Health risks and disparities in services for pregnant individuals

孕妇的健康风险和服务差异

• 批准号: 10619659
• 负责人: Maria F Gallo
• 金额: $ 18.75万
• 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 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10619659
• 关键词: Address; Adoption; Adult; Advertising; Age; Black race; Caring; Child Rearing; Childbirth; Client; Clinic; Complex; Counseling; County; Data; Directories; Disparity; Ectopic Pregnancy; Emergency Situation; Enrollment; Ethnic Origin; Evaluation; Family Planning; Frequencies; Funding; Grant; Health; Health Services Accessibility; Hour; Individual; Infant; Intervention; Interview; Legitimacy; Licensing; Life; Literature; Marital Status; Marriage; Maternal and Child Health; Medicaid; Medical; Medical Staff; Mission; Nonprofit Organizations; Not Hispanic or Latino; Ohio; Outcome; Parents; Patient Care; Patients; Persons; Physicians; Planned Pregnancy; Play; Pregnancy; Pregnancy Tests; Prenatal care; Preparation; Procedures; Publishing; Qualitative Research; Race; Religion; Reporting; Research; Risk; Role; Sales; Sampling; Services; Shapes; Site; Source; State Government; Surveys; Time; Transportation; Unmarried; Urine; Visit; Woman; Work; abortion; care seeking; comparison group; court; demographics; early pregnancy; experience; improved; interest; low socioeconomic status; obstetric care; peer; population based; pregnant; prevent; programs; racial disparity; racism; reproductive; ultrasound

PROJECT SUMMARY 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 pregnant people 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 the functioning of CPCs. 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. According to 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 of adult, reproductive-age women in Ohio, we found that attending a CPC is common, with 14% of women reporting ever CPC attendance. Attendance was more common among those who reported being non-Hispanic Black and of low socioeconomic status. Second, in a study in which we conducted 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 two 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; and 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. To address the 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. While the literature on CPCs has been expanding in recent years, almost no quantitative data has been published on CPC clients. We expect the study will yield fundamental evidence on the possible consequences of CPC attendance among pregnant people.

项目摘要 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提供孕妇免费服务（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）和机会 通过上课来赚取与婴儿有关的物质项目。公共资金越来越多地在 CPC的功能。在俄亥俄州，CPC的州资金从2019年的100万美元增加到了750万美元。 尽管宣传了提供健康程序并获得国家资金和认可的宣传，但CPCS还是 通常不雇用医务人员，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。专业的 医疗组织警告CPC的健康风险；但是，迄今为止，几乎没有研究 进行了可能的影响。我们进行了两项初步研究，为该项目做准备。第一的， 在我们基于人群的成人，俄亥俄州的生殖年龄妇女的调查中，我们发现参加CPC是 常见，有14％的女性报告CPC出席。出勤率更为普遍 他报告是非西班牙裔黑人，社会经济地位低。第二，在我们的研究中 我们对CPC员工和客户进行了深入的访谈，我们发现客户经常参加CPC 怀孕确认，有些人认为CPC是提供早期怀孕的医疗诊所 关心。该项目旨在量化与参加CPC相关的健康相关结果， 参加CPC的人，服务的服务差异。具体来说，我们将使用调查数据来解决两个 目的：1）评估延迟进入产前护理的人是否更普遍 此前，相对于非参与者，当前妊娠的CPC参加了CPC； 2）评估 CPCS提供的怀孕选择咨询是否因客户的人口统计而有所不同（例如， 在控制CPC之前控制客户怀孕计划之后，种族/种族，婚姻状况和宗教） 访问。为了解决目标，我们将调查400名最近进入产前护理的患者。样本将 包括200名参加CPC的妇女，然后进入产前护理和比较组 在进入产前护理之前，有200名没有参加过CPC的妇女。我们将使用频率匹配 用于招生（年龄和种族/种族），并与分析过程中的倾向分数相匹配，以减少偏见。 尽管有关CPC的文献近年来一直在扩展，但几乎没有定量数据 发表在CPC客户端上。我们预计这项研究将产生有关可能后果的基本证据 孕妇的CPC出勤率。