It’s the Small Things: An Intersectional Approach to African American Women on Medicaid Receiving Prenatal Care

Na’Tasha M. Evans, Kamesha Spates, Danette Conklin, Yu-Lin Hsu
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Abstract

Background: When examining prenatal care utilization rates, African American women were more likely to receive inadequate prenatal care. Yet, research about African American women’s prenatal care experiences fails to account for how their experiences may vary by socioeconomic status and insurance type. Therefore, the purpose of this study was to provide African American women on Medicaid with the opportunity to speak to what they found to be meaningful during their interactions with their prenatal care provider using an intersectionality framework.Methods: Individual interviews were conducted with pregnant African American women (n = 20) receiving Medicaid who were in their second or third trimester of pregnancy. Participants aged 18 to 45 years were recruited from various health care systems located in Ohio. Researchers applied a thematic analysis approach during data collection and data analysis.Results: Two overarching themes emerged about what these African American women considered meaningful when they talked to their prenatal care provider during pregnancy: (1) conversations around my prenatal care and (2) equipping me with knowledge.Conclusion: The results obtained through the application of intersectionality theory allow researchers the opportunity to create effective solutions, interventions, and policies that can be implemented to improve infant health outcomes and reduce the risk of infant mortality among pregnant African American women receiving Medicaid. Implications also suggested that public health practitioners in Ohio should increase their awareness of what is important to this population to build patient's trust in provider recommendations and patient’s confidence in shared decision-making.
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小事一桩:对享受医疗补助的非裔美国妇女接受产前护理采取交叉方法
背景:在研究产前护理使用率时,非裔美国妇女更有可能接受不适当的产前护理。然而,有关非裔美国妇女产前护理经历的研究并未考虑到她们的经历会因社会经济地位和保险类型的不同而有所差异。因此,本研究的目的是为享受医疗补助的非裔美国妇女提供一个机会,让她们在与产前护理提供者的互动过程中,使用交叉性框架讲述她们认为有意义的事情:对接受医疗补助的非裔美国孕妇(n = 20)进行了个人访谈,这些孕妇正处于怀孕的第二个或第三个三个月。参与者年龄在 18 至 45 岁之间,来自俄亥俄州的多个医疗保健系统。研究人员在数据收集和数据分析过程中采用了主题分析方法:这些非裔美国妇女在怀孕期间与她们的产前保健提供者交谈时,认为有意义的话题有两个:(1)围绕我的产前保健进行的交谈;(2)用知识武装我:应用交叉性理论得出的结果使研究人员有机会制定有效的解决方案、干预措施和政策,以改善接受医疗补助的非裔美国孕妇的婴儿健康状况,降低婴儿死亡风险。研究的意义还表明,俄亥俄州的公共卫生从业人员应提高对这一人群重要性的认识,以建立患者对医疗服务提供者建议的信任和患者对共同决策的信心。
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