Integrated Clinic and Patient Technology-Enabled Program to Reduce the Risks of Cardiometabolic Disease Among Latinas with Prior Pregnancy Complications

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Abstract Nearly 40% of Latinas experience an adverse pregnancy outcome (APO) that places them at significantly higher risk of developing cardiometabolic disease (CMD), including type 2 diabetes and/ or cardiovascular disease. The primary care setting has been identified as a key locus for addressing this major public health need, as primary care providers assume responsibility for the majority of care 6 weeks after delivery. Although currently not widely available, digital technologies have been recommended as a solution for expanding access to such preventive services in primary care. This lack of availability of digital technologies for women with prior APOs is a particularly noteworthy gap among primary care clinics serving large Latina populations, given the many historical disparities experienced by Latinas in health, coverage, and access to care. To the best of our knowledge, the proposed SBIR would be the first-ever effort to create and test an integrated clinic platform and patient app to enable primary care practices to deliver behavior-change programming to support Latinas in the 5 years after their APO. The integrated system will be developed using a user centered design approach incorporating feedback from both paraprofessional staff who will deliver the program and provide social support, and Latina patients, with the goal of successfully marketing the program to primary care clinics serving Latinas. The project is innovative in its comprehensive approach that addresses the 5 major APOs associated with future CMD, a clinic platform that overcomes key barriers to delivering lifestyle interventions in primary care, reliance on paraprofessionals to deliver the program, and combining an individualized approach for patients with a population health approach for primary care clinics. Specific aims are: Aim 1: Develop a clinic platform to integrate with our existing patient application to promote healthy behaviors among Latinas with recent APOs predictive of CMD; Aim 2: Develop and test digital tools and digital training toolkit for the new clinic platform for use by paraprofessionals (e.g. CHWs, medical assistants, health educators) and test the new features incorporated in the existing patient app; and, Aim 3: Evaluate feasibility, usability, and acceptability of the integrated clinic and patient application. The team includes a multicultural and multidisciplinary group of clinicians and researchers who have collaborated on prior technology-based interventions for women in the postpartum years. Hola Bebé, Hola Salud addresses a large unmet public health need with significant commercial potential among primary care clinics serving Latina populations. Our B2B approach is consistent with emerging trends on population health and value-based payment in primary care.