Maternal Complication of Pregnancy, Maternal Death
Conditions
Keywords
pregnancy related death, patient reported outcomes, mHealth, patient activation
Brief summary
Pregnancy-related death is a growing public health issues, which are of particular concern to minority groups, including African-Americans and Spanish-speaking Latinas. Our proposal aims to improve a patient's ability to detect warning signs of pregnancy related death and seek medical care.
Detailed description
Pregnancy-related death (PRD) rates have risen 120-200% in the United States in the past two decades, and experts estimate that 40-60% of these cases are preventable. Improvement initiatives are predominantly hospital-based and rely on perinatal people recognizing their own symptoms and seeking care without ample support or education. We hypothesize that we can improve patients' self-efficacy and decision-making about when to seek care by helping them to self-monitor symptoms and by providing decision support. We propose to develop a mHealth-based, patient-reported outcome (PRO) and decision-support system to help mothers determine when to seek care for warning signs of PRD. Our project focuses on diverse populations facing postpartum disparities, particularly African- American and Spanish-speaking Latina women. This protocol involves a single-arm pilot trial assessing the feasibility and preliminary effectiveness of MOMS/MAMA for improving knowledge and patient activation among postpartum patients.
Interventions
OTHERMaternal Outcome Monitoring and Support system
The Maternal Outcome Monitoring and Support system is a mobile health application that allows participants to choose symptoms they may be having that are warning signs of pregnancy related death. They then receive decision support about when they should seek medical care (call their provider or go to an emergency room).
Sponsors
Columbia University
National Institute on Minority Health and Health Disparities (NIMHD)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Greater than 28 weeks pregnant * Receiving healthcare in the United States * Age 18 years or older * \[Identify as Black or African American race AND able to speak and read English, AND preferred language of English\] OR \[Identify as Hispanic/Latino Ethnicity AND Spanish able to speak and read Spanish AND preferred language of Spanish\] * Planned delivery at the following NewYork-Presbyterian hospitals: Children's Hospital of New York, Allen Hospital, Weill Cornell Medical Center, Lower Manhattan Hospital
Exclusion criteria
* Severe cognitive impairment * Major psychiatric illness * Concomitant terminal illness that would preclude participation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient activation | Baseline to 6 weeks postpartum | Change in patient activation measured using the validated Patient Activation Measure (PAM) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Knowledge of pregnancy related death warning signs | Baseline to 6 weeks postpartum | Change in knowledge of warning signs for pregnancy related death |
Countries
United States
Outcome results
None listed