Health risks and disparities in services for pregnant individuals

孕妇的健康风险和服务差异

基本信息

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
项目类别：
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

项目摘要

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.

项目概要危机怀孕中心 (CPC) 是非营利组织，其使命是为孕妇提供支持没有堕胎。为此，CPC 为孕妇提供免费服务（例如尿妊娠测试、非诊断性超声波检查，以及对有限范围的怀孕选择的同伴咨询）和机会通过参加课程来获得与婴儿相关的物品。公共资金在其中发挥着越来越重要的作用 CPC 的运作。在俄亥俄州，2019 年国家对 CPC 的资助从 100 万美元增加到 750 万美元。尽管宣传提供医疗程序并接受国家资助和认可，CPC 通常不雇用医务人员，也没有获得医疗机构许可。据美国最近的一份报告称根据最高法院的案例，CPC 不必披露其不是医疗机构。专业的医疗机构警告CPC可能存在的健康风险；然而，迄今为止，很少有研究对其可能产生的影响进行了研究。为了准备这个项目，我们进行了两项初步研究。第一的，在我们对俄亥俄州成年育龄妇女进行的人口调查中，我们发现参加 CPC 是很常见，14% 的女性表示曾经参加过 CPC。这些人的出席率更为普遍他们自称是非西班牙裔黑人，社会经济地位较低。其次，在一项研究中，我们我们对CPC员工和客户进行了深入访谈，我们发现客户经常参加CPC 怀孕确认，一些人认为 CPC 是一家提供早期怀孕服务的医疗诊所关心。该项目旨在量化与参加 CPC 相关的健康相关结果，其中那些参加 CPC 的人，所获得的服务存在差异。具体来说，我们将使用调查数据来解决两个问题目的： 1) 评估延迟进入产前护理在有过产前护理的人群中是否更常见与未参加者相比，之前参加过本次怀孕的 CPC； 2) 评估 CPC 提供的怀孕选择咨询是否因客户人口统计数据而异（例如，在 CPC 之前控制客户怀孕计划后的种族/民族、婚姻状况和宗教）访问。为了实现这些目标，我们将对 400 名最近接受产前护理的患者进行调查。样品将包括 200 名在进入产前护理前参加过 CPC 的妇女和对照组 200 名在进入产前护理前未参加过 CPC 的女性。我们将使用频率匹配用于登记（年龄和种族/民族）并在分析过程中与倾向得分进行匹配以减少偏差。尽管近年来有关 CPC 的文献不断增多，但几乎没有定量数据发布在 CPC 客户端上。我们预计这项研究将为可能的后果提供基本证据孕妇参加 CPC 的比例。