Joyuus: A Web-based Tool for Postpartum Care Self-care to Address the Complex Needs of Underserved Women

项目总结/文摘

PROJECT SUMMARY/ABSTRACT In the United States, the postpartum period is a critical time for both maternal and child health; the US maternal mortality rate is the highest among other developed, high-income countries. More than half of all maternal deaths occur postpartum, from one day to one year after birth.1-9 There are vast racial and ethnic disparities in maternal mortality and severe morbidity, disproportionately experienced by Black and Latina mothers and other BIPOC women. Black women are 3-4 times more likely to experience maternal mortality than white women10, and Hispanic women are twice as likely to experience severe maternal outcomes compared with non-Hispanic white women.11 The American College of Obstetricians and Gynecologists recognized the deficiencies in postpartum care and coined the term the ‘fourth trimester’ to mark the time following birth through the first 3- months postpartum. They recently updated recommendations to address these challenges.12 The Biden Build Back Better Act also prioritized this issue. Joyuus is a web-based self-care mobile tool addressing the 12 months postpartum, to reduce the risks of avoidable morbidity and mortality for underserved women. The tool addresses physical, mental, real world, cultural, and knowledge barriers which impact quality postpartum care. Joyuus provides information, resources, expert perspectives, peer communications and red flags presented in a variety of formats to help women identify how to adopt healthy self-care habits. Importantly, it also identifies when self-care leads to seeking provider care. Pregnant women often turn to the internet to find information about their health and their developing baby's health. Yet, studies find that mothers are not finding sufficient resources to match their postpartum needs.13 Our Phase I grant demonstrated in a sample of Black women that this audience is highly engaged across the income and education spectrum and prefers mobile access and text-based communication. In Phase II we will continue our efforts to include lived experiences of women most at risk for negative postpartum outcomes as we build the complete tool. Our first step will be to conduct a needs assessment to understand informational, cultural and language wants and needs in the Latina population. The broader randomized trial will invite a diverse population of BIPOC and white women. Our Phase II scope aims to complete three major tasks: AIM 1: Expand feasibility activities to address Latina population. Explore self-care (and seeking care) needs for the postpartum Latina community and integrate with our Phase I focus group findings. AIM 2: Build complete tool. We will complete the development of a fully interactive Joyuus web based mobile tool in English and Spanish. AIM 3: Test in randomized controlled trial. We will test the effectiveness of Joyuus with a diverse national sample of postpartum women, considering the impact on maternal function, depression, anxiety, resilience, knowledge, and social support.