The issue of racial and ethnic health disparities is a broad and difficult challenge that quickly overwhelms traditional approaches. We propose a program of work that conducts a true interdisciplinary evaluation of health disparities leading to new and integrated strategic approaches. Our interdisciplinary research team will study and develop likely approaches to reduce one of the most stubborn and persistent health disparities in the nation, racial disparities in the outcome of pregnancy, from three important dimensions--Leaders, Providers and Patients. This research proposal has three overarching goals: 1) to develop an optimal infrastructure to support interdisciplinary research on persistent disparities in pregnancy outcomes; 2) using an interdisciplinary approach, develop testable hypotheses for new and more effective approaches to augmented prenatal care as a strategy for improving pregnancy outcome; and 3) to provide an effective mechanism for communicating research-based information to leaders, providers, and patients to improve access to and the quality and effectiveness of augmented prenatal care for African American women. We have chosen three complementary areas of focus, each with specific aims, for this interdisciplinary exploratory proposal. The Leader's Perspective: Assess the role strategic leadership and change agents in closing the gap of prenatal disparities. The Provider's Perspective: Evaluate health care disparities by reviewing microsystem barriers and opportunities to delivering augmented prenatal care. The Patient's Perspective: Evaluate and develop strategies to reduce barriers for pregnant women to seek out and obtain augmented prenatal care. We believe the study of these three different, yet complementary, areas will provide unique opportunities to reduce disparities in pregnancy outcome. This work will serve as a hypothesis generating vehicle to develop future interdisciplinary research protocols and programs. This work will serve as planning activity for the investigators to develop interdisciplinary research strategies to limit health disparities and improve neonatal and maternal care. Scholars representing 17 different, yet collaborative, schools, colleges, centers, institutes and departments will create a unique foundation to develop knowledge leading to more effective approaches. While our investigators are experts in their respective disciplines, the interdisciplinary hypothesis generation approach will allow the investigators to develop integrated and multi-dimensional proposals that will be unique, more likely to be effective, and have a greater impact than a standard single discipline approach.

Agency
National Institute of Health (NIH)
Institute
National Center for Research Resources (NCRR)
Type
Exploratory Grants (P20)
Project #
5P20RR020682-02
Application #
7171429
Study Section
Special Emphasis Panel (ZRR1-BT-8 (01))
Project Start
2005-08-01
Project End
2006-07-31
Budget Start
2005-08-01
Budget End
2006-07-31
Support Year
2
Fiscal Year
2005
Total Cost
$541,094
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Lori, Jody R; Yi, Chin Hwa; Martyn, Kristy K (2011) Provider characteristics desired by African American women in prenatal care. J Transcult Nurs 22:71-6
Debbink, Michelle Precourt; Bader, Michael D M (2011) Racial residential segregation and low birth weight in Michigan's metropolitan areas. Am J Public Health 101:1714-20
Gatny, Heather H; Axinn, William G (2011) Willingness to Participate in Research during Pregnancy: Race, Experience, and Motivation. Field methods 24:135-154
Ranjit, N; Siefert, K; Padmanabhan, V (2010) Bisphenol-A and disparities in birth outcomes: a review and directions for future research. J Perinatol 30:2-9
Xu, Xiao; Siefert, Kristine A; Jacobson, Peter D et al. (2009) Malpractice burden, rural location, and discontinuation of obstetric care: a study of obstetric providers in Michigan. J Rural Health 25:33-42
Xu, Xiao; Grigorescu, Violanda; Siefert, Kristine A et al. (2009) Cost of racial disparity in preterm birth: evidence from Michigan. J Health Care Poor Underserved 20:729-47
Xu, Xiao; Siefert, Kristine A; Jacobson, Peter D et al. (2008) The impact of malpractice burden on Michigan obstetrician-gynecologists'career satisfaction. Womens Health Issues 18:229-37
Vahratian, Anjel; Patel, Divya A; Wolff, Kristen et al. (2008) College students'perceptions of emergency contraception provision. J Womens Health (Larchmt) 17:103-11
Xu, Xiao; Lori, Jody R; Siefert, Kristine A et al. (2008) Malpractice liability burden in midwifery: a survey of Michigan certified nurse-midwives. J Midwifery Womens Health 53:19-27
Xu, Xiao; Siefert, Kristine A; Jacobson, Peter D et al. (2008) The effects of medical liability on obstetric care supply in Michigan. Am J Obstet Gynecol 198:205.e1-9

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