# Development of a novel, patient-centered measure of reproductive autonomy in the healthcare context

> **NIH NIH R21** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2022 · $206,318

## Abstract

ABSTRACT
The United States has among the worst maternal and infant outcomes of developed countries, which are
disproportionately experienced by people who are racial or ethnic minorities, poor, and/or have chronic
medical illnesses. The ability for women to actualize their reproductive decisions around pregnancy, pregnancy
prevention, and termination, may require the involvement of clinicians, who may (or may not) facilitate access
to reproductive services. Thus, to better understand the root causes of adverse maternal and perinatal
outcomes, we believe that the reproductive healthcare setting requires closer investigation. Studies
overwhelmingly suggest that people who are socially marginalized or have chronic and complex medical
illnesses experience negative reproductive health care encounters. Such encounters may prevent patients’
access to the information, services, and supports needed to make and execute reproductive decisions that align
with their values and priorities. Patients who perceive that their reproductive autonomy has been undermined
in the healthcare context may feel disempowered, distrustful of their clinicians and the health care
environment, and unlikely to follow clinical recommendations or receive follow-up care— all of which may have
deleterious effects on their health and well-being. Thus, the extent to which people experience reproductive
autonomy in healthcare settings may be a critical but understudied factor in understanding how the healthcare
environment may influence maternal health and outcomes. No quantitative measure exists to capture this
construct or link it to patient-centered or clinical outcomes. We therefore propose to develop a novel measure
of Reproductive Autonomy in Healthcare (RAH). We will refine our preliminary conceptualization of RAH
through qualitative interviews and concept mapping. We will use this framework to generate preliminary items
for the RAH measure. We will refine the items with guidance from an interdisciplinary panel of content experts
and cognitive interviews with patients. Finally, we will field test the RAH measure among reproductive-age
women who are socially marginalized and/or have chronic diseases to assess its acceptability and evaluate its
preliminary psychometric properties. In future work, we will validate the RAH measure in a large cohort of
diverse women and evaluate the potential roles of RAH as a mediator or moderator of downstream clinical
outcomes in women at high risk for preterm birth, and maternal morbidity and mortality.

## Key facts

- **NIH application ID:** 10508732
- **Project number:** 1R21HD109440-01
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Mehret Birru Talabi
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $206,318
- **Award type:** 1
- **Project period:** 2022-08-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10508732

## Citation

> US National Institutes of Health, RePORTER application 10508732, Development of a novel, patient-centered measure of reproductive autonomy in the healthcare context (1R21HD109440-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10508732. Licensed CC0.

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