Healthcare-Seeking and Violence against American Indian and Alaska Native Women: Examining the Impact of the COVID-19 Pandemic

针对美洲印第安人和阿拉斯加原住民妇女的求医和暴力行为：审视 COVID-19 大流行的影响

• 批准号: 10559049
• 负责人: JULIET P LEE
• 金额: $ 23.19万
• 依托单位: PACIFIC INSTITUTE FOR RES AND EVALUATION
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-05 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10559049
• 关键词: Accident and Emergency department; Address; Administrative Supplement; Adopted; Alaska Native; American Indians; Arizona; Attention; Behavioral; COVID-19; COVID-19 impact; COVID-19 pandemic; COVID-19 pandemic effects; Characteristics; Code; Conditioned Reflex; Crime; Data; Data Set; Databases; Domestic Violence; Emotional; Ethnic Origin; Evaluation; Frequencies; Gender; Geography; Goals; Government; Health; Health Care Costs; Health Services; Health care facility; Healthcare; Hospitals; Improve Access; Indian reservation; Indigenous; Injury; Inpatients; Interview; Law Enforcement; Life Cycle Stages; Measures; Methods; Murder; Muslim religion; Outcome; Outpatients; Parents; Pathway interactions; Patients; Personal Satisfaction; Persons; Population; Prevention Research; Preventive care; Preventive service; Primary Health Care; Public Health; Race; Records; Reporting; Research; Research Institute; Research Methodology; Research Personnel; Resources; Risk; Risk Behaviors; Safety; Sampling; Senior Scientist; Services; Shelter facility; Social Work; System; Tribes; Universities; Variant; Violence; Washington; Well in self; Woman; Women' s Group; Women' s Health; Work; assault; care seeking; cost; evidence base; experience; gender-based violence; health care availability; health care service utilization; help-seeking behavior; hospital analysis; improved; interest; intimate partner violence; lens; parent grant; parent project; perpetrators; post-COVID-19; prevent; public policy on alcohol; residence; response; sexual assault; social; social health determinants; social structure; tribal Nation; tribal community; tribal health; tribal lands; tribal leader; violence against women; violence prevention; violence victimization

PROJECT SUMMARY/ABSTRACT In response to the Notice of Special Interest (NOT-OD-22-031) for “Research on the Health of Women of Understudied, Underrepresented, and Underreported (U3) Populations,” we propose to apply resources from our parent R01 project to examine rates of injurious violence from hospital discharge data for American Indian/Alaska Native (AIAN) women residing on and off American Indian reservations; assess these rates within the context of the COVID-19 pandemic conditions; and utilize results of interviews with key Tribal leaders to interpret results in ways that are valid and useful for Tribal policymakers. With mounting reports of Missing and Murdered Indigenous Women, there is a profound need to expand the capacity of research on gender-based violence to account for the contexts, risks, and services underlying intimate partner violence, domestic violence, and sexual assault. The parent project uses Healthcare Cost and Utilization Project (HCUP) data to perform geospatial analyses across multiple states that are collocated with American Indian reservations populated with at least 2,000 residents. The proposed supplement will investigate injuries associated with gender-based violence specifically for AIAN women whose agency and needs have been historically and continually understudied, underrepresented, and underreported in research. Guided by research that has demonstrated the utility of the HCUP to address intimate partner violence and domestic violence among other groups of women, this supplemental study aligns with the priorities established by the Office of Research on Women's Health regarding disparities related to violence against Indigenous women. We adopt a multi-methods and intersectional approach to achieve the following aims: AIM 1: Assess the type and frequency of hospital discharge records coded for violence, such as assault and battery committed by intimate partners and unknown assailants, for AIAN women residing on versus off Tribal jurisdictions collocated with Arizona by using HCUP data from 2006-2019 (preceding the COVID-19 pandemic). AIM 2: Compare these reports of care-seeking within the scope of the COVID-19 pandemic conditions using HCUP data from 2020. AIM 3: Identify how Tribal community conditions and Tribal services may inform our understanding of the violence-related reporting and impacts of the COVID-19 pandemic control measures using interview data from key leaders. In doing so, this supplemental research addresses the call for creating culturally and contextually relevant evidence that considers the landscape of geographic and structural factors to primary and preventative care and centers the lived experiences of AIAN women to meet group- and population-level needs.

项目概要/摘要 响应“妇女健康研究”特别关注通知 (NOT-OD-22-031) 研究不足、代表性不足和报告不足 (U3) 人群”，我们建议从 我们的母公司 R01 项目旨在根据美国人的出院数据检查伤害性暴力发生率 居住在美洲印第安人保留地内外的印第安/阿拉斯加原住民 (AIAN) 妇女评估这些比率； 在 COVID-19 大流行的背景下；并利用对主要部落的访谈结果 随着越来越多的报告的出现，领导人以对部落决策者有效且有用的方式解释结果。 失踪和被谋杀的土著妇女，迫切需要扩大有关失踪和被谋杀的土著妇女的研究能力 基于性别的暴力，以解释亲密伴侣暴力的背景、风险和服务， 父项目使用医疗保健成本和利用项目 (HCUP)。 用于在与美洲印第安人并置的多个州之间执行地理空间分析的数据 居住在至少 2,000 名居民的保留地 拟议的补充方案将调查受伤情况。 与基于性别的暴力有关，特别是针对 AIAN 妇女，她们的机构和需求已被 在研究的指导下，历史上一直没有得到充分研究、代表性不足和报道不足。 研究证明了 HCUP 在解决亲密伴侣暴力和家庭暴力方面的效用 鉴于其他妇女群体中的暴力行为，这项补充研究符合妇女署确定的优先事项 妇女健康研究办公室关于与暴力侵害土著妇女有关的差异问题。 我们采用多种方法和交叉方法来实现以下目标： 目标 1：评估类型 出院记录中包含暴力行为（例如殴打）的频率 居住在部落管辖区内外的 AIAN 妇女的亲密伴侣和未知袭击者 使用 2006 年至 2019 年（COVID-19 大流行之前）的 HCUP 数据与亚利桑那州进行比较：比较 这些在 COVID-19 大流行病范围内寻求护理的报告使用了 HCUP 数据 2020. 目标 3：确定部落社区条件和部落服务如何帮助我们理解 使用来自以下机构的访谈数据进行与暴力相关的报告以及 COVID-19 大流行控制措施的影响 在此过程中，这项补充研究提出了在文化和背景上进行创造的呼吁。 考虑地理和结构因素景观的相关证据 预防性护理并集中 AIAN 妇女的生活经历以满足群体和人口层面的要求 需要。