超越故意性:在解释性混合方法研究中对产前护理障碍的潜在类分析
1Department of Political Science, Health Services Administration Program, Auburn University, Auburn, AL 36849, USA.
这项研究发现,虽然计划怀孕没有显著预测早期产前护理,但持续的系统和认知障碍阻碍了阿拉巴马州孕妇的准入. 需要多层次的战略来应对这些挑战.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 卫生社会学 卫生社会学
背景情况:
- 及时获得产前护理对母亲和婴儿健康结果至关重要.
- 了解产前护理的障碍对于开发有效的干预措施至关重要.
- 医疗保健准入障碍 (HCAB) 理论框架为研究这些复杂性提供了一个镜头.
研究的目的:
- 为了确定在阿拉巴马州孕妇的产前护理障碍的不同形状.
- 调查这些障碍特征是否调解或缓解怀孕意向与早期产前护理启动之间的关系.
- 为了全面理解,将定量发现与定性见解相结合.
主要方法:
- 一个解释性的混合方法设计,整合了来自阿拉巴马州怀孕风险评估监测系统 (PRAMS) (2016-2021) 和定性专家采访的定量数据.
- 隐性类分析 (LCA) 用于根据报告的障碍物识别子组.
- 多变量和Firth-penalized逻辑回归模型评估了关联和相互作用效应.
主要成果:
- 计划怀孕不是早期产前护理启动的统计学意义上的预测因素 (OR = 0.78,p = 0.286).
- 确定的障碍特征并没有显著调节或调解怀孕意向和早期产前护理之间的关系.
- 定性数据显示,持续存在的系统和认知障碍影响了及时访问.
结论:
- 尽管怀孕的意向缺乏统计学意义,但持续存在的障碍显著阻碍了早期产前护理的获得.
- 解决信息和后勤挑战的多层次战略是必要的.
- 进一步的研究应该探索影响寻求护理行为的额外途径.
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