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

第四个三个月 - 一个基于网络的产后护理工具，可满足服务不足的妇女的需求

• 批准号: 9904878
• 负责人: Lisa D Marceau
• 金额: $ 24.13万
• 依托单位: ORANGE SQUARE DESIGN, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-23 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9904878
• 关键词: Address; Affect; American; American College of Obstetricians and Gynecologists; Area; Birth; Caring; Cellular Phone; Clinical; Coin; Collaborations; Communication; Complex; Coping Skills; Country; Data; E-learning; Effectiveness; Evidence based practice; Family; Focus Groups; Goals; Grant; Health; Health Care Costs; Income; Infant; Infant Care; Infant Health; Internet; Knowledge; Lead; Link; Low income; Managed Care Programs; Maternal Mortality; Maternal and Child Health; Measures; Medicaid; Morbidity - disease rate; Mothers; Outcome; Phase; Population; Postpartum Period; Postpartum Women; Pregnancy; Pregnant Women; Preparation; Program Effectiveness; Provider; Qualitative Methods; Qualitative Research; Recommendation; Research; Research Personnel; Resources; Risk; Self Care; Self Efficacy; Services; Social support; Surveys; Technology; Time; Underserved Population; United States; Update; Visit; Woman; Women' s Group; Women' s Health; college; commercialization; design; ethnic diversity; evidence base; experience; health disparity; improved; innovation; maternal morbidity; mobile application; mortality; peer support; phase 2 study; postpartum care; prototype; public health intervention; quality assurance; racial and ethnic disparities; randomized trial; skills; tool; tool development; usability; visit adherence; web-based tool

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.

项目摘要/摘要 在美国，产后期是母婴健康的关键时期， 这一比率在其他发达国家、高收入国家中最高，占所有孕产妇死亡人数的一半以上。 发生在产后，从出生后一天到一年。2 -10这种不良结果与种族和民族有关。 不成比例地影响黑人妇女的差异，她们经历孕产妇死亡的可能性是黑人妇女的3-4倍。 死亡率高于白色女性。11最近，美国妇产科医师学会12认识到， 产后护理的不足，并创造了“第四个三个月”一词，以纪念产后护理的时间。 在产后头3个月内分娩的婴儿，并更新了解决这些问题的建议 挑战由于对健康结果和医疗保健成本的影响，需要全面弥合差距 为低收入和/或不同种族的妇女群体解决物质、文化和知识方面的问题， 获得优质产后护理的障碍。提高得不到充分服务的妇女的就业率， 由于孕产妇死亡率和发病率不成比例地受到影响，我们需要让妇女参与， 特别是在产后期间，以确定需求领域，并提供减少障碍的工具 让妇女得到适当的产后护理。技术提供创新的解决方案， 平等的信息获取。孕妇经常上网了解更多关于他们的信息。 健康和他们正在发育的婴儿的健康。然而，研究发现，母亲们没有找到足够的资源， 13为了解决这一护理差距，我们将开发一种移动的工具， 增加获得信息的机会，并采取切实可行的办法， 这个“第四季”。这一工具将特别侧重于获得服务不足的妇女，她们面临的风险最大， 产后不良后果。我们建议完成三个主要任务：目标1：收集来自关键的输入 利益相关者告知移动的工具的设计、关键内容和交互式技术组件。到 为了实现这一目标，我们将对孕妇和有过性行为的妇女进行形成性定性研究。 经历了产后的经历目标2：开发一个原型，以展示 完整的工具。该原型将包括自我保健专题部分的内容和互动， 移动的工具，内容和交互功能的详细概述，包括真实的世界的例子和同行 支持.在与我们的临床专家合作，我们将利用在形成性研究中获得的知识 结合相关循证实践，开发原型。目标3：展示 在关键利益攸关方提供投入的情况下，该工具的可接受性、可用性、可行性和商业化潜力 为第二阶段成效研究做准备。我们将使用定量和定性 方法来评估内容的可行性，方法，和计划的有效性，并确定 第二阶段研究的关键措施。