Using Retrofit, Reform, and Reimagine to Advance Toward Health Equity

McLemore, Monica R.

doi:10.1097/jpn.0000000000000639

Cited by 12 publications

(10 citation statements)

References 9 publications

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“…This continued deficit‐based focus on improving a health problem instead of shifting toward supporting underlying rights to bodily autonomy may be a necessary first step, but it will likely fail to advance equity goals on its own. Systemic change can be a slow process that may require operating within established structures while concurrently working toward reconceptualizing and operationalizing measures of pregnancy planning attitudes and behavior to align with goals of reproductive justice 73 …”

Section: Discussionmentioning

confidence: 99%

Critiquing the Unintended Pregnancy Framework

Auerbach

Coleman‐Minahan

Alspaugh

et al. 2023

J Midwife Womens Health

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The unintended pregnancy framework, a central tenet of sexual and reproductive health care delivery and research, has been depicted as an adverse outcome that should be prevented. There is growing criticism of the inadequacies of this framework, although little modification in public health guidelines, measurement, or clinical practice has been seen. This article critically reviews the literature on unintended pregnancy to encourage reflection on how this framework has negatively influenced practice and to inspire the advancement of more patient‐centered care approaches. We begin by outlining the historical origins of the unintended pregnancy framework and review how this framework mischaracterizes patients’ lived experiences, fails to account for structural inequities, contributes to stigma, and is built upon weakly supported claims of a negative impact on health outcomes. We close with a discussion of the relationship between health care provision and unintended pregnancy care and the implications and recommendations for realigning clinical practice, research, and policy goals.

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Section: Discussionmentioning

confidence: 99%

Critiquing the Unintended Pregnancy Framework

Auerbach

Coleman‐Minahan

Alspaugh

et al. 2023

J Midwife Womens Health

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“…The justice aspect of RJ for health equity research suggests that the best way to alleviate health disparities is to involve and center the participants based on the context of their experiences (Julian et al, 2021; McLemore, 2022). Within the context of our case, we hypothesized that Latina women might disproportionately experience birth and reproductive injustices, potentially causing ethical harm.…”

Section: Resultsmentioning

confidence: 99%

“…Researchers must consider the needs and safety of underrepresented groups and may need to adjust recruitment and data collection strategies (Norwood et al, 2022;Ross et al, 2017). Our example occurred during the COVID-19 pandemic, exposing the enduring racial and ethnic inequities perpetuated by the unequal distribution of resources and structural racism that often plague underrepresented groups within the United States (McLemore, 2022). Populations that suffered the most from COVID-19-related health disparities included pregnant, birthing, and parenting individuals and those influenced by incarceration (McLemore, 2022).…”

Section: Changes In Real Timementioning

confidence: 99%

Applying a Reproductive Justice Lens to Enhance Research Engagement Among Systematically Underrepresented Childbearing Women

et al. 2022

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Background: Historically, childbearing women from diverse and systematically hard-to-reach populations have been excluded from nursing research. This practice limits the generalizability of findings. Maximizing research strategies to meet the unique needs of these populations must be a priority. Objectives:The aim of this study was to provide methodological context for the comprehensive application of reproductive justice strategies to guide research methods and promote engagement of underrepresented childbearing women while decreasing systemic bias. Methods:In this article, we use a reproductive justice lens to characterize and define strategies for enhancing ethical and equitable engagement in research involving childbearing women who are often systematically underrepresented using a case study approach. Using a specific case study exemplar, the core tenets of reproductive justice are outlined and affirm the need to advance research strategies that create ethical engagement of diverse populations, transform oppressive social structures, and shift research paradigms so research objectives intentionally highlight the strengths and resiliency inherent to the targeted communities.Results: We begin by describing parallels between the tenets of reproductive justice and the ethical principles of research (i.e., respect for persons, beneficence, and justice). We then apply these tenets to conceptualization, implementation (recruitment, data management, and retention), and dissemination of research conducted with childbearing women from diverse backgrounds who are systemically underrepresented. We highlight our successful research strategies from our case study example of women with histories of incarceration.Discussion: To date, outcomes from our research indicate the need for multilevel strategies with a focus on respectful, inclusive participant and key community partner engagement; the time investment in local communities to promote equitable collaboration; encouragement of the patient's autonomous right to self-determination; and mitigation of power imbalances. Nurse researchers are well positioned to advance research justice at the intersection of reproductive justice and ethics to fully engage diverse populations in advancing health equity to support the best health outcomes.

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“…Finally, it is important to note that individual-level antibias inventions are only 1 facet of changes needed to advance maternal health equity. 1,5,[39][40][41] Our review surfaced numerous projects that sought to mitigate racism and its harms in other ways. One approach focused on structural racism and its effects, including proposals to integrate new resources into communities or replace harmful models of care.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, it is important to note that individual-level antibias inventions are only 1 facet of changes needed to advance maternal health equity 1,5,39–41. Our review surfaced numerous projects that sought to mitigate racism and its harms in other ways.…”

Section: Discussionmentioning

confidence: 99%

Antibias Efforts in United States Maternity Care: A Scoping Review of the Publicly Funded Health Equity Intervention Pipeline

Garrett¹,

Walia²,

Miller³

et al. 2022

Clinical Obstetrics &Amp; Gynecology

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Antibias training is increasingly identified as a strategy to reduce maternal health disparities. Evidence to guide this work is limited. We conducted a community-guided scoping review to characterize new antibias research. Four of 508 projects met our criteria: US-based, publicly funded, initiated from January 1, 2018 to June 30, 2022, and featuring an intervention to reduce bias or racism in maternal health care providers. Training was embedded in multicomponent interventions in 3 projects, limiting its evaluation as a stand-alone intervention. Major public funders have sponsored few projects to advance antibias training research in maternal health. More support is needed to develop a rigorous and scalable evidence base.

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Using Retrofit, Reform, and Reimagine to Advance Toward Health Equity

Cited by 12 publications

References 9 publications

Critiquing the Unintended Pregnancy Framework

Critiquing the Unintended Pregnancy Framework

Applying a Reproductive Justice Lens to Enhance Research Engagement Among Systematically Underrepresented Childbearing Women

Antibias Efforts in United States Maternity Care: A Scoping Review of the Publicly Funded Health Equity Intervention Pipeline

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