Risks and protective factors for unintended pregnancy in women with disabilities

残疾妇女意外怀孕的风险及保护因素

基本信息

批准号：
9111562
负责人：
JEANNE L ALHUSEN
金额：
$ 27.84万
依托单位：
UNIVERSITY OF VIRGINIA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-05-20 至 2018-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9111562
关键词：
Address Affordable Care Act Alcohol or Other Drugs use Birth Caring Child Cognition Cognitive Communities Complex Data Data Set Development Disabled Persons Discrimination Ensure Evaluation Evidence based intervention Exposure to Family Family Planning Female of child bearing age Foundations Future Goals Growth Health Health Insurance Health Personnel Health Planning Health Promotion Healthcare Healthy People 2020 Hearing Improve Access Incidence Income Infant Infant Mortality Interdisciplinary Study Intervention Interview Knowledge Life Link Low Birth Weight Infant Maternal and Child Health Mediating Mental Depression Mental Health Methods Mining Monitor National Institute of Child Health and Human Development Outcome Personal Satisfaction Planned Pregnancy Policies Preconception Care Pregnancy Pregnancy Outcome Premature Birth Prenatal care Prevalence Prevention Preventive Intervention Provider Recommendation Recruitment Activity Reproductive Health Research Research Personnel Risk Risk Factors Role Rural Sampling Stress Surveys Testing Transportation Underserved Population United States Violence Vision Wit Woman Women&apos s Group adverse pregnancy outcome aged design disability early childhood ethnic minority population evidence base experience health care service health disparity improved intimate partner violence low socioeconomic status maternal stress meetings member peripartum depression population based prevent public health relevance racial and ethnic residence therapy development unintended pregnancy working group

项目摘要

DESCRIPTION (provided by applicant) Nearly half of all pregnancies in the United States are unintended. Preventing unintended pregnancy is critical to optimize pregnancy outcomes as unintended pregnancy is strongly associated with inadequate prenatal care, poor maternal mental health, and adverse birth and early childhood outcomes. Unintended pregnancy may be particularly salient for the approximately 11% of U.S. women of childbearing age with disabilities, who are more likely to be of low socioeconomic status, to lack health insurance, and to experience intimate partner violence (IPV), all factors associated with unintended pregnancy. Yet research describing the incidence or correlates of unintended pregnancy among women with disabilities is extremely limited. To address this gap our multi-disciplinary team, together with a community advisory board of diverse women living with disabilities, proposes a mixed-methods study to meet the following specific aims: 1) To identify risk and protective factors for unintended pregnancy among women with disabilities and to compare these factors across women with and without disabilities; 2) To examine whether receipt of reproductive health care services moderates or mediates the association between disability and unintended pregnancy; and 3) to explore the experiences and barriers to reproductive health care of diverse women with disabilities who have experienced unintended pregnancy, including personal, interpersonal, and physical factors, as well as women's own priorities for intervention development. We will analyze recently released data from the 2011-13 National Survey for Family Growth (NSFG) (N=5600), the first population-based survey to employ evidence-based data standards set forth by the Affordable Care Act for defining disability. Quantitative findings will then inform qualitative interviews wit a sample of women with disabilities (N=50), recruited purposively to maximize diversity in terms of disability type (i.e., racial/ethnic minority status, and urban/rural residence. Study findings wil be the first to quantify the prevalence of unintended pregnancy, and risk and protective factors for unintended pregnancy, among a historically marginalized group of women who have frequently experienced disparities in health care. Further, qualitative interviews with women living with diverse disabilities will explore additional factors, not fully captured in the NSFG, to best understand barriers to optimal reproductive health care. Importantly, hearing, vision, cognition, mobility) this research will also serve as the foundation for the development and evaluation of future prevention interventions, including our own team's planned R01 submission to support development and testing of an evidence-based intervention to support effective preconception care, prevent unintended pregnancies, and thereby optimize pregnancy outcomes for women of childbearing age living with disability.

描述（由申请人提供）在美国，几乎一半的怀孕是意想不到的。防止意外怀孕对于优化怀孕结局至关重要，因为意外怀孕与产前不足，孕产妇心理健康和早期童年成果密切相关。对于大约11％的美国残疾人年龄妇女的妇女，意外怀孕可能尤其显着，这些妇女更有可能处于社会经济状况低，缺乏健康保险以及经历亲密伴侣暴力（IPV），这是所有与意外怀孕相关的因素。然而，描述残疾女性意外怀孕事件的研究或相关性非常有限。为了解决这一差距，我们的多学科团队以及一个残疾人妇女的社区顾问委员会，提出一项混合方法研究以满足以下内容。具体目的：1）确定残疾妇女意外怀孕的风险和受保护因素，并在残疾妇女中比较这些因素； 2）检查繁殖医疗服务的接收是适度的或调解残疾与意外怀孕之间的关联； 3）探索经历过意外怀孕的残疾人妇女生殖卫生保健的经验和障碍，包括个人，人际和身体因素，以及妇女自身在干预发展的重点。我们将分析最近发布的2011 - 13年全国家庭增长调查调查（NSFG）（N = 5600）的数据，这是《负担得起的CARE法案针对定义残疾》提出的第一次基于人群的调查。然后，定量发现将为定性访谈提供依据的妇女样本（n = 50），通常是为了在残疾人类型（即种族/族裔少数族裔状况和城市/农村住所）方面招募最大化多样性。研究结果将是第一个量化无视怀孕的妇女，并在量身定量的妇女中始终有一定的妇女，并且有一定的妇女因素，并且有一定的病态，并且有一定的疾病，是一群人的疾病，是一定有一定的疾病，是一定有一定的疾病。医疗保健的差异。预智护理，防止意外怀孕，从而优化患有残疾年龄的妇女的妊娠结局。