Fourth Trimester - A web-based tool for Postpartum Care to Address the Needs of Underserved Women

项目摘要/摘要 在美国，产后期是孕产妇和儿童健康的关键时期，死亡率 这一比率是其他发达国家和高收入国家中最高的，占所有孕产妇死亡的一半以上 发生在产后，从出生后一天到一年。2-10这种不良结局与种族和民族有关 不成比例地影响黑人女性的差异，黑人女性经历母性疾病的可能性是她们的3-4倍 死亡率高于白人妇女。11最近，美国妇产科医师学会12承认 在产后护理方面的不足，并创造了术语“第四个三个月”，以纪念随后的时间 婴儿在产后3个月内出生，并更新了其建议以解决这些问题 挑战。由于对健康结果和医疗成本的影响，有必要从整体上弥合差距 为低收入和/或不同种族的妇女群体提供物质、文化和知识 获得优质产后护理的障碍。以提高妇女服务不足的比率 不成比例地受到孕产妇死亡率和发病率的影响，我们需要让妇女参与到 特别是在产后期间，以确定需要的领域，并提供减少障碍的工具 让妇女得到适当的产后护理。技术为以下挑战提供了创新的解决方案 平等的信息获取。孕妇经常求助于互联网，以了解更多关于她们的信息 健康和他们发育中的婴儿的健康。然而，研究发现，母亲们没有找到足够的资源来 匹配他们的产后需求。13为了解决这一护理缺口，我们将开发一种移动工具，旨在 增加获取信息的机会和解决妇女在#年的复杂需求的实际办法 这是‘第四个三个月’。这一工具将专门针对服务不足的妇女，她们面临着最大的 产后不良后果。我们计划完成三项主要任务：目标1：从KEY收集信息 利益相关者告知移动工具的设计、关键内容和交互技术组件。至 为了实现这一目标，我们将对孕妇和有 经历了产后的经历。目标2：开发一个原型来演示 完整的工具。原型将包括自理主题部分的内容和互动性 移动工具，内容和交互功能的详细概述，包括真实世界的示例和同行 支持。与我们的临床专家合作，我们将利用形成性研究中获得的知识 结合相关循证实践，开发出样机。目标3：展示 工具的可接受性、可用性、可行性和商业化潜力，以及关键利益攸关方的投入 和最终用户，为第二阶段有效性研究做准备。我们将用定量和定性相结合的方法 方法评估计划的内容、方法和有效性的可行性，并确定 第二阶段研究的主要措施。

PROJECT SUMMARY/ABSTRACT In the United States, the postpartum period is a critical time for both maternal and child health, the mortality rate is the highest among other developed, high income countries and more than half of all maternal deaths occur postpartum, from one day to one year after birth.2-10 This poor outcome is linked to the racial and ethnic disparities that disproportionately effect black women who are 3-4 times more likely to experience maternal mortality than white women.11 Recently, the American College of Obstetricians and Gynecologists12 recognized the deficiencies in postpartum care and coined the term the ‘fourth trimester’ to mark the time following the birth of the infant through the first 3-months postpartum, and updated its recommendations to address these challenges. With impacts to health outcomes and healthcare costs, there is a need to holistically bridge the gap for low-income and/or ethnically diverse groups of women to address the physical, cultural, and knowledge barriers to accessing quality postpartum care. To improve the rate at which underserved women are disproportionately affected by maternal mortality and morbidity, we need to engage women leading into and specifically during the postpartum period to identity areas of need, and to provide tools which reduce barriers for women to get appropriate postpartum care. Technology offers innovative solutions to challenges around equal information access. Pregnant women often turn to the internet to find out more information about their health and their developing babies health. Yet, studies find that mothers are not finding sufficient resources to match their postpartum needs.13 To address this gap in care, we will develop a mobile tool designed to increase accessibility to information and practical approaches for addressing the complex needs of women in this ‘fourth trimester’. This tool will specifically focus on underserved women who are at greatest risk of adverse postpartum outcomes. We propose to complete three major tasks: AIM 1: Gather input from key stakeholders to inform the design, key content, and interactive technological components of the mobile tool. To achieve this aim we will conduct formative qualitative research with pregnant women and women who have gone through the postpartum experience. AIM 2: Develop a prototype to demonstrate the goals of the complete tool. The prototype will include content and interactivity for the Self Care thematic section of the mobile tool, a detailed outline of content and interactive features including real world examples and peer support. In collaboration with our clinical experts, we will draw on the knowledge gained in formative research in combination with relevant evidence-based practices to develop the prototype. AIM 3: Demonstrate the acceptability, usability, feasibility and commercialization potential of the tool with input from key stakeholders and end-users in preparation for the Phase II effectiveness study. We will use quantitative and qualitative methods to assess the feasibility of the content, approach, and effectiveness of the program and identify the key measures for the Phase II study.