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Providing an Optimized and emPowered Pregnancy for You (PᵌOPPY) Feasibility Study

Providing an Optimized and emPowered Pregnancy for You (PᵌOPPY) Feasibility Study

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05940688
Acronym
PᵌOPPY
Enrollment
40
Registered
2023-07-11
Start date
2023-07-17
Completion date
2024-07-01
Last updated
2025-10-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Disparities, Infants, Pregnancy

Keywords

Pregnancy outcomes, Health inequities

Brief summary

The P3OPPY Project is one of five projects within the American Heart Association P3 EQUATE Network. The overarching goal of the P3 EQUATE American Heart Association Health Equity Research Network (HERN) is to promote equity in Maternal and Infant Health outcomes by identifying innovative and cost-effective strategies to enhance access to quality health information, care, and experiences during pregnancy, postnatal and postpartum/preconception periods, particularly for Black and under-served populations. Collectively, the investigators will collaborate with pregnant and postpartum individuals and their families, hospitals, and communities to discover ways to reduce racism and social problems that contribute to poor health outcomes.

Detailed description

Feasibility Study Aims 1. To assess the feasibility of the digital health (DHI) and community health worker (CHW) interventions by assessing participant acceptance and use of the intervention. 2. To assess study enrollment to determine appropriateness and usefulness of the inclusion and exclusion criteria to estimate enrollment duration in the planned trial. 3. To determine the number of prenatal visits and the incidence of some of the maternal and neonatal outcomes (ones with higher prevalence) or surrogate outcomes that will be targeted in the planned factorial design randomized controlled trial. (Data will be collected on all relevant maternal and neonatal outcomes. The randomized feasibility design will allow for effect size estimates of the intervention on the incidence of maternal and neonatal outcomes, which will aid in determining the appropriate target outcomes as well as power calculation of the more definitive trial.) The PᵌOPPY study is designed to support the American Heart Association's mission to improve maternal/infant health outcomes and address inequities in maternal/infant health care. The promise of digital health and community health worker engagement makes PᵌOPPY interventions potentially transformative, sustainable, and scalable for Non-Hispanic Black mothers and their infants from under-served communities in Alabama and beyond. The objective of this pilot study is to determine if it is feasible to randomize and implement digital health and community health worker interventions. Design Summary The investigators will challenge existing care paradigms by testing the effectiveness of integrating innovative platforms into the existing healthcare system, including existing digital health and community health worker programs from within the EQUATE consortium, to eliminate critical barriers to equitable healthcare access. After seeking input from a Community Advisory Board, these interventions will be refined and deployed for pilot testing. Individuals in Non-Hispanic Black communities at the highest risk of adverse pregnancy outcomes which were historically underrepresented in clinical research due to structural racism will be included. The investigative team employs experts across the community, maternal, and infant health continuum. For this pilot, 40 eligible participants will be randomized, 10 to usual care, 10 to DHI, 10 to CHW, and 10 to DHI + CHW

Interventions

BEHAVIORALDigital Health intervention

Health care information delivered via a link in a text message that is then opened in a secure browser.

BEHAVIORALCommunity Health Worker

Health care information delivered via CHW.

Health care information delivered via DHI plus CHW

Sponsors

American Heart Association
CollaboratorOTHER
ConnectionHealth
CollaboratorUNKNOWN
Memora Health
CollaboratorUNKNOWN
University of Alabama at Birmingham
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Caregiver)

Intervention model description

Study is a pilot randomized trial (n=40) randomizing eligible participants to usual care (n=10), or usual care plus a digital health intervention (n=10), or usual care plus a community health worker intervention (n=10), or usual care plus both a digital health intervention and a community health worker intervention.

Eligibility

Sex/Gender
FEMALE
Age
16 Years to 49 Years
Healthy volunteers
No

Inclusion criteria

* Self Identifies as Non-Hispanic Black * Between 16-49 years old * Pregnant individuals between 8⁰ - 22⁶ weeks gestational age * Live singleton or dichorionic twin gestation * Dating sonogram at \<23 weeks gestation * Area Deprivation Index (ADI) National 4th or 5th Quintile * Planning to deliver at UAB Hospital * Speaks and writes in English * No indication for delivery at the time of enrollment

Exclusion criteria

* Declines randomization * Speaks or writes in languages other than English * Currently incarcerated * Fetal demise diagnosed prior to enrollment * Known major structural chromosomal abnormalities prior to enrollment

Design outcomes

Primary

MeasureTime frameDescription
Participant Acceptance of Randomization Arm / Intervention6 weeks postpartumParticipant acceptance is defined as a yes response to this question: I would recommend the care I received to someone in a similar situation.
Participant Use of Digital Health and/or Community Health Worker InterventionsFrom randomization to 6 weeks postpartumUse of the intervention for the digital health arm(s) is defined as the % of opened text messages. Use of the intervention for the community health worker arm(s) is defined as the % of planned sessions in which the participant engages with the community health worker.

Secondary

MeasureTime frameDescription
Neonatal BirthweightAt birthWeight of neonate at birth
Cesarean DeliveryAt birthOccurrence of a cesarean birth
Maternal Blood TransfusionAt birthTransfusion of blood products
Outpatient Perinatal Care VisitsRandomization to study completion (up to 34 weeks)Number of perinatal care visits
Vaccination RatePregnancy through 6 weeks postpartum / 6 weeks of lifeThe number of mothers who received Tdap and infants who received the Hep B vaccine.
Maternal Postpartum ReadmissionFrom discharge from the delivery-associated hospitalization to 6 weeks postpartumAdmission of the mother to the hospital after discharge from the delivery-associated hospitalization
Neonatal Hospital ReadmissionBirth to 6 weeks of lifeAnswer to the question How is your baby doing?
Breastfeeding IntentUpon admission to the delivery-associated hospitalizationParticipant's self-reported intent of whether or not to express breast milk upon admission to the delivery-associated hospitalization
Preterm BirthAt birthDelivery of a neonate at less than 37 weeks

Countries

United States

Participant flow

Participants by arm

ArmCount
Digital Health Intervention (DHI)
This group will receive routine prenatal care services. Additionally, those randomized to this arm will receive a DHI intervention. A modified DHI will be utilized that was developed by Memora Health in conjunction with EQUATE partners at UPenn and feedback from the POPPY Study Team and Community Advisory Board. All content is designed for 7th grade Flesch-Kincaid level or lower.
9
Community Health Worker (CHW)
Individuals randomized to this group will receive routine prenatal care services. Additionally, they will receive a CHW intervention. The CHW intervention will be adapted from an ongoing CHW program in Jefferson County, AL called From Day One (FDO), a comprehensive patient-centered program designed to educate and provide non-clinical, psychosocial, emotional support to expectant mothers from the 1st trimester of pregnancy through their child's first year of life. The intervention has been modified by the POPPY Study Team and Community Advisory Board.
10
DHI Plus CHW
This group will receive routine prenatal care services. Additionally, this group will receive both DHI and CHW interventions.
11
Usual Care
This group will receive routine prenatal care services.
10
Total40

Baseline characteristics

CharacteristicTotalUsual CareDHI Plus CHWDigital Health Intervention (DHI)Community Health Worker (CHW)
Age, Continuous29.1 years24.9 years29.1 years30.8 years29.5 years
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
40 Participants10 Participants11 Participants9 Participants10 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
40 Participants10 Participants11 Participants9 Participants10 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
0 Participants0 Participants0 Participants0 Participants0 Participants
Sex: Female, Male
Female
40 Participants10 Participants11 Participants9 Participants10 Participants
Sex: Female, Male
Male
0 Participants0 Participants0 Participants0 Participants0 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 90 / 100 / 110 / 10
other
Total, other adverse events
0 / 90 / 100 / 110 / 10
serious
Total, serious adverse events
0 / 90 / 100 / 110 / 10

Outcome results

Primary

Participant Acceptance of Randomization Arm / Intervention

Participant acceptance is defined as a yes response to this question: I would recommend the care I received to someone in a similar situation.

Time frame: 6 weeks postpartum

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Digital Health Intervention (DHI)Participant Acceptance of Randomization Arm / InterventionYes8 Participants
Digital Health Intervention (DHI)Participant Acceptance of Randomization Arm / InterventionNo0 Participants
Digital Health Intervention (DHI)Participant Acceptance of Randomization Arm / InterventionMissing or Unknown1 Participants
Community Health Worker (CHW)Participant Acceptance of Randomization Arm / InterventionYes8 Participants
Community Health Worker (CHW)Participant Acceptance of Randomization Arm / InterventionNo0 Participants
Community Health Worker (CHW)Participant Acceptance of Randomization Arm / InterventionMissing or Unknown2 Participants
DHI Plus CHWParticipant Acceptance of Randomization Arm / InterventionMissing or Unknown1 Participants
DHI Plus CHWParticipant Acceptance of Randomization Arm / InterventionYes10 Participants
DHI Plus CHWParticipant Acceptance of Randomization Arm / InterventionNo0 Participants
Usual CareParticipant Acceptance of Randomization Arm / InterventionYes7 Participants
Usual CareParticipant Acceptance of Randomization Arm / InterventionNo1 Participants
Usual CareParticipant Acceptance of Randomization Arm / InterventionMissing or Unknown2 Participants
Primary

Participant Use of Digital Health and/or Community Health Worker Interventions

Use of the intervention for the digital health arm(s) is defined as the % of opened text messages. Use of the intervention for the community health worker arm(s) is defined as the % of planned sessions in which the participant engages with the community health worker.

Time frame: From randomization to 6 weeks postpartum

Population: We did not collect data for this outcome as planned because the University legal department would not allow texting in the manner initially planned.

Secondary

Breastfeeding Intent

Participant's self-reported intent of whether or not to express breast milk upon admission to the delivery-associated hospitalization

Time frame: Upon admission to the delivery-associated hospitalization

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Digital Health Intervention (DHI)Breastfeeding IntentDo not know yet1 Participants
Digital Health Intervention (DHI)Breastfeeding IntentFormula feed only3 Participants
Digital Health Intervention (DHI)Breastfeeding IntentMissing0 Participants
Digital Health Intervention (DHI)Breastfeeding IntentBoth breast and formula feed3 Participants
Digital Health Intervention (DHI)Breastfeeding IntentBreastfeed only2 Participants
Community Health Worker (CHW)Breastfeeding IntentBoth breast and formula feed1 Participants
Community Health Worker (CHW)Breastfeeding IntentDo not know yet3 Participants
Community Health Worker (CHW)Breastfeeding IntentMissing2 Participants
Community Health Worker (CHW)Breastfeeding IntentFormula feed only3 Participants
Community Health Worker (CHW)Breastfeeding IntentBreastfeed only1 Participants
DHI Plus CHWBreastfeeding IntentBoth breast and formula feed1 Participants
DHI Plus CHWBreastfeeding IntentBreastfeed only1 Participants
DHI Plus CHWBreastfeeding IntentFormula feed only3 Participants
DHI Plus CHWBreastfeeding IntentDo not know yet2 Participants
DHI Plus CHWBreastfeeding IntentMissing4 Participants
Usual CareBreastfeeding IntentDo not know yet1 Participants
Usual CareBreastfeeding IntentFormula feed only1 Participants
Usual CareBreastfeeding IntentBreastfeed only2 Participants
Usual CareBreastfeeding IntentBoth breast and formula feed6 Participants
Usual CareBreastfeeding IntentMissing0 Participants
Secondary

Cesarean Delivery

Occurrence of a cesarean birth

Time frame: At birth

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Digital Health Intervention (DHI)Cesarean DeliveryCesarean7 Participants
Digital Health Intervention (DHI)Cesarean DeliveryMissing0 Participants
Digital Health Intervention (DHI)Cesarean DeliveryVaginal2 Participants
Community Health Worker (CHW)Cesarean DeliveryCesarean5 Participants
Community Health Worker (CHW)Cesarean DeliveryMissing2 Participants
Community Health Worker (CHW)Cesarean DeliveryVaginal3 Participants
DHI Plus CHWCesarean DeliveryVaginal8 Participants
DHI Plus CHWCesarean DeliveryCesarean3 Participants
DHI Plus CHWCesarean DeliveryMissing0 Participants
Usual CareCesarean DeliveryCesarean3 Participants
Usual CareCesarean DeliveryMissing0 Participants
Usual CareCesarean DeliveryVaginal7 Participants
Secondary

Maternal Blood Transfusion

Transfusion of blood products

Time frame: At birth

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Digital Health Intervention (DHI)Maternal Blood TransfusionMissing0 Participants
Digital Health Intervention (DHI)Maternal Blood TransfusionNo8 Participants
Digital Health Intervention (DHI)Maternal Blood TransfusionYes1 Participants
Community Health Worker (CHW)Maternal Blood TransfusionNo8 Participants
Community Health Worker (CHW)Maternal Blood TransfusionYes0 Participants
Community Health Worker (CHW)Maternal Blood TransfusionMissing2 Participants
DHI Plus CHWMaternal Blood TransfusionYes1 Participants
DHI Plus CHWMaternal Blood TransfusionNo10 Participants
DHI Plus CHWMaternal Blood TransfusionMissing0 Participants
Usual CareMaternal Blood TransfusionNo8 Participants
Usual CareMaternal Blood TransfusionMissing0 Participants
Usual CareMaternal Blood TransfusionYes2 Participants
Secondary

Maternal Postpartum Readmission

Admission of the mother to the hospital after discharge from the delivery-associated hospitalization

Time frame: From discharge from the delivery-associated hospitalization to 6 weeks postpartum

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Digital Health Intervention (DHI)Maternal Postpartum ReadmissionNo Readmission9 Participants
Digital Health Intervention (DHI)Maternal Postpartum ReadmissionReadmission0 Participants
Community Health Worker (CHW)Maternal Postpartum ReadmissionNo Readmission10 Participants
Community Health Worker (CHW)Maternal Postpartum ReadmissionReadmission0 Participants
DHI Plus CHWMaternal Postpartum ReadmissionReadmission1 Participants
DHI Plus CHWMaternal Postpartum ReadmissionNo Readmission10 Participants
Usual CareMaternal Postpartum ReadmissionReadmission2 Participants
Usual CareMaternal Postpartum ReadmissionNo Readmission8 Participants
Secondary

Neonatal Birthweight

Weight of neonate at birth

Time frame: At birth

ArmMeasureValue (MEDIAN)
Digital Health Intervention (DHI)Neonatal Birthweight3160.0 grams
Community Health Worker (CHW)Neonatal Birthweight3150.0 grams
DHI Plus CHWNeonatal Birthweight2815.0 grams
Usual CareNeonatal Birthweight2920.0 grams
Secondary

Neonatal Hospital Readmission

Answer to the question How is your baby doing?

Time frame: Birth to 6 weeks of life

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Digital Health Intervention (DHI)Neonatal Hospital ReadmissionMissing1 Participants
Digital Health Intervention (DHI)Neonatal Hospital ReadmissionSome Illness (Hospitalization, Clinic, or ER)0 Participants
Digital Health Intervention (DHI)Neonatal Hospital ReadmissionHealthy8 Participants
Digital Health Intervention (DHI)Neonatal Hospital ReadmissionBaby Died0 Participants
Community Health Worker (CHW)Neonatal Hospital ReadmissionSome Illness (Hospitalization, Clinic, or ER)0 Participants
Community Health Worker (CHW)Neonatal Hospital ReadmissionBaby Died0 Participants
Community Health Worker (CHW)Neonatal Hospital ReadmissionHealthy8 Participants
Community Health Worker (CHW)Neonatal Hospital ReadmissionMissing2 Participants
DHI Plus CHWNeonatal Hospital ReadmissionHealthy7 Participants
DHI Plus CHWNeonatal Hospital ReadmissionSome Illness (Hospitalization, Clinic, or ER)0 Participants
DHI Plus CHWNeonatal Hospital ReadmissionBaby Died4 Participants
DHI Plus CHWNeonatal Hospital ReadmissionMissing0 Participants
Usual CareNeonatal Hospital ReadmissionSome Illness (Hospitalization, Clinic, or ER)1 Participants
Usual CareNeonatal Hospital ReadmissionHealthy7 Participants
Usual CareNeonatal Hospital ReadmissionMissing1 Participants
Usual CareNeonatal Hospital ReadmissionBaby Died1 Participants
Secondary

Outpatient Perinatal Care Visits

Number of perinatal care visits

Time frame: Randomization to study completion (up to 34 weeks)

ArmMeasureValue (MEDIAN)
Digital Health Intervention (DHI)Outpatient Perinatal Care Visits13 Visits
Community Health Worker (CHW)Outpatient Perinatal Care Visits9.5 Visits
DHI Plus CHWOutpatient Perinatal Care Visits9 Visits
Usual CareOutpatient Perinatal Care Visits12 Visits
Secondary

Preterm Birth

Delivery of a neonate at less than 37 weeks

Time frame: At birth

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Digital Health Intervention (DHI)Preterm BirthYes2 Participants
Digital Health Intervention (DHI)Preterm BirthMissing0 Participants
Digital Health Intervention (DHI)Preterm BirthNo7 Participants
Community Health Worker (CHW)Preterm BirthYes1 Participants
Community Health Worker (CHW)Preterm BirthMissing2 Participants
Community Health Worker (CHW)Preterm BirthNo7 Participants
DHI Plus CHWPreterm BirthNo7 Participants
DHI Plus CHWPreterm BirthYes4 Participants
DHI Plus CHWPreterm BirthMissing0 Participants
Usual CarePreterm BirthYes3 Participants
Usual CarePreterm BirthMissing0 Participants
Usual CarePreterm BirthNo7 Participants
Secondary

Vaccination Rate

The number of mothers who received Tdap and infants who received the Hep B vaccine.

Time frame: Pregnancy through 6 weeks postpartum / 6 weeks of life

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
Digital Health Intervention (DHI)Vaccination RateNewborn Hep. BAccepted6 Participants
Digital Health Intervention (DHI)Vaccination RateMaternal TDAPAccepted7 Participants
Digital Health Intervention (DHI)Vaccination RateMaternal TDAPNewborn Death0 Participants
Digital Health Intervention (DHI)Vaccination RateMaternal TDAPDid not receive2 Participants
Digital Health Intervention (DHI)Vaccination RateNewborn Hep. BDid not receive3 Participants
Digital Health Intervention (DHI)Vaccination RateNewborn Hep. BNewborn Death0 Participants
Community Health Worker (CHW)Vaccination RateNewborn Hep. BDid not receive3 Participants
Community Health Worker (CHW)Vaccination RateNewborn Hep. BNewborn Death1 Participants
Community Health Worker (CHW)Vaccination RateMaternal TDAPDid not receive6 Participants
Community Health Worker (CHW)Vaccination RateMaternal TDAPNewborn Death0 Participants
Community Health Worker (CHW)Vaccination RateMaternal TDAPAccepted4 Participants
Community Health Worker (CHW)Vaccination RateNewborn Hep. BAccepted6 Participants
DHI Plus CHWVaccination RateMaternal TDAPDid not receive6 Participants
DHI Plus CHWVaccination RateNewborn Hep. BDid not receive5 Participants
DHI Plus CHWVaccination RateNewborn Hep. BAccepted6 Participants
DHI Plus CHWVaccination RateMaternal TDAPAccepted5 Participants
DHI Plus CHWVaccination RateMaternal TDAPNewborn Death0 Participants
DHI Plus CHWVaccination RateNewborn Hep. BNewborn Death0 Participants
Usual CareVaccination RateNewborn Hep. BNewborn Death0 Participants
Usual CareVaccination RateMaternal TDAPDid not receive5 Participants
Usual CareVaccination RateMaternal TDAPNewborn Death0 Participants
Usual CareVaccination RateNewborn Hep. BAccepted7 Participants
Usual CareVaccination RateNewborn Hep. BDid not receive3 Participants
Usual CareVaccination RateMaternal TDAPAccepted5 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026