Improving Health by Linking Postpartum and Well-Baby Visits

项目摘要/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 尽管努力改善产妇健康。美国大多数与怀孕有关的死亡发生在产后 (PP)期，因此，在从产前到#年过渡期间及时获得高质量的综合护理 PP周期是降低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局； 降低与怀孕有关的发病率和死亡率。将跨专业的新生儿和 避孕护理(LINCC)试验于2019年获得资助，以测试一种以患者为中心的新方法，以提供 避孕护理，结合婴儿的健康婴儿探视(WBV)，为PP妇女提供。LINCC试验旨在 通过与WBV共同安排PP避孕访问，消除获得PP护理的障碍。LINCC审判 提供了一个理想的基础，在此基础上开发一种可重复使用的模型，以确定MM和 SMM，并将她们与护理联系起来，在接受护理的主要是低收入妇女的全国样本中 社区卫生中心(CHC)。本建议通过以下方式与本补编的目标保持一致：1) 对减少SMM和MM感兴趣的社区伙伴关系；2)重点关注低收入少数群体妇女 对于SMM和MM来说风险最大；3)利用来自全国大量妇女样本的数据来创建工具 准确识别SMM和MM的风险女性；以及4)将女性的声音纳入到 实施计划。 本补充文件的具体目的是：(1)建立人群-健康接口，以识别孕妇和PP 使用电子医疗记录中的标准临床健康数据和(2)验证有SMM或MM风险的妇女 使用来自全国各地的儿童保健中心的数据进行登记(即，将母亲联系起来)。最后，我们的目标是：(3)设计一个 全国妇幼保育机构母婴健康中心联网登记实施计划。 增加获得及时全面护理的机会是预防妊娠相关发病率的一个有希望的战略 和死亡率。这项研究的长期影响是通过以下方式减少PP妇女的不良健康后果 增加孕前、孕期和孕后以病人为中心的护理。调查结果可能会提供证据 支持关联PP护理的范式转变，并确定重要见解以促进成功 在全国医疗保健系统中实施这一登记。

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.