿（<1岁），并确定是否合并成为身体疾病的黑人妇女或拉丁裔的影响是加性的或倍增的。 3）识别未满足的需求和障碍对黑人妇女和有身体残疾的拉丁裔围产期护理：（a）对目前怀孕或最近已经怀孕的身体疾病的黑人妇女和拉丁裔的采访出生，以及（b）与产科护理提供者的焦点小组。这项研究将导致有史以来第一个系统的了解黑人妇女的怀孕和婴儿健康结果和怀孕护理费用具有身体障碍的拉丁裔，从而为未来的发展和测试建立了基础改善结果的干预措施。这项研究将填补了解对黑人妇女和拉丁裔与怀孕有关的经历之前，期间，期间和怀孕后。