种族歧视与美国东南部以人为本的避孕护理

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2025-10-13 DOI:10.1016/j.contraception.2025.111070

AA Luke, A Newton-Levinson, S Narasimhan, MD Livingston, C Gary, S Parikh, JM Sales, SK Redd, WS Rice

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引用次数: 0

摘要

目的：我们评估了在计划生育护理中普遍的和基于刻板印象的种族歧视的终生经历与患者在最近的计划生育就诊中对以人为本的护理的看法之间的关系。方法在2024年8月至9月期间，年龄在18-44岁、居住在美国南部各州、在过去一年中可以怀孕并寻求计划生育服务的有色人种（n=339）完成了一项横断面调查。以病人为中心的护理是两分法测量的，使用Dehlendorf的四项量表，所有项目都被评为“优秀”。种族歧视的评估采用Bird-Bogart量表的七项版本，作为歧视类型的计数（0-7）和两个子量表（一般歧视和刻板印象歧视）进行检查。我们进行了描述性、双变量和多变量逻辑回归分析，调整了社会人口变量。结果71.7%的受访者表示在终身计划生育服务中存在至少一种歧视，24.8%的受访者表示在终身计划生育服务中存在以患者为中心的良好服务。当我们调整社会人口统计学因素时，每增加一种歧视类型，获得以人为中心的优质护理的几率就会降低33% （aOR=0.67; 95% CI, 0.58-0.77）。对歧视亚量表的分析显示，普通医疗保健（aOR=0.56; 95% CI, 0.46-0.67）和基于刻板印象的歧视（aOR=0.50; 95% CI, 0.36-0.69）与较低的以人为本的优质护理相关。结论在计划生育环境中，终生的种族歧视经历与最近一次计划生育就诊中报告优秀的以患者为中心的护理的几率显著降低相关。这些发现突出表明，需要采取结构性干预措施来解决计划生育护理中的种族主义问题。

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RACIAL DISCRIMINATION AND PERSON-CENTERED CONTRACEPTIVE CARE IN THE US SOUTHEAST

Objectives

We assessed how lifetime experiences of general and stereotype-based racial discrimination during family planning care relate to patient perceptions of person-centered care during their most recent family planning visit.

Methods

People of color aged 18-44 living in Southern states who can become pregnant and sought family planning services in the past year (n=339) completed a cross-sectional survey from August to September 2024. Patient-centered care was measured dichotomously, using Dehlendorf's four-item scale with “excellent” ratings on all items. Racial discrimination was assessed using a seven-item version of the Bird-Bogart scale, examined as a count of discrimination types (0-7) and as two subscales (general and stereotype discrimination). We conducted descriptive, bivariate, and multivariable logistic regression analyses adjusting for sociodemographic variables.

Results

Some 71.7% of respondents reported at least one type of discrimination during lifetime family planning care, while 24.8% of respondents reported excellent patient-centered care. Each additional discrimination type experienced was associated with 33% lower odds of excellent person-centered care (aOR=0.67; 95% CI, 0.58-0.77), when we adjusted for sociodemographics. Analysis of discrimination subscales revealed that both general healthcare (aOR=0.56; 95% CI, 0.46-0.67) and stereotype-based discrimination (aOR=0.50; 95% CI, 0.36-0.69) were associated with lower odds of excellent person-centered care.

Conclusions

Lifetime experience of racial discrimination in family planning settings is significantly associated with reduced odds of reporting excellent patient-centered care at the most recent family planning visit. These findings highlight the need for structural interventions to address racism within family planning care.

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.