Mixed Methods Study of Asian American Perinatal Healthcare Experiences and Health Outcomes - Project Summary The reproductive and perinatal (antepartum, intrapartum, and postpartum) health of Asian Americans (AAs), as a growing and increasingly heterogeneous population, is of critical research importance. Recent studies document significant differences in preterm birth, low-risk cesarean delivery, and low birthweight among AA women compared to other groups, as well as high rates of preeclampsia and gestational diabetes. AAs have higher risk of perinatal depression compared to non-Asian counterparts yet are 36% less likely to be screened for perinatal mental health. Integrative health (IH), which combines biomedicine with complementary health approaches, is commonly used in the United States, particularly among women. IH can improve healthcare quality, and health professional associations recognize the importance of IH for reproductive and perinatal health as well as the unique position of clinical providers in supporting holistic care for their patients. Yet little is known about when, how, and why AA women use IH for their perinatal health needs. Additionally, few studies utilize multi-level approaches to explore interpersonal, organizational, and societal predictors of AA perinatal health, including IH use. The goal of this F31 proposal is to gain experience, training, and mentorship in leading mixed methods research to examine AA perinatal and integrative health experiences and outcomes. Training goals and activities focus on developing expertise in AA women’s health across the life course, acquiring of substantive knowledge and experience conducting integrative health research, leading quantitative and mixed methods research, and solidifying scientific writing and dissemination skills. I will also join the BRAVE Study, the first national survey of AA women’s reproductive healthcare utilization. To achieve training goals, I will use a concurrent mixed methods design to analyze BRAVE survey data and conduct semi- structured interviews to execute two research training project specific aims. For Aim 1, I will characterize multi- level predictors (1a) and associations (1b) of IH use for AA reproductive and perinatal health. For Aim 1a, I will identify individual, interpersonal, organizational, and societal predictors of IH use among reproductive-aged AA women, For Aim 1b, I will examine the association between IH use and perinatal health outcomes. Concurrently, I will conduct semi-structured interviews to explore how AA women navigate biomedical care and IH throughout the perinatal period. (Aim 2). Quantitative and qualitative findings will be integrated and interpreted in partnership with the BRAVE Community Advisory Board (CAB), to yield robust explanations of results and illuminate linkages among multi-level factors, lived experiences, and perinatal health outcomes. A strong team of multidisciplinary health scientists, with expertise in AA women’s health research, perinatal and integrative health, and quantitative, qualitative, and mixed methods will provide close, individualized mentorship and guidance throughout this fellowship.
