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首页> 外文期刊>BioResearch open access. >Improving Uptake and Adherence to 17-Hydroxyprogesterone Caproate in Non-Hispanic Black Women: A Mixed Methods Study of Potential Interventions from the Patient Perspective
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Improving Uptake and Adherence to 17-Hydroxyprogesterone Caproate in Non-Hispanic Black Women: A Mixed Methods Study of Potential Interventions from the Patient Perspective

机译：改善非西班牙裔黑人女性对癸酸17羟孕酮的摄取和依从性：从患者角度进行潜在干预的混合方法研究

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摘要

Women with a history of a preterm birth (PTB) are at high risk for recurrence. Weekly 17-hydroxyprogestrone caproate (17-P) injections can reduce the risk of recurrence in women with prior spontaneous PTB. PTB occurs disproportionately in non-Hispanic black (NHB) women, and uptake and adherence to 17-P among NHB women are lower compared to women in other racial/ethnic groups. Evidence-based interventions to improve 17-P uptake and adherence that incorporate women's perceptions and preferences are needed. Our objective was to identify women's perspectives and preferences for interventions to promote uptake of and adherence to 17-P, particularly among NHB women. We conducted an exploratory sequential mixed methods study using focus group discussions (FGDs), a survey, and in-depth interviews (IDIs). We recruited women with a history of PTB who self-identified as NHB for the FGDs and IDIs. Survey participation was open to any woman with a history of PTB regardless of their race and ethnicity. Women could only participate in one of the three data collection activities. Transcripts from the qualitative focus groups and in-depth interviews were analyzed using applied thematic analysis. Descriptive statistics was used to analyze the quantitative survey. Eighty-two women participated in the study (FGDs [ n =?7], surveys [ n =?60], and IDIs [ n =?15]). Suggested interventions were separated into two categories: (1) clinic-based interventions (i.e., interventions delivered during the clinical encounter) and (2) community-based interventions (i.e., interventions delivered outside of the clinical encounter). Clinic level interventions included improved clinic access and scheduling, same-day appointments, appointment reminders, making the clinic experience more comfortable for patients, and encouragement from providers. Interventions at the community level included increased 17-P awareness among support persons, employers, and community members and administration of 17-P outside the clinic setting. Our findings offer multiple potential interventions that could improve uptake of and adherence to 17-P for PTB prevention among NHB women. These proposed interventions have the potential to mitigate barriers to 17-P and narrow the disparity in PTB rates. Given the alarming and increasing rates of prematurity and PTB disparities, it is imperative to test, refine, and incorporate effective interventions into clinical practice. Our findings provide insights from patients that can help shape such interventions.
机译：有早产史（PTB）的女性复发风险很高。每周注射己酸17-羟孕酮（17-P）可以降低患有先前自发性PTB的女性复发的风险。在非西班牙裔黑人（NHB）妇女中，PTB的发病率不成比例，与其他种族/族裔妇女相比，NHB妇女的摄取和坚持17-P水平较低。需要采取循证干预措施，以提高妇女对17-P的摄取和依从性，纳入妇女的观念和偏好。我们的目标是确定妇女的观点和偏爱干预措施，以促进尤其是NHB妇女对17-P的吸收和遵守。我们使用焦点小组讨论（FGD），调查和深入访谈（IDI）进行了探索性顺序混合方法研究。我们招募了具有PTB病史的女性，她们在FGD和IDI中自称为NHB。任何有PTB历史的妇女，不论其种族和种族，都可以参加调查。妇女只能参加三项数据收集活动之一。使用应用主题分析对定性焦点小组的笔录和深入访谈进行了分析。描述性统计用于分析定量调查。八十二名妇女参加了这项研究（FGD [n =？7]，调查[n =？60]和IDI [n =？15]）。建议的干预措施分为两类：（1）基于临床的干预措施（即在临床相遇期间提供的干预措施）和（2）基于社区的干预措施（即在临床相遇之外进行的干预措施）。临床级别的干预措施包括改善门诊准入和安排，当日预约，预约提醒，使患者的诊所体验更舒适以及提供者的鼓励。社区一级的干预措施包括提高支持人员，雇主和社区成员的17-P意识，以及在诊所外进行17-P的管理。我们的发现提供了多种潜在的干预措施，可以改善NHB妇女对PTB预防的摄取和遵守17-P。这些拟议的干预措施有可能减轻17-P的障碍并缩小PTB率之间的差距。鉴于早产和PTB差异令人震惊且不断增加的比率，必须测试，完善并将有效的干预措施纳入临床实践。我们的发现提供了来自患者的见解，可以帮助制定此类干预措施。

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