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

• 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
• 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

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.

项目概要 K01奖项的目的是支持研究培训并促进博士的职业发展。 丽贝卡·德拉菲尔德博士的长期职业目标是建立一个独立的研究项目。 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结果 (NHPI) 研究计划：美国孕产妇死亡率和发病率正在上升。夏威夷最近的一项研究 发现 NHPI 占孕产妇死亡人数的 44%，尽管它们只占该州的 25% 除了这项单一研究之外，NHPI 孕产妇死亡率基本上是不可见的。 NHPI 的孕产妇死亡率因其他主要研究的死亡而加剧。 常见的孕产妇健康结局，例如严重孕产妇发病率 (SMM)（例如子痫和 然而，一小部分研究表明 NHPI 社区在获取医疗服务方面面临障碍。 医疗保健系统并与医疗保健提供者合作，这可能会影响怀孕期间的护理。 妇女对于生育也可能有独特的文化观点，这可能会减轻或加剧这些问题。 为了全面解决 NHPI 中的孕产妇健康问题，需要进行研究以 1) 评估关键问题。 NHPI 的孕产妇结局 2) 更好地描述 NHPI 经历，以及 3) 确定与 产妇护理的流程和质量有两个研究目标：1) 比较 NHPI 女性的 SMM 率。 通过分析夏威夷、俄勒冈州和非西班牙裔白人女性的出院数据 华盛顿 2) 对 300 名 NHPI 女性进行调查，以评估患者与临床医生的关系和沟通因素 与高质量以人为本的护理、感知到的歧视和参与产前护理有关。 职业规划：该项目将为候选人提供科学领域所需的指导和培训 以及针对小群体的统计方法、社区参与的研究和健康传播 实现她的长期职业目标和短期目标是：完成严格的任务。 培训计划，以提高小群体健康研究和统计方法、调查分析、 和社区参与的研究组成的指导团队拥有多样化的技能和丰富的经验。 在 NHPI 健康、健康差异研究、流行病学、社区参与研究、健康等领域 沟通、孕产妇和生殖健康方面的培训目标将通过相关课程来实现， 指导研究培训、与社区合作伙伴的双向培训以及实践学习 植根于太平洋文化传统。完成这些目标将为候选人提供经验。 作为独立研究者竞争 R01 资金所需的初步数据以及进展 她未来的目标是开发和测试文化响应和社区参与的多层次干预措施 改善 NHPI 孕产妇和围产期健康。