Investigating the prevalence of medical mistrust amongst pregnant and perinatal women

调查孕妇和围产期妇女医疗不信任的患病率

• 批准号: 10622940
• 负责人: Maria F Gallo
• 金额: $ 3.73万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-09 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10622940
• 关键词: Address; Adoption; Adult; Advertising; Age; Age-Years; Black Populations; Black race; Caring; Child Rearing; Client; Clinic; Consent; Counseling; Data; Development; Enrollment; Ethnic Origin; Evaluation; Family Planning; Frequencies; Funding; Future; Health; Health Services Accessibility; Infant; Intervention; Interview; Legitimacy; Literature; Marital Status; Maternal and Child Health; Mediating; Medicaid; Medical; Medical Staff; Mission; Nonprofit Organizations; Not Hispanic or Latino; Ohio; Outcome; Parents; Participant; Patient Care; Patients; Pattern; Persons; Planned Pregnancy; Play; Population; Pregnancy; Pregnancy Tests; Pregnant Women; Prenatal care; Preparation; Prevalence; Procedures; Publishing; Qualitative Research; Race; Religion; Reporting; Reproductive Medicine; Research; Risk; Role; Sampling; Services; Site; Source; State Government; Surveys; Time; Transportation; Trust; Typology; Urine; Visit; Woman; abortion; base; comparison group; court; demographics; early pregnancy; experience; follow-up; health knowledge; improved; insight; interest; low socioeconomic status; parent grant; parent project; peer; perinatal women; population based; pregnant; prenatal; prevent; racial difference; racial diversity; racism; reproductive; sociodemographics; ultrasound

SUMMARY / ABSTRACT OF PARENT GRANT Crisis pregnancy centers (CPCs) are non-profit organizations with the mission of supporting pregnant people in not having an abortion. To this end, CPCs offer free services (e.g., urine pregnancy tests, non-diagnostic ultrasounds, and peer counseling on a limited range of pregnancy options) and the opportunity to earn infant- related material items by attending classes. Public funding increasingly plays an important role in CPC functioning. In Ohio, state funding of CPCs increased from $1 million to $7.5 million in 2019. Despite advertising the provision of health procedures and receiving state funding and endorsement, CPCs typically do not employ medical staff and are not licensed as medical facilities. Per a recent U.S. Supreme Court case, CPCs are not compelled to disclose that they are not medical facilities. Professional medical organizations warn of possible health risks of CPCs; however, to date, little research has been conducted on their possible effects. We conducted two preliminary studies in preparation for this project. First, in our population-based survey, we found that attending a CPC is common, with 14% of women 18-45 years of age in Ohio reporting ever CPC attendance. Attendance was more common among non-Hispanic Black people and those of low socioeconomic status. Second, by conducting in-depth interviews with CPC staff and clients, we found that clients often attend the CPC for pregnancy confirmation and some perceived the CPC to be a medical clinic that provides early pregnancy care. This project seeks to quantify health-related outcomes associated with attending a CPC and, among those attending a CPC, disparities in services received. Specifically, we will use survey data to address three aims: 1) To assess whether delayed entry into prenatal care is more common among people who had previously attended a CPC for the current pregnancy relative to non- attendees; 2) To assess whether the pregnancy options counseling provided at CPCs differs by client demographics (e.g., race/ethnicity, marital status, and religion) after controlling for client pregnancy plans before the CPC visit; and 3) To assess the prevalence and patterns of medical mistrust among prenatal patients overall and among the subset who attended a CPC. To address these aims, we will survey 400 patients who recently entered into prenatal care. The sample will include 200 women who had attended a CPC before entering into prenatal care and a comparison group of 200 women who had not attended a CPC before entering into prenatal care. We will use frequency matching for enrollment (age and race/ethnicity) and matching with propensity scores during the analysis to reduce bias. In addition, we will conduct follow-up interviews with 40 participants who express medical mistrust 4) To assess racial differences in the patterns and typology of medical mistrust. While CPC literature has been expanding in recent years, almost no quantitative data has been published on CPC clients. We expect this project will yield fundamental evidence on the possible consequences of CPC attendance among pregnant people.

父母赠款的摘要 /摘要 危机怀孕中心（CPC）是非营利组织，其使命是支持孕妇 没有流产。为此，CPC提供免费服务（例如尿液妊娠测试，非诊断 超声波和同行咨询以有限的怀孕选择）以及获得婴儿的机会 相关的材料项目通过上课。公共资金越来越多地在CPC中发挥重要作用 功能。在俄亥俄州，CPC的州资金从2019年的100万美元增加到750万美元。 宣传提供健康程序并获得国家资金和认可的宣传，CPC通常会做 不雇用医务人员，也没有被许可为医疗机构。根据最近的美国最高法院案件 CPC不得透露它们不是医疗设施。专业医疗组织 警告CPC的健康风险；但是，迄今为止，很少对他们的可能进行研究 效果。我们进行了两项初步研究，为该项目做准备。首先，在我们的人群中 调查，我们发现参加CPC很常见，俄亥俄州的18-45岁女性中有14％的妇女报告 CPC的出席率。出勤率在非西班牙裔黑人中更为常见 社会经济地位。第二，通过对CPC员工和客户进行深入的访谈，我们发现 客户经常参加CPC以进行怀孕确认，有些人认为CPC是医疗诊所 这提供了早期的怀孕护理。该项目旨在量化与健康相关的结果 参加CPC，在参加CPC的人中，所收到的服务差异。具体来说，我们将使用 解决三个目标的调查数据：1）评估延迟进入产前护理是否更多 在以前曾参加过CPC的当前怀孕相对于非 - 与会者； 2）评估CPC提供的怀孕期权咨询是否有所不同 控制客户怀孕后，人口统计学（例如种族/种族，婚姻状况和宗教） CPC访问之前的计划； 3）评估医疗不信任的患病率和模式 总体患者以及参加CPC的子集中的患者。为了解决这些目标，我们将 调查400例最近接受产前护理的患者。样本将包括200名女性 参加了CPC，然后才进入产前护理和由200名没有的比较组 在进入产前护理之前，参加了CPC。我们将使用频率匹配进行入学（年龄和年龄 种族/民族）并与分析过程中的倾向得分相匹配，以减少偏差。此外，我们将 对40名表达医疗信念的参与者进行后续访谈4）评估种族 医学不信任的模式和类型学的差异。 CPC文献一直在扩展 近年来，几乎没有关于CPC客户的定量数据。我们预计这个项目将产生 关于CPC出席孕妇的可能后果的基本证据。