Improving Health by Linking Postpartum and Well-Baby Visits

项目总结/文摘

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.