scholarly journals Incarceration Exposure and Barriers to Prenatal Care in the United States: Findings from the Pregnancy Risk Assessment Monitoring System

2020 ◽  
Vol 17 (19) ◽  
pp. 7331 ◽  
Author(s):  
Alexander Testa ◽  
Dylan B. Jackson
Keyword(s):  
United States ◽  
Risk Assessment ◽  
Prenatal Care ◽  
Parental Care ◽  
Monitoring System ◽  
Negative Binomial ◽  
The United States ◽  
Pregnancy Risk ◽  
Logistic Regression Models ◽  
Specific Barriers

Previous research demonstrates that exposure to incarceration during pregnancy – either personally or vicariously through a partner – worsens parental care. However, little is known about the specific barriers to parental care that are associated with incarceration exposure. Using data from the Pregnancy Risk Assessment Monitoring System (years 2009–2016), the current study examines the relationship between exposure to incarceration during pregnancy and barriers to prenatal care in the United States. Negative binomial and logistic regression models were used to assess the association between the recent incarceration of a woman or her partner (i.e., incarceration that occurred in the 12 months prior to the focal birth) and several barriers to prenatal care. Findings indicate that exposure to incarceration, either personally or vicariously through a partner, increases the overall number of barriers to prenatal care and this association operates through several specific barriers including a lack of transportation to doctor’s appointments, having difficulty finding someone to take care of her children, being too busy, keeping pregnancy a secret, and a woman not knowing she was pregnant. Policies designed to help incarceration exposed women overcome these barriers can potentially yield benefits for enhancing access to parental care.

scholarly journals Use of open-text responses to recode categorical survey data on postpartum contraception use among women in the United States: A mixed-methods inquiry of Pregnancy Risk Assessment Monitoring System data

PLoS Medicine ◽  
2022 ◽  
Vol 19 (1) ◽  
pp. e1003878
Author(s):  
Nicole K. Richards ◽  
Christopher P. Morley ◽  
Martha A. Wojtowycz ◽  
Erin Bevec ◽  
Brooke A. Levandowski
Keyword(s):  
Risk Assessment ◽  
Monitoring System ◽  
Pregnancy Prevention ◽  
The United States ◽  
Pregnancy Risk ◽  
Postpartum Contraception ◽  
Response Options ◽  
Unintended Pregnancies ◽  
Survey Questions ◽  
Contraception Use

Background Postpartum contraception prevents unintended pregnancies and short interpregnancy intervals. The Pregnancy Risk Assessment Monitoring System (PRAMS) collects population-based data on postpartum contraception nonuse and reasons for not using postpartum contraception. In addition to quantitative questions, PRAMS collects open-text responses that are typically left unused by secondary quantitative analyses. However, abundant preexisting open-text data can serve as a resource for improving quantitative measurement accuracy and qualitatively uncovering unexpected responses. We used PRAMS survey questions to explore unprompted reasons for not using postpartum contraception and offer insight into the validity of categorical responses. Methods and findings We used 31,208 categorical 2012 PRAMS survey responses from postpartum women in the US to calculate original prevalences of postpartum contraception use and nonuse and reasons for contraception nonuse. A content analysis of open-text responses systematically recoded data to mitigate survey bias and ensure consistency, resulting in adjusted prevalence calculations and identification of other nonuse themes. Recoded contraception nonuse slightly differed from original reports (21.5% versus 19.4%). Both calculations showed that many respondents reporting nonuse may be at a low risk for pregnancy due to factors like tubal ligation or abstinence. Most frequent nonuse reasons were not wanting to use birth control (27.1%) and side effect concerns (25.0%). Other open-text responses showed common themes of infertility, and breastfeeding as contraception. Comparing quantitative and qualitative responses revealed contradicting information, suggesting respondent misinterpretation and confusion surrounding the term “pregnancy prevention.” Though this analysis may be limited by manual coding error and researcher biases, we avoided coding exhaustion via 1-hour coding periods and validated reliability through intercoder kappa scores. Conclusions In this study, we observed that respondents reporting contraception nonuse often described other methods of pregnancy prevention and contraception barriers that were not included in categorical response options. Open-text responses shed light on a more comprehensive list of pregnancy prevention methods and nonuse options. Our findings contribute to survey questions that can lead to more accurate depiction of postpartum contraceptive behavior. Additionally, future use of these qualitative methods may be used to improve other health behavior survey development and resulting data.

scholarly journals Correlates of Early Prenatal Care Access among U.S. Women: Data from the Pregnancy Risk Assessment Monitoring System (PRAMS)

2021 ◽  
Author(s):  
Rebecca A. Krukowski ◽  
Lisette T. Jacobson ◽  
Jemima John ◽  
Patricia Kinser ◽  
Kendra Campbell ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Prenatal Care ◽  
Monitoring System ◽  
Pregnancy Risk ◽  
Care Access

scholarly journals Travel Distance and Home Dialysis Rates in the United States

2014 ◽  
Vol 34 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Suma Prakash ◽  
Rick Coffin ◽  
Jesse Schold ◽  
Steven A. Lewis ◽  
Douglas Gunzler ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Travel Distance ◽  
Home Dialysis ◽  
Future Studies ◽  
Logistic Regression Models ◽  
Dialysis Facility ◽  
Dialysis Facilities ◽  
Specific Barriers ◽  
Travel Distances

IntroductionRural residence is associated with increased peritoneal dialysis (PD) utilization. The influence of travel distance on rates of home dialysis utilization has not been examined in the United States. The purpose of this study was to determine whether travel distances to the closest home and in-center hemodialysis (IHD) facilities are a barrier to home dialysis.MethodsThis was a retrospective cohort study of patients aged ≥ 18 years initiating dialysis between 2005 and 2011. Unadjusted PD and home hemodialysis (HHD) rates were compared by travel distances to both the closest home dialysis and closest IHD facilities. Adjusted PD and HHD utilization rates were examined using multivariable Logistic regression models.ResultsThere were 98,608 patients in the adjusted analyses. 55.5% of the dialysis facilities offered home dialysis. IHD, PD and HHD patients traveled median distances of 5.4,3.5 and 6.6 miles respectively to their initial dialysis facilities. Unadjusted analyses showed an increase in PD rates and decrease in HHD rates with increased travel distances. Adjusted odds of PD and HHD were 1.6 and 1.2 respectively for a ten mile increase in distance to the closest home dialysis facility, while for distances to the closest IHD facility the odds ratios for both PD and HHD were 0.7 (all p< 0.01).ConclusionsIn metropolitan areas, PD and HHD generally increased with increased travel distance to the closest home dialysis facility and decreased with greater distance to an IHD facility. Examination of travel distances to PD and HHD facilities separately may provide further insight on specific barriers to these modalities which can serve as targets for future studies examining expansion of home dialysis utilization.

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