Community Care Implementation to Reduce Maternal Health Inequities

点击翻译按钮获取中文摘要

PROJECT SUMMARY: Research Project 1 - Community Care Implementation to Reduce Maternal Health Inequities As rates of mortality and serious complications during and after childbirth have increased in the United States, so has the focus on improving the quality of postpartum care to reverse these trends and eliminate preventable maternal mortality, severe maternal morbidity, and inequities. In recent years, postpartum care has been recognized as an important aspect of the continuum of women’s healthcare across the life cycle. Importantly, care during the postpartum period should involve not just a single visit to the gynecologist, but a series of visits tailored to the needs of the woman. Evidence-based home visiting programs show measurable improvements in both maternal and newborn outcomes but have yet to show an impact on the persistently high maternal morbidity and mortality rates and the racial disparities in maternal health care in the Mississippi Delta. In addition, women in the Mississippi Delta women are more likely to experience postpartum depressive symptoms and face financial and emotional stressors before and during pregnancy compared with mothers across the United States. Thus, postpartum care in the Mississippi Delta must encompass clinical health, mental health, and social support. The proposed postpartum home visiting program – an adapted multicomponent needs-based postpartum care and follow-up program for high-risk women – will address these gaps in care. Our program has been tailored to meet the various needs of at-risk mothers in underserved Mississippi communities. Specifically, evidence-based program elements focus on areas of key importance: (a) physical well-being and chronic disease management, (b) social work and financial support, (c) psychological well-being and sleep, and (d) infant care and feeding. Importantly, the proposed program will expand the postpartum care period beyond a single 6-week postpartum check-up to include a minimum of four in-person visits (three within 3 weeks of hospital discharge and one visit after 12 weeks to discharge the mother). Continued care will include further contacts (home visit, phone, text, or telehealth) with the mother, scheduled by nurse/ community health worker team. Community health workers with understanding of the community will be essential team members and serve as the primary contact for mothers. This research project will implement and evaluate the proposed program through the following aims: (1) establish an adapted multicomponent needs-based postpartum care and follow-up program in Mississippi; (2) evaluate the effectiveness of the postpartum care and follow-up program in improving uptake, trust, and satisfaction; and (3) evaluate the effectiveness of the postpartum care and follow-up program in improving clinical and mental maternal health outcomes and disparities. This research project has the potential to reduce severe maternal morbidity within populations experiencing the greatest maternal health inequities in Mississippi, supporting the overall mission of the Mississippi Delta Research Center of Excellence for Maternal Health.