Contraception, Family Dynamics, Family Structure, Health Literacy, Maternal Behavior, Postpartum Mood Disturbance, Trust in Healthcare System
Conditions
Brief summary
Maternal mortality in the United States is higher than in peer nations and has not decreased since 1990. Beyond mortality, severe maternal mortality impacts far too many women. Not only are these high rates alarming, but notable racial/ethnic and socioeconomic disparities exist. These inequities are highly regional, with women living in the rural southeast part of the United States, including the Mississippi Delta, having the highest rates of maternal mortality and morbidity. Unfortunately, these disparities have proven to be stubbornly resistant to interventions, necessitating an innovative multifaceted approach focused on community practice, building trust, and prioritizing patient voices. To meet this need, this proposal aims to establish the Mississippi Delta Research Center of Excellence for Maternal Health with the goal of addressing preventable maternal mortality, decreasing severe maternal morbidity, and promoting maternal health equity in partnership with the Mississippi Delta community. This patient-clinical linkages intervention study will evaluate the effectiveness of a multilevel and multisector communication and health literacy strategy to increase trust and engagement in postpartum healthcare among women in the Mississippi Delta, with a specific focus on Black women, their families, and their communities. These research projects both have the overarching goal of partnering with the community to determine and meet the needs of pregnant and postpartum women in the Mississippi Delta and address the disparities within maternity health and health care outcomes.
Detailed description
Maternal mortality in the United States is higher than in peer nations and has not decreased since 1990. Beyond mortality, severe maternal mortality impacts far too many women. Not only are these high rates alarming, but notable racial/ethnic and socioeconomic disparities exist. These inequities are highly regional, with women living in the rural southeast part of the United States, including the Mississippi Delta, having the highest rates of maternal mortality and morbidity. Unfortunately, these disparities have proven to be stubbornly resistant to interventions, necessitating an innovative multifaceted approach focused on community practice, building trust, and prioritizing patient voices. To meet this need, this proposal aims to establish the Mississippi Delta Research Center of Excellence for Maternal Health with the goal of addressing preventable maternal mortality, decreasing severe maternal morbidity, and promoting maternal health equity in partnership with the Mississippi Delta community. This research center will conduct two multi-layered research projects. Research Project 1 will determine the effectiveness of an evidenced-based community health worker home visiting program grounded in extensive patient and community participation. Research Project 2 will evaluate the effectiveness of a multilevel and multisector communication and health literacy strategy to increase trust and engagement in postpartum healthcare among women in the Mississippi Delta, with a specific focus on Black women, their families, and their communities. These research projects both have the overarching goal of partnering with the community to determine and meet the needs of pregnant and postpartum women in the Mississippi Delta and address the disparities within maternity care.
Interventions
BEHAVIORALThe PEN-3 Intervention Model
The PEN-3 Model is a sociocultural model for planning and assessing participant behavior within the context a cultural phenomenon. It will be used to assess intervention impact on patient-clinical linkages in the Mississippi Delta.
Sponsors
Jackson State University
University of Mississippi Medical Center
Harvard School of Public Health (HSPH)
Mississippi State Department of Health
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Clinical trial with one arm.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Identified as high risk pregnancy * Postpartum mothers/parents 18-45 years * Resident of the one of 5 target counties (Washington, Bolivar, Scott, Humphreys, and Carroll) * Maternal healthcare providers in target counties * Maternal community health leaders
Exclusion criteria
* not identified as high risk pregnancy * 18 years of age postpartum * cesarean birth * non-resident of the 5 target counties
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Improve trust in the healthcare system | 12 months from consent to participate | Mixed methods approach using Trust in Physician Scale \& Researcher developed qualitative tool |
| Increase maternal health literacy (patient and provider perspectives) | 12 months from consent to participate in the intervention | Brief literacy screening tool to evaluate health literacy in the health system (Qualitative and Quantitative Measures |
| Increase engagement in the maternal health care system (patient-clinic linkages) | 12 month from consent to participation in the intervention | Contraceptive Counseling measure tool to evaluate the patient experiences with provider care and vice-versa; minimally 2 post-partum clinec visits in postpartum period |
| Strengthen structuring of family support systems | 12 months from consent to participation in the intervention | Family crisis coping response (F-COPES) measure to determine patient (mother) and family perceptions and experiences with structuring family support fo postpartum care period. |
Countries
United States
Contacts
CONTACTMary Shaw, PhD
CONTACTGirmay Berhie, PhD
PRINCIPAL_INVESTIGATORMary Shaw, PhD
Jackson State University
STUDY_DIRECTORMary Shaw, PHD, M.ED
Jackson State University
Outcome results
None listed