PhD Student Cebert, Gonzalelz-Guarda and Stevenson Submit NIH NRSA F31 Application

Kudos to Morine Cebert, PhD student, and her sponsors Rosa Gonzalez-Guarda, associate professor; and Eleanor Stevenson, associate professor; for the submission of her NIH NRSA F31 application entitled “Understanding Decisions to Initiate and Continue Treatment Seeking Among Black Women with Infertility." This proposal requests funding for a nine-month period with a start date of July 1, 2019.

Black women are two times more likely to experience infertility, yet twice less likely to seek treatment than non-Hispanic White women. Research on treatment decisions among Black women with infertility is scarce and provide incomplete understanding of their reproductive experiences. Black women with untreated infertility experience issues such as high levels of isolation, silence, and negative medical experiences, yet little is known about what factors influences decisions to initiate and continue care. The purpose of this study is to understand what influences Black women with infertility to initiate and continue treatment.

The specific aims of this study are to: 1) Identify biological, clinical, and socio-cultural factors that predict decisions to continue infertility treatment plans among Black women who have initiated treatment; and 2) Generate a multidimensional description and conceptualization of Black women’s perceptions of biological, clinical, socio-cultural influences on decisions to initiate and complete treatment for infertility. This study will utilize a convergent mixed methods approach combining data from a retrospective chart review and individual semi-structured interviews. Biological (age, BMI, past medical/surgical/gynecological history, type of infertility), clinical (diagnostic results and proposed treatment plan), and socio-cultural (insurance, education, employment status, marital status, religion) data of Black women with infertility from a large infertility clinic will be extracted through a retrospective chart review. Concurrently, a purposive sample of Black who have initiated care at the same clinic will be interviewed regarding their perspectives of how biological (perceptions/attitudes/beliefs of health and infertility and impact of infertility), clinical (perceptions of clinical encounter, patient-provider relationship, and perceptions of treatment plan), and sociocultural (education, employment, marital status, racial identify, culture significance of infertility, and social support) elements influenced their decisions to initiate and continue care. The knowledge generated from this proposed study will identify the currently unknown influences on infertility treatment seeking and decision making among Black women. Identifying what factors and perspectives are present in treatment decisions will lead to the development of self-management interventions aimed at improving health disparities affecting Black women with infertility. The training proposed under this award will satisfy future goals to develop a thoughtful program of research focused on improving the lives of Black women with infertility as a health disparities nurse researcher using mixed methods approaches. Duke University and other public and private institutions will provide a rich environment with unique resources to complete this study.