RP1 _NBEC

RP1_NBEC

基本信息

批准号：
10749376
负责人：
Susan Perez
金额：
$ 59.19万
依托单位：
TULANE UNIVERSITY OF LOUISIANA
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：
2023-08-17 至 2030-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10749376
关键词：
Address Adoption American College of Obstetricians and Gynecologists Black race Caring Centers for Disease Control and Prevention (U.S.)Cessation of life Client satisfaction Clinical Conceptions Continuity of Patient Care Country Data Developed Countries Discrimination Disparate Disparity Educational Intervention Electronic Health Record Emotional Equity Ethnic Origin Evidence based intervention Goals Harm Reduction Health Personnel Healthcare Systems Hospitals Incidence Individual Inequity Institution Intervention Interview Link Maternal Health Maternal Mortality Maternal health equity Measures Minority Women Mothers Not Hispanic or Latino Outcome Patients Postpartum Period Provider Public Health Race Randomized, Controlled Trials Recommendation Recording of previous events Reporting Research Surveys Training Uncertainty United States Woman Work care systems clinically relevant community intervention community organizations community partnership comorbidity disparity reduction ethnic minority evidence base experience health assessment health care settings implementation intervention implicit bias improved maltreatment maternal outcome mortality multi-component intervention outcome disparities patient safety racial bias racial minority racism satisfaction

项目摘要

Clinical evidence of persistent, large, and increasing mortality gaps between Non-Hispanic Black and other women in the United States, along with patient surveys and personal stories leave no doubt that implicit bias and racism in the health care system contribute significantly to disparate maternal outcomes. Central to identifying the factors to reduce maternal mortality are interventions for healthcare providers and institutions to recognize the root causes of racism and bias. Our long-term goal is to make respectful care practices the standard across the care continuum—pre-conception to 1-year postpartum—to reduce disparities in maternal outcomes. The overall objective for this application, which is the next step toward attainment in our long-term goal, is to demonstrate a multifaceted, evidence-based intervention will reduce hospital disparities in maternal outcomes. Our central hypothesis is that hospitals that implement the multifaceted intervention of training, incorporating equity in all quality improvement efforts, and partnership building with community-based organizations will have better maternal health outcomes than hospitals who have implemented remote asynchronous implicit bias training alone. Our previous studies connect mistreatment, discrimination, and racism across the care continuum to physical and emotional harm to Black mothers. The rationale that underlies the proposed research is that reducing inequitable and disrespectful treatment is likely to offer strong scientific rationale for taking a multifaceted approach to equity work to reduce disparities. Our research strategy will be to conduct a multi-hospital cluster-randomized controlled trial within 9 Ochsner hospitals (~1900 staff and 14000 deliveries per year) to compare an interactive multifaceted intervention—implicit bias training, incorporating equity in all quality improvement, and community partnership building— to a remote asynchronous training alone intervention. Maternal health will be measured by a composite outcome matched to ACOG patient safety bundle recommendations, collected centrally through electronic health records, and patient satisfaction by Hospital Consumer Assessment of Healthcare Providers and Systems routinely collected data. This will enable us to achieve the following Aims: 1) Determine the effect of a multifaceted respectful maternity care intervention on hospital maternal outcome and patient satisfaction disparities; 2) Determine the effect of a multifaceted respectful maternity care intervention on provider bias; 3) Examine how a respectful maternity care and implicit bias intervention among impacts patient and hospital staff satisfaction. These results are expected to have an important positive impact because they will provide strong evidence- based proof of principle that, by bringing together existing approaches for addressing biased treatment and care, maternal outcome disparities are reduced.

非西班牙裔黑人和其他其他人之间持续，较大和增加死亡率差异的临床证据美国的妇女，以及患者调查和个人故事以及造成偏见的诺比特医疗保健系统中的种族主义极大地助长了孕产妇的核心确定减少孕产妇死亡率的因素也是医疗保健提供者和机构的干预措施认识到种族主义和偏见的根本原因。整个护理连续体的标准 - 产后1年的预期 - 以减少母体的差异结果。目标是展示多方面的基于证据的干预措施将减少孕产妇的医院差异结果。将权益纳入所有质量改进的范围，并与基于社区的合作关系建立组织将比实施遥远的医院拥有更好的孕产妇健康成果异步隐式偏见训练。种族主义在整个护理中，对黑人母亲的身体和情感伤害基础支撑研究是减少不平等和不尊重的待遇可能是强大的采用多方面的股权工作的科学原理来减少我们的研究策略将是在9 ochsnered Hosspitals中进行多医院聚类的对照试验（每年约有1900名员工和14000送货）比较互动式干预措施 - iplicit偏见培训，将平等纳入所有主要改进，以及社区伙伴关系建设 - 到遥远单独的异步培训干预。向ACOG患者安全捆绑包vundle建议，通过电子健康记录收集中央医院消费者对医疗保健提供者和系统常规评估的患者满意度收集数据。尊重的产妇护理干预措施的结果和满意度的满足感；确定多方面的尊敬的产妇护理对提供者偏见的影响； 3）检查如何尊敬的产妇护理和隐性偏见在Patitalcact上的干预会带来职职人员满意度。预计这些结果将产生重要的积极影响，因为它们将提供强有力的证据 - 基于原则的证明，通过将现有的属于偏见的治疗和护理，孕产妇的结果差异减少。