Improving Health by Linking Postpartum and Well-Baby Visits

项目总结/摘要 严重的孕产妇发病率（SMM）和孕产妇死亡率（MM）仍然是美国的公共卫生危机 尽管为改善产妇健康做出了努力。在美国，大多数与怀孕有关的死亡发生在产后。 (PP)因此，在从产前到产后的过渡时期， PP期是减少SMM和MM的关键。 高质量的纵向保健改善了妇女在怀孕前、怀孕期间和怀孕后的结果; 降低与怀孕有关的发病率和死亡率。“将新生儿和 避孕护理（LINCC）试验”于2019年获得资助，以测试一种新颖的，以患者为中心的方法， 为参加计划生育的妇女提供避孕护理，同时进行婴儿健康检查。LINCC试验旨在 通过与WBV共同安排PP避孕访视，消除获得PP护理的障碍。LINCC试验 提供了一个理想的基础，在此基础上开发一个可重复的模型，以确定妇女的风险为MM， 在全国范围内抽样调查接受护理的主要是低收入妇女， 社区卫生中心（CHCs）。本提案通过以下方式与本补充文件的目标保持一致：1）纳入 有兴趣减少SMM和MM的社区伙伴关系; 2）关注低收入少数民族妇女， 在SMM和MM的风险最大; 3）利用来自全国妇女大样本的数据来创建一个工具， 准确识别有SMM和MM风险的妇女;以及4）在设计一个 执行计划。 该补充的具体目标是：（1）建立人口-健康界面，以识别妊娠和PP 使用来自电子医疗记录的标准临床健康数据，有SMM或MM风险的女性;（2） 注册表（即，链接MOMS）使用全国各地社区卫生中心的数据。最后，我们的目标是：（3）设计一个 全国社区卫生中心LINK MOMS登记册的实施计划。 增加获得及时全面护理的机会是预防与怀孕有关的发病率的一项有希望的战略 and mortality.这项研究的长期影响是通过以下方式减少PP妇女的不良健康结果： 增加在怀孕前、怀孕期间和怀孕后获得面向病人的护理的机会。调查结果可以提供证据 支持关联PP护理的范式转变，并确定重要见解，以促进成功 在全国保健系统实施这一登记制度。

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.