Improving Health by Linking Postpartum and Well-Baby Visits

通过将产后检查和婴儿健康检查联系起来来改善健康

• 批准号: 10200413
• 负责人: RACHEL CASKEY
• 金额: $ 20.34万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-21 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10200413
• 关键词: Caring; Clinical; Clinical Data; Comprehensive Health Care; Computerized Medical Record; Contraceptive methods; Country; Current Procedural Terminology Codes; Data; Electronic Health Record; Ensure; Federally Qualified Health Center; Foundations; Funding; Goals; Health; Health Personnel; Healthcare; Healthcare Systems; Infant; Infant Care; International Classification of Disease Codes; Intervention; Interview; Link; Low income; Manuals; Maternal Health; Maternal Mortality; Minority; Modeling; Morbidity - disease rate; Neighborhood Health Center; Newborn Infant; Outcome; Patients; Population; Postpartum Period; Postpartum Women; Pregnancy; Pregnant Women; Prevention; Process; Public Health; Registries; Reproducibility; Risk; Sampling; Schedule; Services; Site; Testing; Time; United States; Visit; Voice; Woman; Women' s Health; catalyst; clinical research site; community partnership; data registry; demographics; design; health care settings; health data; implementation trial; improved; improved outcome; informant; insight; interest; maternal risk; mortality; novel; patient oriented; population health; postpartum care; postpartum contraception; pregnancy related death; prenatal; prevent; recruit; severe maternal morbidity; tool

PROJECT SUMMARY/ABSTRACT Severe maternal morbidity (SMM) and maternal mortality (MM) remain a public health crisis in the United States despite efforts to improve maternal health. Most pregnancy-related deaths in the U.S. occur in the postpartum (PP) period, thus, timely access to high quality comprehensive care during the transition period from prenatal to PP period is critical to reduce SMM and MM. High quality longitudinal health care improves outcomes for women before, during and after pregnancy; and decreases morbidity and mortality related to pregnancy. The “Linking Inter-professional Newborn and Contraception Care (LINCC) Trial” was funded in 2019 to test a novel, patient-centered approach to providing contraception care, in conjunction with an infant’s well baby visit (WBV), for PP women. The LINCC trial aims to remove barriers to accessing PP care by co-scheduling the PP contraception visit with WBVs. The LINCC trial provides an ideal foundation upon which to develop a reproducible model to identify women at risk for MM and SMM, and link them into care, among a national sample of predominantly low-income women receiving care at Community Health Centers (CHCs). This proposal is aligned with the goals of this supplement by 1) incorporating community partnerships interested in reducing SMM and MM; 2) focusing on low-income minority women who are at greatest risk for SMM and MM; 3) leveraging data from a large national sample of women to create a tool to accurately identify women at risk for SMM and MM; and 4) incorporating women’s voices in the design of an implementation plan. The specific aims of this supplement are to: (1) build a population-health interface to identify pregnant and PP women at risk for SMM or MM using standard clinical health data from electronic medical records and (2) Validate the registry (i.e., LINK MOMS) using data from CHCs across the country. Lastly, we aim to: (3) design an implementation plan for the LINK MOMS registry in CHCs across the country. Increasing access to timely comprehensive care is a promising strategy to prevent pregnancy-related morbidity and mortality. The long-term impact of this study is to reduce adverse health outcomes among PP women by increasing access to patient-oriented care before, during, and after pregnancy. Findings may provide evidence supporting a paradigm shift for linked PP care and identify important insights to facilitate successful implementation of this registry in health care systems across the nation.

项目概要/摘要 严重孕产妇发病率（SMM）和孕产妇死亡率（MM）仍然是美国的公共卫生危机 尽管努力改善孕产妇健康。在美国，大多数与妊娠相关的死亡发生在产后 （PP）期，因此，在从产前到产后的过渡期间及时获得高质量的综合护理 PP周期对于减少SMM和MM至关重要。 高质量的纵向医疗保健可改善女性孕前、孕中和孕后的结局；和 降低与妊娠相关的发病率和死亡率。 “连接跨专业新生儿和 避孕护理 (LINCC) 试验”于 2019 年获得资助，旨在测试一种以患者为中心的新颖方法，以提供 为 PP 女性提供避孕护理，并结合婴儿健康探访 (WBV)。 LINCC 试验旨在 通过与 WBV 共同安排 PP 避孕就诊，消除获得 PP 护理的障碍。 LINCC 试验 为开发可重复模型来识别有 MM 风险的女性提供了理想的基础 SMM，并将她们与护理联系起来，在接受护理的主要是低收入女性的全国样本中 社区卫生中心 (CHC)。该提案通过以下方式与本补充的目标保持一致：1) 纳入 对减少 SMM 和 MM 感兴趣的社区伙伴关系； 2）关注低收入少数族裔妇女 对于 SMM 和 MM 来说风险最大； 3）利用全国大量女性样本的数据来创建工具 准确识别有 SMM 和 MM 风险的女性； 4）将女性的声音纳入设计中 实施计划。 该补充文件的具体目标是：(1) 建立人口-健康界面，以识别怀孕和 PP 使用电子病历中的标准临床健康数据评估有 SMM 或 MM 风险的女性，以及 (2) 验证 登记处（即 LINK MOMS）使用来自全国各地 CHC 的数据。最后，我们的目标是：（3）设计一个 全国 CHC LINK MOMS 注册实施计划。 增加获得及时综合护理的机会是预防妊娠相关发病率的一项有前景的策略 和死亡率。这项研究的长期影响是通过以下方式减少 PP 女性的不良健康后果： 增加在怀孕前、怀孕期间和怀孕后获得以患者为中心的护理的机会。研究结果可能提供证据 支持关联 PP 护理的范式转变，并确定重要的见解以促进成功 在全国医疗保健系统中实施该登记册。