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Improving Health Outcomes and Equity by Targeting Postpartum Mothers at Highest Risk

针对风险最高的产后母亲，改善健康成果和公平

基本信息

批准号：
10392562
负责人：
Elizabeth A Howell
金额：
$ 127.49万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-18 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10392562
关键词：
Address Anxiety Asians Attention Attenuated Behavioral Birth Blood Pressure Body mass index Buffers COVID-19 COVID-19 mortality COVID-19 pandemic Cardiovascular system Cessation of life Childbirth Color Communities Coronavirus Dangerousness Data Discrimination Economics Educational Intervention Emergency department visit Enrollment Evidence based intervention Exposure to Goals Health Healthcare High Risk Woman Home Hospitals Hypertension Immigrant Individual Inequality Infection Intervention Investigation Latina Latinx Maternal Health Maternal Mortality Measures Mental Depression Mental Health Methods Morbidity - disease rate Mothers New York City Outcome Parents Patient Self-Report Patients Personal Satisfaction Persons Philadelphia Postpartum Depression Postpartum Period Psychiatric Diagnosis Quality of life Recording of previous events Reporting Research Risk SARS-CoV-2 infection Stress Structural Racism Structure Surveys Testing Time Virus Waist-Hip Ratio Woman Work anxiety symptoms base black women cardiovascular health cohort design experience health related quality of life high risk hospital readmission improved maternal morbidity mortality mortality disparity multi-ethnic pandemic disease postpartum care postpartum complications postpartum health pregnancy related death prospective racial and ethnic racial and ethnic disparities racism recruit resilience segregation severe maternal morbidity social social vulnerability socioeconomics

项目摘要

Summary Racism is under scrutiny as a fundamental cause of racial-ethnic inequity in maternal morbidity and mortality, and now, the COVID-19 pandemic is replicating existing structures of inequality and disproportionately harming communities of color. Current evidence on racism in birthing people centers around birth outcomes, with little known of its influence on maternal postpartum health, when racial-ethnic disparities in maternal mortality are widest. Thus, it is urgent to investigate the influence of racism on postpartum maternal morbidity during the COVID-19 pandemic. To fill this gap, we propose a prospective postpartum cohort examining the influence of exposure to structural and interpersonal racism and the COVID-19 pandemic on postpartum maternal health. This goal aligns with that of the parent R01, to identify high-risk women in the postpartum period and design and implement a behavioral educational intervention to reduce inequity in maternal mortality and morbidity. We will recruit a postpartum cohort of 400 multiethnic mothers in Philadelphia and New York City. Our primary aim is to assess multiple levels of racism using contextual and self-reported measures at delivery, then prospectively follow postpartum patients three months to assess blood pressure (BP) trajectories, anxiety, depression, and quality of life among. Our second aim is to explore associations between COVID-19 exposures, including infection or social and economic stress, and postpartum maternal morbidity outcomes. Finally, we will test if individual or community resilience buffers associations between racism and postpartum maternal morbidity. The proposed study will provide new evidence of the influence of perceived and structural racism on postpartum maternal morbidity, with a focus on outcomes with strong ties to maternal mortality. Our findings will be used to target exposure to racism as a driver of maternal morbidity and resilience as a modifiable buffer in the design of a multilevel intervention to reduce maternal mortality.

总结