Assessing Native Hawaiian and Pacific Islander Maternal Outcomes and Health Care Experiences

评估夏威夷原住民和太平洋岛民的产妇结局和医疗保健体验

基本信息

批准号：
10644888
负责人：
Rebecca Delafield
金额：
$ 15.08万
依托单位：
UNIVERSITY OF HAWAII AT MANOA
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：
2023-07-21 至 2028-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10644888
关键词：
Address Advanced Development Area Asian Pacific Islander Biometry Birth Career Mobility Caring Cessation of life Communication Communities Competence Data Data Analyses Data Collection Data Pooling Data Set Databases Dedications Development Plans Eclampsia Epidemiology Ethnic Population Face Funding Future Goals Government Grant Hawaii Health Health Disparities Research Health Personnel Healthcare Healthcare Systems Hemorrhage Hospitals Inequity Inpatients Insurance Coverage Intervention Knowledge Language Learning Left Maternal Health Maternal Health Services Maternal Mortality Measures Mentored Research Scientist Development Award Mentors Methodology Morbidity - disease rate National Institute on Minority Health and Health Disparities Native Hawaiian or Other Pacific Islander Not Hispanic or Latino Oregon Outcome Pacific Islander Patients Pattern Population Postpartum Period Pregnancy Prenatal care Process Public Health Quality of Care Reproductive Health Research Research Methodology Research Personnel Research Project Grants Research Support Research Training Risk Factors Statistical Methods Stereotyping Subgroup Surveys Testing Training Training Programs Transportation United States National Institutes of Health Visit Washington Woman Work care outcomes career career development child bearing community engaged research community organizations comorbidity design disparity elimination ethnic minority experience hands-on learning health care availability health care settings health communication health disparity health inequalities improved maternal morbidity maternal outcome patient-clinician communication perceived discrimination perinatal health person centered population health programs racial disparity racial minority racial population severe maternal morbidity skills social culture

项目摘要

PROJECT SUMMARY The purpose of this K01 award is to support research training and advance the career development of Dr. Rebecca Delafield. Dr. Delafield’s long-term career goal is to establish an independent research program focused on improving maternal health and health care outcomes for Native Hawaiian and Pacific Islanders (NHPI). Research Plan: Maternal mortality and morbidity are increasing in the U.S. A recent study from Hawai‘i found that NHPI accounted for 44% of the maternal deaths, although they make up only 25% of the state population. Beyond this single study, NHPI maternal mortality is largely invisible. Federal agencies do not publish maternal mortality rates of NHPIs. This void is exacerbated by a dearth of research on other major and more common maternal health outcomes, such as severe maternal morbidity (SMM) (e.g., eclampsia and hemorrhage). Yet, a small body of research suggests NHPI communities face obstacles accessing the healthcare system and engaging with health care providers, which may compromise care in pregnancy. NHPI women may also have unique cultural perspectives on childbearing which could mitigate or exacerbate these challenges. To comprehensively address maternal health among NHPIs, research is needed to 1) assess critical maternal outcomes for NHPIs 2) better characterize NHPI experiences, and 3) identify key factors related the processes and quality of maternity care. There are two research aims: 1) Compare rates of SMM in NHPI women to non-Hispanic white women by analyzing hospital discharge data from facilities in Hawaiʻi, Oregon, and Washington. 2) Survey 300 NHPI women to assess patient-clinician relationship and communication factors associated with high-quality person-centered care, perceived discrimination, and engagement in prenatal care. Career Plan: This project will provide the candidate the mentoring and training needed in the areas of scientific and statistical methodologies for small populations, community-engaged research and health communication to achieve her long-term career goal and short-term objectives. The third (training) aim is: Complete a rigorous training program to advance skills in small population health research and statistical methods, survey analysis, and community-engaged research. The Mentoring Team assembled has diverse skills and extensive experience in the areas of NHPI health, health disparities research, epidemiology, community-engaged research, health communication, maternal and reproductive health. Training objectives will be met through relevant coursework, mentored research training, bi-directional training with community-based partners, and hands-on learning grounded in Pacific cultural traditions. The completion of these aims will provide the candidate the experience and preliminary data needed to compete for R01 funding as an independent investigator and progress toward her future goal of developing and testing a culturally-responsive and community-engaged multilevel intervention to improve NHPI maternal and perinatal health.

项目摘要该K01奖的目的是支持研究培训并推进博士的职业发展。丽贝卡·德拉菲尔德（Rebecca Delafield）。德拉菲尔德博士的长期职业目标是建立一个独立的研究计划专注于改善夏威夷原住民和太平洋岛民的孕产妇健康和医疗保健成果（NHPI）。研究计划：美国的孕产妇死亡率和发病率正在增加发现NHPI仅占孕产妇死亡的44％，尽管它们仅占州的25％人口。除了这项单一的研究之外，NHPI的遗产死亡率在很大程度上是看不见的。联邦机构不发布 NHPI的孕产妇死亡率。对其他主要的研究死亡以及更多的研究，这种空白加剧了常见的孕产妇健康结果，例如严重的孕产妇发病率（SMM）（例如Eclampsia和Eclampsia和出血）。然而，一小部分研究表明，NHPI社区面临障碍医疗保健系统并与医疗保健提供者互动，这可能会损害怀孕的护理。 NHPI 妇女也可能对生育有独特的文化观点，这可能减轻或加剧这些挑战。为了全面解决NHPI中的母校健康，需要研究1）评估至关重要 NHPI的母亲结果2）更好地表征NHPI体验，3）确定关键因素与产妇护理的过程和质量。有两个研究目的：1）比较NHPI妇女的SMM率通过分析俄勒冈州夏威夷设施的医院出院数据，向非西班牙裔白人妇女和华盛顿。 2）调查300名NHPI妇女评估患者 - 阵容的关系和沟通因素与高质量的以人为中心的护理，感知的歧视和参与产前护理有关。职业计划：该项目将为候选人提供科学领域所需的修改和培训以及针对小人群，社区参与研究和健康沟通的统计方法实现她的长期职业目标和短期目标。第三个（培训）目的是：完成严格的培训计划，以提高小人口健康研究和统计方法的技能，调查分析，和社区参与研究。集会的指导团队具有潜水技能和丰富的经验在NHPI健康，健康差异研究，流行病学，社区参与研究，健康方面沟通，母亲和生殖健康。培训对象将通过相关课程来满足鉴定研究培训，与社区合作伙伴的双向培训以及动手学习以太平洋文化传统为基础。这些目标的完成将为候选人提供体验以及作为独立研究者竞争R01资金所需的初步数据，并进步她未来的目标是开发和测试具有文化响应和社区参与的多层次干预改善NHPI母校和围产期健康。