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，近一半的怀孕是意外怀孕，因为意外怀孕与产前护理不足、孕产妇心理健康状况不佳以及不良出生和幼儿期结局可能尤其相关，因此，大力预防意外怀孕对于优化妊娠结局至关重要。对于大约 11% 的美国育龄残疾妇女来说，这一问题尤为突出，她们更有可能社会经济地位较低、缺乏健康保险并遭受亲密伴侣暴力 (IPV)，所有这些因素都与然而，描述残疾妇女意外怀孕的发生率或相关性的研究极其有限，为了解决这一差距，我们的多学科团队与不同残疾妇女的社区咨询委员会一起提出了一项混合方法研究。实现以下具体目标： 1) 确定残疾妇女意外怀孕的风险和保护因素，并比较残疾妇女和非残疾妇女的这些因素 2) 检查接受生殖保健服务是否会调节或调节这种关联；介于残疾和意外怀孕；3）探讨经历过意外怀孕的不同残疾妇女的生殖保健经历和障碍，包括个人、人际关系和身体因素，以及妇女自身的干预发展优先事项。发布了 2011-13 年全国家庭成长调查 (NSFG) (N=5600) 的数据，这是第一项采用《平价医疗法案》规定的循证数据标准来定义残疾的人口调查。然后，我们将对残疾妇女样本（N = 50）进行定性访谈，这些样本是有目的地招募的，以最大限度地提高残疾类型（即种族/少数民族状况和城市/农村居住地）的多样性。研究结果将是第一个量化历史上经常经历医疗保健差异的妇女群体中意外怀孕的发生率以及意外怀孕的风险和保护因素。此外，对患有不同残疾的妇女进行定性访谈将探讨尚未完全捕获的其他因素。在NSFG，了解最佳生殖保健的最佳障碍（重要的是听力、视力、认知、活动能力），这项研究还将作为未来预防干预措施的开发和评估的基础，包括我们自己的团队计划提交的 R01 以支持开发。测试循证干预措施，以支持有效的孕前护理，防止意外怀孕，从而优化残疾育龄妇女的妊娠结局。