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Improving service delivery models of medically assisted reproduction: A patient journey mapping study of sexual minority women couples’ experience of medicalized family formation

Award Number: R01MD015256
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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PROJECT SUMMARY/ABSTRACT The parent R01 grant has quantified numerous obstetrical and perinatal health disparities among sex- ual minority women (SMW; e.g., those with same-sex attractions, same-sex behavior, and/or lesbian/gay/bi- sexual identity) and their offspring compared to their heterosexual counterparts using data from unique, pro- spective, intergenerational cohorts—the Nurses' Health Studies and Growing Up Today Study. Documented disparities include adverse perinatal mental health—a known contributor to adverse obstetrical and perinatal outcomes. Yet, due to small sample sizes and other methodological limitations, little is known about the mech- anisms that drive SMW's perinatal mental health inequities and how this may influence subsequent health in- equities. When forming biological and/or genetic families, many SMW in same-sex couples require specialized fertility services due to a lack of sperm within their relationship. However, negative and discriminating experi- ences, lack of provider knowledge, and barriers to accessing care are common experiences among SMW fertil- ity patients. Additionally, undergoing fertility care can be emotionally and financially distressing, and SMW are more likely to have a history of mental illness—a risk factor for perinatal mental illness. Given these considera- tions, it is prudent to understand SMW's preconception mental health and if the role of structural antecedents to the perinatal period (e.g., fertility care experiences) may uniquely influence SMW's adverse perinatal mental health. Consequently, this research will help identify whether promoting positive patient experiences and men- tal health during fertility care may serve as a critical intervention point for this population. To address these gaps, the proposed aims of this community-placed, mixed methods study are to 1) elucidate the patient experi- ence of fertility care among SMW and their partners in same-sex couples and 2) develop best practices for in- clusive family formation data collection in the Nurses' Health Studies and Growing Up Today Study. We will achieve these aims by conducting online semi-structured interviews, quantitative assessments of mental health and patient experiences, and family formation timelines—an established graphical elicitation method that pro- motes the report of temporal narratives through the co-creation of research data. This project will produce the first investigation of the patient experience of fertility care among SMW across the U.S. It will also be among the first best practices developed for accurately collecting inclusive family formation data in large population- based surveys. This work will have a positive impact on the field of SMW's perinatal health by identifying po- tential mechanisms of adverse preconception mental health and, subsequently, adverse perinatal and obstetri- cal outcomes. Additionally, this work will reconceptualize how fertility research is conducted to accurately char- acterize and measure health-related inequities among diverse families and enable subsequent R01 proposals from our team and others to advance the science of perinatal health inequities among minoritized populations.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $902,426 )
2024	2024	HARVARD PILGRIM HEALTH CARE INC	1 WELLNESS WAY	CANTON	MA	02021	NORFOLK	USA	Minority Health and Health Disparities Research	000	5	2/2/2024	NON-COMPETING CONTINUATION	$722,186
2024	2024	HARVARD PILGRIM HEALTH CARE INC	1 WELLNESS WAY	CANTON	MA	02021	NORFOLK	USA	Minority Health and Health Disparities Research	002	5	9/3/2024	SUPPLEMENT FOR EXPANSION	$99,998
2024	2024	HARVARD PILGRIM HEALTH CARE INC	1 WELLNESS WAY	CANTON	MA	02021	NORFOLK	USA	Minority Health and Health Disparities Research	001	5	5/29/2024	NON-COMPETING CONTINUATION	$80,242
														Subtotal = $902,426

Issue Date FY: 2023 ( Subtotal = $964,652 )
2023	2023	HARVARD PILGRIM HEALTH CARE INC	1 WELLNESS WAY	CANTON	MA	02021	NORFOLK	USA	Minority Health and Health Disparities Research	000	4	2/25/2023	NON-COMPETING CONTINUATION	$798,652
2023	2023	HARVARD PILGRIM HEALTH CARE INC	1 WELLNESS WAY	CANTON	MA	02021	NORFOLK	USA	Minority Health and Health Disparities Research	001	4	8/9/2023	SUPPLEMENT FOR EXPANSION	$166,000
														Subtotal = $964,652

Issue Date FY: 2022 ( Subtotal = $1,171,038 )
2022	2022	HARVARD PILGRIM HEALTH CARE INC	93 WORCESTER ST	WELLESLEY	MA	02481	NORFOLK	USA	Minority Health and Health Disparities Research	004	3	7/15/2022	SUPPLEMENT FOR EXPANSION	$415,000
2022	2022	HARVARD PILGRIM HEALTH CARE INC	93 WORCESTER ST	WELLESLEY	MA	02481	NORFOLK	USA	Minority Health and Health Disparities Research	002	3	2/17/2022	NON-COMPETING CONTINUATION	$675,449
2022	2022	HARVARD PILGRIM HEALTH CARE INC	93 WORCESTER ST	WELLESLEY	MA	02481	NORFOLK	USA	Minority Health and Health Disparities Research	003	3	5/3/2022	NON-COMPETING CONTINUATION	$80,589
2022	2021	CHILDREN'S HOSPITAL CORPORATION, THE	300 LONGWOOD AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	1	1/11/2022	NEW	-$49,831
2022	2021	HARVARD PILGRIM HEALTH CARE INC	1 WELLNESS WAY	CANTON	MA	02021	NORFOLK	USA	Minority Health and Health Disparities Research	001	2	1/11/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$49,831
														Subtotal = $1,171,038

Issue Date FY: 2021 ( Subtotal = $929,389 )
2021	2021	CHILDREN'S HOSPITAL CORPORATION, THE	300 LONGWOOD AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	001	1	9/27/2021	NEW	-$879,558
2021	2021	HARVARD PILGRIM HEALTH CARE INC	93 WORCESTER ST	WELLESLEY	MA	02481	NORFOLK	USA	Minority Health and Health Disparities Research	002	2	9/27/2021	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$879,558
2021	2021	CHILDREN'S HOSPITAL CORPORATION, THE	300 LONGWOOD AVE	BOSTON	MA	02115	SUFFOLK	USA	Minority Health and Health Disparities Research	000	1	5/16/2021	NEW	$929,389
														Subtotal = $929,389

Grand Total All Awards = $3,967,505

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Improving service delivery models of medically assisted reproduction: A patient journey mapping study of sexual minority women couples’ experience of medicalized family formation

Award Number: R01MD015256

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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