“无人谈及此”：美国中西部农村地区女性的孕前健康与保健。
"Nobody talks about it": Preconception health and care among women in the rural, Midwestern United States.
机构信息
AmeriCorps VISTA, Ohio Public Health Association, Columbus, OH, USA.
Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.
出版信息
Womens Health (Lond). 2022 Jan-Dec;18:17455057221097563. doi: 10.1177/17455057221097563.
INTRODUCTION
Good preconception and interconception health are fundamental to optimizing women's health and reducing risk factors for adverse maternal-infant outcomes. Although rural women in the United States tend to experience health disparities, no published qualitative studies have focused on their preconception/interconception health. The purpose of this study was to determine what rural, Midwestern women perceive to be their most pressing health needs and effective ways to provide outreach and education regarding preconception/interconception health and care.
METHODS
Non-pregnant, reproductive-age women in Hardin County, Ohio, regardless of parity, were recruited through convenience sampling. Semi-structured interviews with four domains (beliefs and behaviors; perceived needs; knowledge and information sources; barriers to care) were conducted in May-June 2021 until saturation was reached. Qualitative methods were used to analyze data and determine themes. Binomial tests were used to compare selected demographic characteristics of participants to the county's reproductive-age residential female population.
RESULTS
Nineteen women aged 20-44 years were individually interviewed. Comparing race/ethnicity, education, and insurance status, participants appeared to be representative of the county population. Four themes were identified: (1) needs regarding healthcare and other resources; (2) lack of preconception/interconception care and perceived unimportance due to intergenerational knowledge transfer and paucity of healthcare providers; (3) difference in understanding of the term "women's health" and low health literacy; and (4) suggested interventions including education and outreach.
CONCLUSION
Interviews with rural Midwestern women revealed needs regarding preconception/interconception health and care and potential ways to raise awareness. These findings can inform strategies to improve rural women's health and birth outcomes.
简介
良好的孕前和孕期健康是优化女性健康和减少不良母婴结局风险因素的基础。尽管美国农村妇女往往存在健康差距，但没有发表的定性研究关注她们的孕前/孕期健康。本研究旨在确定农村、中西部妇女认为自己最紧迫的健康需求是什么，以及提供有关孕前/孕期健康和护理的外展和教育的最有效方法。
方法
在俄亥俄州哈丁县，通过便利抽样招募了非怀孕、育龄期妇女，无论其生育次数如何。在 2021 年 5 月至 6 月期间，通过四个领域（信念和行为；感知需求；知识和信息来源；护理障碍）进行半结构化访谈，直到达到饱和。使用定性方法分析数据并确定主题。使用二项式检验比较参与者的选定人口统计学特征与该县育龄期常住女性人口。
结果
对 19 名年龄在 20-44 岁的妇女进行了个体访谈。比较种族/民族、教育程度和保险状况后，参与者似乎代表了该县的人口。确定了四个主题：（1）医疗保健和其他资源需求；（2）缺乏孕前/孕期保健和由于代际知识转移和医疗服务提供者匮乏而认为不重要；（3）对“妇女健康”一词的理解差异和健康素养低；（4）建议的干预措施，包括教育和外展。
结论
对农村中西部妇女的访谈揭示了她们对孕前/孕期健康和护理的需求，以及提高认识的潜在方法。这些发现可以为改善农村妇女的健康和生育结局提供策略。
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