Enhancing Perinatal Care Support to Improve Maternal Mortality Disparities
加强围产期护理支持以改善孕产妇死亡率差异
基本信息
- 批准号:10630873
- 负责人:
- 金额:$ 57.99万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-08-24 至 2026-04-30
- 项目状态:未结题
- 来源:
- 关键词:AddressAmerican College of Obstetricians and GynecologistsAreaBirthBlack, Indigenous, People of ColorCardiovascular systemCaringChicagoChildCollaborationsCommunitiesCommunity Health AidesDeveloped CountriesDiscipline of obstetricsDiscriminationDisparityEmergency SituationEmotionalEthnic OriginFailureFeedbackFosteringGoalsGuidelinesGunsHealthHealthcare SystemsHigh-Risk PregnancyHomeHospitalsHybridsInstitutional RacismInterventionKnowledgeLeadMaternal HealthMaternal MortalityMedicalMedical Care TeamMedical centerMental DepressionMental HealthModelingOpioidOutcomePatient CarePatient SelectionPatientsPerceptionPerinatal CarePersonal SatisfactionPersonsPostpartum PeriodPostpartum WomenPractical Robust Implementation and Sustainability ModelPregnancyPregnancy ComplicationsPregnant WomenPrenatal carePublic HealthQualitative MethodsQuality of CareRaceRecommendationResourcesRoleSafetySelf EfficacyService delivery modelSiteSocial supportSubstance abuse problemSupport GroupsSymptomsTestingTimeUnderserved PopulationUninsuredVariantVisitWomanWomen&aposs HealthWorkblack womencare coordinationcohesioncompare effectivenessdistrusteffectiveness-implementation randomized trialethnic disparityexperiencegroup interventionhealth care availabilityhealth care deliveryhealth care qualityhealth disparityhigh riskimplementation evaluationimplementation interventionimprovedindividual patientinnovationintervention effectintimate partner violencelow and middle-income countriesmaternal morbiditymaternal outcomemedically underservedmortality disparitypatient navigatorperinatal periodpostpartum carepregnantprimary outcomeracial disparityracismrandomized trialsecondary outcomesevere maternal morbidityskillssocial health determinantsstandard caretelehealthuptakevirtualwomen of color
项目摘要
ABSTRACT
Persistent and worsening racial and ethnic disparities in severe maternal morbidity and mortality in the US are
urgent public health concerns requiring innovative, sustainable solutions. The perinatal period, the time before
and after birth, has important implications for a woman’s health and that of her child. Unfortunately, standard
perinatal care fails to meet the needs of women from Black, Indigenous and People of Color (BIPOC)
communities, especially with consideration to the Social Determinants of Health (SDoH) and the systemic racism
that drive health disparities. Doula care is increasingly recommended to support high-risk BIPOC women during
labor and the immediate postpartum period and is posited to mitigate the effects of racism and SDoH in
underserved populations. However, a key limitation to doula care is that doulas are largely relegated to working
in parallel with the healthcare team and the potential consequences of this include disjointed care coordination
and missed opportunities to improve healthcare quality for BIPOC women. Building on our team’s prior and
current work optimizing perinatal care for medically underserved women, we will develop and evaluate a Well-
Mama intervention in 3 participating medical centers in Chicago IL, Baton Rouge LA, and Newark NJ which have
some of the highest US rates of maternal morbidity and mortality. The Well-Mama intervention is centered on
uninsured and publicly insured pregnant and postpartum BIPOC women supported by Community Doula
Navigators (CDNs) who will conduct in-person and telehealth wellness check-ins using the Well-Mama safety
checklist; make referrals to resources following the check-ins, with feedback provided to the perinatal care team;
lead virtual pregnancy and postpartum support groups; attend select patient visits; and provide labor support.
The Well-Mama checklist includes 5 priority topic areas representing leading factors in maternal morbidity and
mortality in which to attune doulas and their patients: (a) mental health/depression; (b) cardiovascular symptoms;
(c) safety (e.g., guns at home and intimate partner violence); (d) opioid/substance abuse; and (e) social support,
self-agency, and well-being. Well-Mama advances a Shared Care Model approach to health care delivery
focused on interprofessional collaboration in relation to centering care on the individual patient. Through a Hybrid
Type 1 randomized effectiveness-implementation trial of N=576 women, we will compare the effectiveness of
the Well-Mama intervention relative to standard perinatal care in improving women’s receipt of recommended
care components (primary outcome), reducing patient medical distrust and experience of racism/discrimination,
increasing health engagement, self-efficacy, and perception of care team quality, and enhancing perinatal care
team cohesion (secondary outcomes), while evaluating intervention implementation. Results will optimize doula
integrated perinatal care to address the top drivers of maternal morbidity and mortality with the goal of reducing
maternal health disparities experienced by pregnant and postpartum BIPOC women.
摘要
项目成果
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MELISSA A. SIMON其他文献
MELISSA A. SIMON的其他文献
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{{ truncateString('MELISSA A. SIMON', 18)}}的其他基金
Enhancing Perinatal Care Support to Improve Maternal Mortality Disparities
加强围产期护理支持以改善孕产妇死亡率差异
- 批准号:
10474451 - 财政年份:2021
- 资助金额:
$ 57.99万 - 项目类别:
Enhancing Perinatal Care Support to Improve Maternal Mortality Disparities
加强围产期护理支持以改善孕产妇死亡率差异
- 批准号:
10317866 - 财政年份:2021
- 资助金额:
$ 57.99万 - 项目类别:
The Northwestern University Cancer Health Equity Research SPORE (NU-CHERS)
西北大学癌症健康公平研究 SPORE (NU-CHERS)
- 批准号:
10488603 - 财政年份:2020
- 资助金额:
$ 57.99万 - 项目类别:
The Northwestern University Cancer Health Equity Research SPORE (NU-CHERS)
西北大学癌症健康公平研究 SPORE (NU-CHERS)
- 批准号:
10265425 - 财政年份:2020
- 资助金额:
$ 57.99万 - 项目类别:
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