Community Care Implementation to Reduce Maternal Health Inequities

实施社区护理以减少孕产妇健康不平等

基本信息

批准号：
10749764
负责人：
Dr Beryl POLK
金额：
$ 115.46万
依托单位：
JACKSON STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-17 至 2030-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10749764
关键词：
Address Affect American College of Obstetricians and Gynecologists Area Birth Blood coagulation Cardiovascular Diseases Caring Cause of Death Centers of Research Excellence Cessation of life Child Child Rearing Childbirth Chronic Chronic Disease Clinical Communities Community Health Community Health Aides Community Healthcare Community Participation Computerized Medical Record Consult County Data Disease Management Disparity Early Intervention Effectiveness Elements Emergency department visit Emotional Evidence based program Face Financial Support Gynecologist Health Health Personnel Healthcare Hematology High Risk Woman Home Home visitation Homicide Hospitalization Hospitals Hypertension Inequity Infant Care Kidney Knowledge Life Cycle Stages Maternal Health Maternal Health Services Maternal Mortality Maternal health equity Measurable Medical Mental Health Methods Mission Mississippi Mothers Newborn Infant Nurses Observational Study Outcome Overdose Patient Self-Report Personal Satisfaction Persons Pharmaceutical Preparations Population Postpartum Period Pregnancy Pregnancy Complications Process Psyche structure Race Recommendation Research Research Personnel Research Project Grants Research Training Risk Schedule Series Service delivery model Sleep Social Work Social support Suicide Telephone Text Training Programs Trust United States Universities Visit Well in self Woman Women&apos s Health checkup examination community partnership cultural competence depressive symptoms effectiveness evaluation evidence base experience feeding follow-up health disparity health inequalities improved intervention program maternal morbidity maternal outcome member mortality novel obstetric care postpartum care pregnancy related death prevent programs public health relevance racial disparity randomized trial satisfaction service utilization severe maternal morbidity stressor structural determinants teenage mother telehealth trend uptake

项目摘要

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.

项目摘要：研究项目1-社区护理实施以减少孕产妇健康不平等随着美国在分娩期间和分娩后的死亡率和严重的并发症的增加，美国因此，重点是提高产后护理的质量以扭转这些趋势并消除可预防的孕产妇死亡率，严重的孕产妇发病率和不平等。近年来，产后护理在整个生命周期中，被认为是女性医疗保健连续体的重要方面。重要的是，产后期间的护理不仅涉及对妇科医生的一次访问，还应涉及一次针对女人的需求量身定制的一系列访问。循证家庭访问计划显示可衡量的孕产妇和新生儿结果的改善，但尚未对持续的影响密西西比州孕产妇医疗保健中的高母亲发病率和死亡率以及种族分布三角洲。此外，密西西比三角洲女性的女性更有可能体验产后抑郁症与母亲相比整个美国。那是密西西比三角洲的产后护理必须包括临床健康，心理健康和社会支持。拟议的产后家庭访问计划 - 适应高风险女性的基于多组分需求的产后护理和后续计划 - 将解决这些差距在护理中。我们的计划是为满足处于危险母亲的各种需求而量身定制的密西西比州服务不足的社区。具体而言，基于证据的计划要素着重于关键领域重要性：（a）身体健康和慢性疾病管理，（b）社会工作和财政支持，（c）心理健康和睡眠，以及（d）婴儿护理和喂养。重要的是，拟议的计划将将产后护理期扩展到一次为期6周的产后检查，至少包括四个面对面的访问（在住院后3周内3周内3周后进行一次访问母亲）。持续护理将包括与母亲的进一步联系（家庭访问，电话，文字或远程医疗），由护士/社区卫生工作者团队计划。社区卫生工作者了解社区将是必不可少的团队成员，并成为母亲的主要接触。这项研究项目将通过以下目的实施和评估拟议程序：（1）建立一个密西西比州的改编基于需求的产后护理和后续计划；（2）评估产后护理和后续计划在改善摄取，信任和满意度方面的有效性；和（3）评估产后护理和后续计划在改善临床和心理方面的有效性孕产妇的健康结果和差异。该研究项目有可能减少严重的母亲在密西西比州遇到最大的遗嘱健康不平等的人群中的发病率，支持密西西比三角洲孕产妇健康卓越研究中心的整体任务。