Inequities in family engagement in the neonatal intensive care unit

新生儿重症监护病房中家庭参与的不平等

• 批准号: 10606766
• 负责人: Mary Quinn
• 金额: $ 6.95万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10606766
• 关键词: Address; Advisory Committees; Affect; Automobile Driving; Black race; Breast Feeding; Breastfed infant; California; Caring; Child; Child Care; Data; Development; Disparity; Ensure; Epidemiologist; Ethnic Origin; Exclusion; Face; Family; Family Leave; Foundations; Future; Goals; Health; Health Services Research; Hospitalization; Hospitals; Human Milk; Income; Inequity; Infant; Infant Care; Infant Development; Infant Health; Interruption; Intervention; Interview; Language; Latinx; Length of Stay; Mental Health; Methods; Modeling; Modification; Native Americans; Neonatal; Neonatal Intensive Care Units; Observational Study; Occupations; Outcome; Parents; Pattern; Perinatal; Policies; Population; Premature Infant; Prevalence; Qualitative Research; Race; Reduce health disparities; Reporting; Research; Research Personnel; Research Project Grants; Risk; Role; Series; Skin; Skin Care; Structure; Subgroup; Surveys; Time; Training; Transportation; Visit; barrier to care; career; cohort; design; disadvantaged background; evidence base; experience; extreme prematurity; falls; feeding; health inequalities; improved; infant outcome; informant; lower income families; marginalization; marginalized population; neonatal health; neonatal outcome; perinatal health; prevent; programs; racial disparity; social; socioeconomic disadvantage; socioeconomic disparity; sociologist; success; theories; therapy design; transportation access; trend

Families’ engagement in NICU care facilitates holding, skin-to-skin care, and human milk feeding, which improve neonatal survival and long-term infant development. However, there are many disproportionate structural barriers faced by marginalized families when visiting the NICU. Few studies have characterized these structural barriers and evaluated how they affect infant and parental disparities and outcomes. In this project, Dr. MK Quinn, hypothesizes that parents of children in the NICU from marginalized backgrounds are less likely to have access to paid family leave, childcare, transportation, and may encounter language barriers, and that this contributes racial, ethnic, and socioeconomic disparities in preterm infant health outcomes. This hypothesis will be addressed with two specific aims. First, to understand the barriers that families face to engaging in the care of their preterm infants in mixed methods study Dr. Quinn will identify barriers through key informant interviews of low-income families with preterm infants in the NICU. This rich qualitative data of parents’ experiences will inform the development of evidenced based theory of what is driving disparities in family visitation and engagement. This will be followed by a multicenter survey of parents with preterm infants in the NICU, in order to first understand the prevalence of these barriers and investigate how these barriers are experienced by marginalized groups. Second, Dr. Quinn will conduct an observational study of the health effects of the most salient barrier to care, paid family leave. For this analysis she will investigate how the implementation of California’s paid family leave policy contributed to racial and socioeconomic disparities in preterm infant care and outcomes. The results of this study will provide the groundwork for designing policy interventions to ensure families can engage in their preterm infant’s care, and ultimately, reduce inequities and improve preterm health outcomes. The sponsor for this research is Dr. Henry Lee, a neonatologist with expertise in health services research. The cosponsor, Dr. Jochen Profit, is a neonatologist with expertise in neonatal inequities. The advisory team includes Dr. Maya Rossin-Slater, an economist with expertise in family leave policy, Dr. Suzan Carmichael, an epidemiologist with expertise in perinatal health inequities, and Dr. Christine Morton, a sociologist with expertise in perinatal qualitative research. The research in this study in concert her training plan will provide Dr. Quinn a foundation in the study of neonatal health inequities and prepare her for a career continuing this research as an independent investigator.

家庭参与 NICU 护理有助于抱抱、肌肤接触护理和母乳 喂养可以提高新生儿的存活率和婴儿的长期发育。 边缘化家庭在就诊新生儿重症监护室时面临许多不成比例的结构性障碍。 很少有研究描述这些结构性障碍的特征并评估它们如何影响婴儿 在这个项目中，MK Quinn 博士是父母的英雄。 新生儿重症监护病房 (NICU) 中来自边缘化背景的儿童不太可能获得有偿医疗服务 探亲假、育儿、交通等都可能会遇到语言障碍，而这 造成早产儿健康结果的种族、民族和社会经济差异。 这一假设的解决有两个具体目标：首先，了解实现这一假设的障碍。 Quinn 博士的混合方法研究中，家庭面临着参与早产儿护理的问题 将通过对有早产儿的低收入家庭进行重要知情人士访谈来找出障碍 新生儿重症监护病房 (NICU) 中父母经验的丰富定性数据将为孩子的发展提供信息。 关于家庭探视和参与度差异的原因的基于证据的理论。 随后将对 NICU 中早产儿的父母进行多中心调查，以便 首先了解这些障碍的普遍程度并调查这些障碍是如何产生的 其次，奎因博士将对边缘群体进行观察性研究。 对于健康影响最显着的障碍是带薪探亲假，她将对此进行分析。 调查加州带薪家庭假政策的实施如何促进种族歧视 以及早产儿护理和结果方面的社会经济差异。 本研究的结果将为设计政策干预措施提供基础，以确保 家庭可以参与早产儿的护理，最终减少不平等并改善 这项研究的发起人是新生儿学家亨利·李 (Henry Lee) 博士。 共同发起人 Jochen Profit 博士是一位新生儿学家，拥有 该咨询团队包括 Maya Rossin-Slater 博士，她是一位新生儿不平等问题专家。 苏珊·卡迈克尔 (Suzan Carmichael) 博士是一位在家庭休假政策方面具有专业知识的经济学家，她是一位流行病学家， 克里斯汀·莫顿 (Christine Morton) 博士是一位在围产期健康不平等方面拥有专业知识的社会学家， 围产期定性研究将与她的培训计划相结合。 奎因博士为新生儿健康不平等研究奠定了基础，并为她的职业生涯做好准备 作为独立调查员继续这项研究。