NY Community-Hospital-Academic Maternal Health Equity Partnerships (NY-CHAMP)

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OVERALL: PROJECT SUMMARY/ABSTRACT The broad goal of the New York Community-Hospital-Academic Maternal Health Equity Partnerships (NY- CHAMP) is to upend the maternal healthcare ecosystem in New York City (NYC) and New York State (NYS) by establishing a sustainable, highly collaborative infrastructure for community-centered maternal health science. We have carefully co-designed, with our partners, a research, training, and community engagement agenda that will 1) identify and address the comorbid biologic and psychologic pathways linking adverse social determinants of health (SDoH) to disparities in SMM and MM; and 2) co-create and implement scalable multi-level strategies grounded in anti-racism and empowerment to inform systems and policy change in our city and region. NY- CHAMP is set against the compelling backdrop of persistently high rates and disparities in SMM/MM across urban and rural parts of our state alike, despite a multitude of healthcare facilities and resources. More effective partnerships that break down siloes and leverage the knowledge and strengths of our diverse communities, hospitals, academic institutions, and government agencies are essential to assuring equitable access to culturally congruent, patient-centered care, redressing SMM/MM inequities, and maximizing our collective impact. We convene Columbia University and Weill Cornell Medicine, four lead community organizations (Black Women's Blueprint, Caribbean Women's Health Association, Northern Manhattan Perinatal Partnership, and The Bridge), and a broad coalition of multisector actors to address 3 synergistic Overall Aims. In Aim 1, we will implement a unified, community-driven research program that will: Project 1) Develop and implement novel artificial intelligence risk prediction models and a resulting clinical decision support system for SMM, accounting for SDoH, bias and fairness. Project 2) Conduct a Type 1 Hybrid Effectiveness-Implementation Trial of a novel doula-delivered cognitive behavioral therapy program holistically designed to address CV, MH, and SDoH outcomes during postpartum; build trauma-informed and empowerment-based service delivery models; and strengthen hospital-community care linkages. Project 3) Apply mixed methods to evaluate the effects of and excess costs attributable to structural racism and SMM/MM and the mitigating effects of two policy interventions for reducing maternal health disparities. In Aim 2, we will establish the Community Engagement and Policy Action Core (CEPA) to serve as an enduring platform for iterative community input, co-design processes, and research dissemination, capacity building, and policy action. In Aim 3, we will establish the Career Development and Training Core (CDTC) to transform the maternal health research culture and pipeline of early-stage investigators expertly trained in community partnerships, interdisciplinarity, anti-racism, and diversity, equity, inclusion, and justice. Our vision is perfectly aligned with the priorities, needs, and assets of our communities and with the NIH's IMPROVE initiative. Ultimately, NY-CHAMP will alter the underlying structural drivers of SMM/MM in NYC and NYS and shift the scientific paradigm for excellence in maternal health research.