High reach, multi-level digital intervention for Pregnancy-Related and -Associated Morbidity and Mortality (PRAMM) Disparities
针对妊娠相关和相关发病率和死亡率 (PRAMM) 差异的高覆盖范围、多层次数字干预
基本信息
- 批准号:10755550
- 负责人:
- 金额:$ 74.91万
- 依托单位:
- 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:
- 关键词:Abnormal coordinationAddressAdoptedAwarenessBehavioralBirthBirth RecordsBlack PopulationsBlack raceCessation of lifeClinicCollaborationsColorCommunitiesCommunity Health AidesCountryDataData SetDevelopmentDisparityEarly identificationElementsEnrollmentEnsureFamily memberFeedbackGeographyHealthHealth PersonnelHealth Services AccessibilityHome visitationIncomeIndividualInterventionKnowledgeLife StyleLinkManualsMaternal HealthMaternal MortalityMeasuresMediationMedicaidMental DepressionMental HealthMichiganMorbidity - disease rateNot Hispanic or LatinoOutcomeParticipantPatientsPersonsPostpartum PeriodPregnancyPregnancy RatePrimary CarePrivatizationProviderRacial EquityRecommendationResearchResearch PersonnelResourcesRiskRisk FactorsRuralSamplingSecureServicesSiteSocial supportStructureSupport SystemSymptomsTechnologyTextTranslatingantenatalantenatal carebrief motivational interventioncheckup examinationcluster randomized designcommunity-level factorcost effectivecost effectivenessdesigndigitaldigital interventiondisparities in morbidityefficacy testingflexibilityhealth care settingsimplicit biasimprovedindexingineffective therapiesinnovationmaternal morbiditymortalitymortality disparitymortality risknovelopen sourcepartner violencepeople of colorpregnantprimary outcomeprogramsprovider communicationprovider factorsrandomized trialresidencerural areascale upscreeningsecondary outcomeservice providerssocialsocial stigmasubstance useunderserved rural areaurban areaurban residence
项目摘要
Rates of pregnancy-associated and related morbidity and mortality (PRAMM) are far higher in the U.S. than in
any other high-income country, particularly in rural areas and among non-Hispanic (NH) Black birthing people.
Technology has clear potential for reduction of PRAMM by providing screening, tailored digital content,
and connection to live assistance. Digital approaches also provide tremendous scalability and potential for
long-term optimization. Finally, technology that is sufficiently flexible and easy to use—as is the platform used in
this project—can also support deep community input through direct content creation. The proposed study builds
upon an existing app (the Pregnancy Checkup) developed by project PI Ondersma, already integrated with
antenatal services throughout Michigan, that provides universal digital screening for health risks, a brief
motivational intervention, and referral to services. The proposed project will create the Pregnancy Checkup-
PRAMM (PC-PRAMM) by extending the Pregnancy Checkup in two ways: (1) adding elements to address key
determinants of PRAMM risks at four distinct levels (individual, support system, provider, and community), with
further optimization to address the needs of Black pregnant people and those residing in underserved rural areas;
and (2) providing pregnant participants with immediate and secure “live chat” text access to a Community Health
Worker who can facilitate warm handoffs to local services. Development of PC-PRAMM will use an innovative
community partnered approach to co-creating app content. The PC-PRAMM will target known preventable
determinants of PRAMM at four levels throughout pregnancy and the first year postpartum. Our first specific
aim is to collaborate with pregnant and postpartum people (including people of color and those from
rural areas), healthcare providers, family members, and researchers to develop the PC-PRAMM, including
a manual for CHWs providing live chat assistance and facilitating engagement in services. Our second specific
aim is to evaluate PC-PRAMM effects using a cluster randomized design in 10 geographically and
demographically diverse antenatal care clinics throughout Michigan (N = 500 participants receiving Medicaid
and enrolled at less than 20 weeks gestation). We will measure change on an index of PRAMM risk factors
directly targeted by the PC-PRAMM (e.g., substance use, treatment-seeking, partner violence, early warning
sign awareness, mental health); total PRAMM among trial participants through 1 year postpartum as measured
using a pre-existing linked dataset of Medicaid claims, deaths, birth records, and primary care program data,
and disparities in both measures. This innovative community-engaged trial will translate key findings from
PRAMM research into a technology-driven intervention with strong potential for cost-effective dissemination. If
supported, this approach could provide a highly scalable approach to PRAMM reduction, particularly among
Black people and in rural areas. Further, the novel open-source platform on which the PC-PRAMM is built would
allow long-term optimization and adaptation based on new findings, quality improvement, and regional needs.
在美国,与妊娠相关的发病率和死亡率(PRAMM)远高于英国
项目成果
期刊论文数量(0)
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Claire E Margerison其他文献
Claire E Margerison的其他文献
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{{ truncateString('Claire E Margerison', 18)}}的其他基金
Training program addressing the multilevel factors that affect pregnancy-related and pregnancy-associated morbidity and mortality disparities
针对影响妊娠相关发病率和死亡率差异的多层次因素的培训计划
- 批准号:
10755553 - 财政年份:2023
- 资助金额:
$ 74.91万 - 项目类别:
Administrative Supplement to Policy Change and Women's Health
政策变化和妇女健康的行政补充
- 批准号:
10194963 - 财政年份:2020
- 资助金额:
$ 74.91万 - 项目类别:
Pregnancy and beyond: windows into disparities in women's cardiovascular health
怀孕及以后:了解女性心血管健康差异的窗口
- 批准号:
9096667 - 财政年份:2015
- 资助金额:
$ 74.91万 - 项目类别:
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