Institute of Translational Health Sciences

转化健康科学研究所

• 批准号: 10731707
• 负责人: Mary L. Disis
• 金额: $ 16.81万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10731707
• 关键词: Administrator; Adolescent and Young Adult; American College of Obstetricians and Gynecologists; Area; Award; Birth; Bisexual; Caring; Childbirth; Clinic; Clinical; Clinical Research; Communities; Conscious; Continuity of Patient Care; Data; Development; Disparity population; Ensure; Equity; Focus Groups; Future; Goals; Grouping; Health; Healthcare; Healthcare Systems; Heterosexuality; Heterosexuals; Inequity; Institution; Interview; Justice; K-Series Research Career Programs; Knowledge; Left; Lesbian; Literature; Maternal Health; Maternal Health Services; Maternal Mortality; Maternal health equity; Medical; Medical Staff; Mental Health; Methods; Outcome; Perception; Perinatal; Perinatal Care; Population Intervention; Pregnancy; Pregnancy Rate; Prenatal care; Provider; Qualitative Methods; Recommendation; Reporting; Research; Resources; Role; Service delivery model; Shapes; Sterile coverings; Structure; Translational Research; Underrepresented Populations; United States; Woman; Work; adverse birth outcomes; care preference; care providers; care systems; child bearing; clinical care; clinical practice; community engagement; community organizations; ethnic identity; evidence base; expectation; experience; health care disparity; health disparity; health equity; health inequalities; improved; innovation; intervention delivery; lens; maternal morbidity; people of color; perceived discrimination; perinatal health; physical conditioning; preference; prevent; racial identity; racism; reproductive; sexual identity; sexual minority women; skills; translation factor; translational health science; women of color

I. Project Summary: A Qualitative Study of Bisexual Women of Color's Perinatal HealthCare Experiences Both women of color (WOC) and sexual minority women (SMW) experience striking inequities in maternal health and healthcare in the United States. Most notably, bisexual women have the highest rates of pregnancy among SMW, while childbearing rates in bisexual adolescents and young adults significantly exceed that of their heterosexual counterparts. However, maternal health research commonly aggregates bisexual women with lesbians and assumes heterosexuality among WOC, despite the distinctive health and healthcare disparities faced by bisexual WOC. These imprecise groupings at the intersection of maternal healthcare for WOC and SMW obscure the perinatal health needs of bisexual WOC within maternal health research and clinical practice. Adequate perinatal care is crucial for optimizing maternal and birth outcomes, yet no maternal health studies have examined the perinatal healthcare experiences of bisexual WOC. It is urgent to engage bisexual WOC in translational health research to understand their perinatal healthcare needs and identify gaps in care to develop effective maternal health interventions for this population. This application proposes to develop community-driven approaches to engaging bisexual WOC in translational health research. Using qualitative methods, the secondary goals of this proposed study are to: 1) improve the understanding of lived experiences with perinatal healthcare in bisexual WOC using an intersectional, reproductive justice lens, and 2) identify recommendations for improving perinatal care for bisexual WOC. A community steering committee (n=10), comprised of a majority of bisexual WOC, will regularly convene throughout the study to develop equitable and affirming strategies for engaging bisexual WOC in translational health research. Interviews will be conducted with bisexual WOC (n=31) to identify their preferences, needs, and experiences while they are seeking and utilizing perinatal care. Finally, three focus groups will be held with perinatal providers and medical staff, birth workers, and healthcare administrators (n=24) to characterize healthcare system perceptions and perspectives on perinatal care for bisexual WOC and identify recommendations for improving perinatal care practices. This study will address key knowledge gaps in our current understanding of bisexual WOC's perinatal encounters, following evidenced-based community engagement (CE) methods and through the innovative lens of reproductive justice. The new strategies developed for engaging bisexual WOC in research will be adaptable to other clinical areas, serving as a valuable resource for the wider scientific community. The proposed study is also expected to inform the future development of effective clinical interventions and care delivery models to improve maternal and birth outcomes for bisexual WOC and other historically disadvantaged populations in the long term, thus advancing maternal health equity for all. With the support of a two-year Diversity Supplement, the candidate will further develop her translational health research skills, preparing her to submit a K application based on the findings from this award to support her in attaining her long-term research goals.

一、项目概要：有色人种双性恋女性围产期保健的定性研究 经验 有色人种女性 (WOC) 和性少数女性 (SMW) 在孕产方面都经历着惊人的不平等 美国的健康和医疗保健。最值得注意的是，双性恋女性的怀孕率最高 法定最低工资者的生育率，而双性恋青少年和年轻人的生育率则显着超过 他们的异性恋伙伴。然而，孕产妇健康研究通常汇总双性恋女性 与女同性恋者在一起，并在 WOC 中假定异性恋，尽管其健康和医疗保健与众不同 双性恋 WOC 面临的差异。这些在孕产妇保健交叉点上的不精确分组 WOC 和 SMW 在孕产妇健康研究和研究中掩盖了双性恋 WOC 的围产期健康需求 临床实践。充分的围产期护理对于优化孕产妇和分娩结局至关重要，但孕产妇还没有 健康研究调查了双性恋 WOC 的围产期保健经历。迫切需要参与 双性恋 WOC 参与转化健康研究，以了解其围产期保健需求并找出差距 致力于为这一人群制定有效的孕产妇保健干预措施。本申请建议 制定社区驱动的方法，让双性恋 WOC 参与转化健康研究。使用 定性方法，本研究的次要目标是：1）提高对生活的理解 使用交叉、生殖正义视角对双性恋 WOC 进行围产期保健的经验，以及 2) 确定改善双性恋 WOC 围产期护理的建议。社区指导委员会 (n=10)，由大多数双性恋 WOC 组成，将在整个研究过程中定期召开会议，制定 让双性恋 WOC 参与转化健康研究的公平和肯定的策略。面试将 与双性恋 WOC（n=31）一起进行，以确定他们的偏好、需求和经历 寻求和利用围产期护理。最后，将与围产期提供者和医疗人员举行三个焦点小组会议 工作人员、助产士和医疗保健管理人员 (n=24) 来描述医疗保健系统的看法和 对双性恋 WOC 围产期护理的看法并确定改善围产期护理的建议 做法。这项研究将解决我们目前对双性恋 WOC 的理解中的关键知识差距 围产期遭遇，遵循基于证据的社区参与（CE）方法并通过 生殖正义的创新视角。为让双性恋 WOC 参与研究而制定的新策略 将适用于其他临床领域，为更广泛的科学界提供宝贵的资源。这 拟议的研究预计还将为有效临床干预和护理的未来发展提供信息 改善双性恋 WOC 和其他历史上的孕产妇和分娩结果的分娩模式 从长远来看，保护弱势群体，从而促进所有人的孕产妇健康公平。在一个 两年的多样性补充，候选人将进一步发展她的转化健康研究技能， 准备她根据该奖项的调查结果提交 K 申请，以支持她实现她的目标 长期研究目标。