Use of Reproductive Health Care among Asian Immigrant Women

亚洲移民妇女对生殖保健的利用

• 批准号: 10700961
• 负责人: May Sudhinaraset
• 金额: $ 61.91万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10700961
• 关键词: Accounting; Address; Adolescence; Adult; Affect; Age; Asian; Asian Pacific American; Asian population; Birth; California; Categories; Childhood; Chinese; Cities; Communities; Country; Data; Discrimination; Economics; Ethnic Origin; Exclusion; Face; Family; Female; Filipino; Food; Fright; Goals; Health; Healthcare; Heterogeneity; Hispanic; Hispanic Populations; Immigrant; Immigration; Improve Access; Individual; Inequity; Intervention; Interview; Justice; Knowledge; Koreans; Latino Population; Legal; Life; Life Cycle Stages; Los Angeles; Mediating; Mediator; Methods; Modeling; New York; New York City; Policies; Politics; Population; Population Heterogeneity; Positioning Attribute; Recording of previous events; Reporting; Reproductive Health; Reproductive Health Services; Research; Resources; Respondent; Risk; Sampling; Services; Sexual Health; Stress; Students; Surveys; Texas; Time; Unsafe Sex; Variant; Voice; Woman; Work; aged; community building; community organizations; economic determinant; ethnic disparity; experience; health care availability; health data; health equity; health inequalities; high risk; improved; interest; life history; multidisciplinary; neglect; novel; outreach; peer; programs; protective factors; psychosocial; racial disparity; recruit; reproductive; social; social capital; social cohesion; social stigma; starfish sampling; statistics; trend; unintended pregnancy

Project Summary/Abstract There are over 20 million Asians in the US, 60% of whom are immigrants. By 2055, this demographic is expected to surpass Hispanics to become the largest immigrant group in the country. This includes 1.5 million undocumented Asians, who experience greater barriers to access than their documented peers. Despite these trends, national health statistics often lump Asians into an “other” category or exclude them entirely. For Asian immigrant women, who report greater odds of unintended pregnancies and are less likely to use sexual and reproductive health (SRH) care compared to their US-born counterparts, detailed SRH data accounting for their diversity of social, economic, and political experiences is critical to addressing SRH inequities in their growing community. Moreover, past studies treat immigration status as a binary (documented/undocumented) and static variable; however, there is increasing recognition that there is a hierarchy of statuses and that status can change across the life of an immigrant. Building on the PI’s past work with Asian immigrants, the goal of this study is to provide critical SRH data among the most diverse sample of Asian immigrant women to date. We propose to establish the first multi-city, sequential mixed-methods study of the SRH of Asian women across multiple ethnicities and immigration statuses, including naturalized citizens, lawful permanent residents, temporary workers and students, DACA recipients, and undocumented immigrants. Guided by the social ecological model and life course perspective, this study will assess multilevel factors that mediate and moderate associations between immigration status and SRH care use. We first conduct 48 qualitative life history interviews to examine how sociopolitical experiences of immigration statuses act as barriers to SRH care use over time (Aim 1). Next, using a novel starfish sampling method used to recruit hidden populations, we will recruit 2,000 Asian immigrant women aged 18-49 years, including an oversampling of the four largest undocumented Asian ethnicities (Indian, Chinese, Filipinos, and Koreans) in cities with the highest numbers of Asian immigrants (Los Angeles, New York City, Houston, and Atlanta). Using quantitative survey data, we will 1) examine how immigration status is associated with use of recent SRH services; 2) explore histories of immigration statuses and assess cumulative risks on SRH care use during sensitive periods (e.g. childhood, adolescence, adulthood) (Aim 2); 3) and examine mediators and moderators (Aim 3). In order to improve the quality, relevance, and accessibility of our research, we will partner with the National Asian Pacific American Women’s Forum (NAPAWF), the first national Asian reproductive justice organization, and its chapters located in each of our cities of interest. In addition, we will closely engage the knowledge, expertise, and sensitivities of local community-based organizations throughout California, New York, Texas, and Georgia. Our short-term goal is to identify and inform multi-level SRH outreach and intervention efforts, which will help us achieve our long-term goal to improve the SRH equity of immigrants, families, and communities.

项目概要/摘要 美国有超过 2000 万亚裔，其中 60% 是移民，到 2055 年，这一人口数量将达到 100 万。 预计将超过西班牙裔，成为该国最大的移民群体，其中包括 150 万。 尽管如此，无证亚洲人仍比有证同龄人面临更大的准入障碍。 根据趋势，国家健康统计数据经常将亚洲人归入“其他”类别或将其完全排除在外。 移民妇女报告意外怀孕的可能性更大，并且不太可能使用性和性行为 生殖健康 (SRH) 护理与美国出生的婴儿相比，详细的 SRH 数据说明 他们的社会、经济和政治经历的多样性对于解决他们所在地区的性健康和生殖健康不平等问题至关重要。 此外，过去的研究将移民身份视为二元（有证/无证）。 和静态变量；然而，人们越来越认识到存在层次结构并且状态 以 PI 过去与亚洲移民相关的工作为基础，其目标是能够改变移民的一生。 本研究旨在提供迄今为止最多样化的亚洲移民女性样本中的关键性健康和生殖健康数据。 我们提议建立第一个针对亚洲女性性健康和生殖健康的多城市连续混合方法研究 跨越多个种族和移民身份，包括入籍公民、合法永久居民、 临时工人和学生、DACA 受益者以及无证移民。 生态模型和生命历程的角度，本研究将评估调解和 移民身份与 SRH 护理使用之间的适度关联 我们首先进行 48 定性生活。 历史访谈，探讨移民身份的社会政治经历如何成为性健康和生殖健康的障碍 随着时间的推移护理使用（目标 1）接下来，使用一种新颖的海星采样方法来招募隐藏种群， 我们将招募 2,000 名年龄在 18 至 49 岁之间的亚洲移民女性，其中包括对四个最大的女性进行过抽样 人口最多城市中的无证亚洲族裔（印度人、中国人、菲律宾人和韩国人） 亚洲移民（洛杉矶、纽约、休斯顿和亚特兰大）我们将使用定量调查数据。 1) 检查移民身份与最近使用 SRH 服务的关系 2) 探索历史； 移民身份并评估敏感时期（例如童年、 青春期、成年期）（目标 2）；并检查中介者和调节者（目标 3）。 我们的研究的质量、相关性和可及性，我们将与全国亚太裔美国人协会合作 妇女论坛（NAPAWF）是亚洲第一个国家生殖正义组织，其分会位于 此外，我们将在每个感兴趣的城市密切利用知识、专业知识和敏感性。 我们的短期活动遍布加利福尼亚州、纽约州、德克萨斯州和佐治亚州的当地社区组织。 目标是确定并通报多层次的性健康和生殖健康外展和干预工作，这将帮助我们实现我们的目标 改善移民、家庭和社区的性健康和生殖健康公平性的长期目标。