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Screening for Prevention of Preeclam...

Lucas, Kathryn A.

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Screening for Prevention of Preeclampsia with Low-Dose Aspirin in Navajo Women: A Program Evaluation Project.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Screening for Prevention of Preeclampsia with Low-Dose Aspirin in Navajo Women: A Program Evaluation Project./
作者:	Lucas, Kathryn A.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2024,
面頁冊數:	194 p.
附註:	Source: Dissertations Abstracts International, Volume: 85-06, Section: B.
Contained By:	Dissertations Abstracts International85-06B.
標題:	Obstetrics. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30696131
ISBN:	9798381164473

Screening for Prevention of Preeclampsia with Low-Dose Aspirin in Navajo Women: A Program Evaluation Project.
Lucas, Kathryn A.

Screening for Prevention of Preeclampsia with Low-Dose Aspirin in Navajo Women: A Program Evaluation Project. - Ann Arbor : ProQuest Dissertations & Theses, 2024 - 194 p.

Source: Dissertations Abstracts International, Volume: 85-06, Section: B.

Thesis (D.N.P.)--The Catholic University of America, 2024.

Preeclampsia disproportionately affects American Indian and Alaska Native (AIAN) women, who face a twofold higher maternal death risk than White women in the United States. The U.S. Preventive Services Task Force (USPSTF) recommends low-dose aspirin prophylaxis (LDAP) for preeclampsia and related perinatal mortality risk reduction (Grade B) in pregnancies with relevant risk factors as outlined in their clinical guidance table. This project focused on a Navajo tribal facility prenatal clinic with a high preeclampsia rate. In 2020, the clinic adopted LDAP clinical guidelines per the American College of Obstetricians and Gynecologists (ACOG) based on USPSTF 2014 recommendations. A 2021 USPSTF update since broadened consideration of LDAP for women facing societal inequities, and ACOG concurred, additionally stating that universal LDAP may be medically reasonable for high-risk practices in which most patients would be LDAP candidates. Methods: A retrospective chart review assessed AIAN pregnancies (June 2020 - October 2022), using the Promoting Action on Research Implementation in Health Services (PARIHS) Framework to evaluate LDAP implementation. Data gathered on preeclampsia risk factors, delivery demographics, LDAP prescription and LDAP retrieval underwent univariate and bivariate analyses to provide insights from which future revisions to the local LDAP guideline and implementation efforts can be considered. Results: Most patients (81.2%) were LDAP candidates by 2014 criteria. Only 47.3% of candidates retrieved adequate supply; 31.9% of those who had it prescribed did not retrieve adequate supply and 20.8% were not prescribed LDAP. By the expanded 2021 USPSTF criteria, 93.6% would be LDAP candidates. Preeclampsia was diagnosed in 22.0% of the pregnancies. Optimizing LDAP in this AIAN clinic population could avert cases and costs totaling nearly $150,000 by national preeclampsia cost estimates. Significance: The project highlights suboptimal provision and retrieval of LDAP, and an exceedingly high preeclampsia rate among AIAN patients at this rural Navajo tribal facility prenatal clinic. Findings inform potential local LDAP guideline revisions to enhance preeclampsia prevention efforts and maternal health outcomes in this high-risk AIAN clinic population.

ISBN: 9798381164473Subjects--Topical Terms:

634501
Obstetrics.
Subjects--Index Terms:

American Indians

Screening for Prevention of Preeclampsia with Low-Dose Aspirin in Navajo Women: A Program Evaluation Project.
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