Perinatal Population Health
Conditions
Keywords
Community Care Hubs, Community Health Worker, Prenatal Care, Postpartum Care, Integrated Data Systems, Resiliency Skill Building, Learning Collaboratives
Brief summary
Enhancing Perinatal Population Health through Community Care Hubs (CARE) is designed to test system level, organizational level, and workforce level strategies that may activate individual, community health worker (CHW), CHW supervisor, and system level mechanisms to improve care coordination, timely connection to prenatal and postpartum services, and downstream clinical outcomes related to maternal morbidity and mortality.
Detailed description
Enhancing Perinatal Population Health through Community Care Hubs (CARE) is designed to test system level, organizational level, and workforce level strategies that may activate individual, community health worker (CHW), CHW supervisor, and system level mechanisms to improve care coordination, timely connection to prenatal and postpartum services, and downstream clinical outcomes related to maternal morbidity and mortality. The purpose of this study is to evaluate whether multi-level enhancements to Pathways Community Hub infrastructure improve evidence based prenatal and postpartum service delivery and maternal health outcomes among pregnant and postpartum women experiencing social needs.
Interventions
OTHERIntegrated Data Systems
Integrated Data Systems support intervention includes standardized social needs screening, improved data sharing and care coordination and health information exchange integration.
Learning Collaborative intervention includes specialized perinatal training for CHWs, peer learning and expert-led education, and trauma-informed and evidence-based care practices.
OTHERResiliency Skill Building
Resiliency Skill Building intervention includes Community Resiliency Model training, burnout prevention and workforce well-being support and ongoing coaching for CHWs and supervisors.
Sponsors
Ohio State University
National Institute of Nursing Research (NINR)
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
This study is an experimental, cluster-randomized trial using a 2×2 factorial design. The research evaluates hub-level system-level and workforce-level interventions implemented within Pathways Community Hubs that serve pregnant and postpartum individuals.
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
The trial includes 8 Pathways Community Hubs located throughout Ohio. Hubs are randomly assigned to study conditions rather than individual participants.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Timely prenatal and postpartum care connection | Prenatal care visit within first trimester AND postpartum care visit within 7-84 days after delivery | Prenatal care initiation and postpartum care attendance |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Screening completion rates | First trimester of pregnancy | The percentage of participants who are screened for social needs by CHWs |
| Brief Resiliency Scale | Annually during the trial | Measure of resiliency for CHWs |
| Self-efficacy for CHWs | Annually during the trial | self-efficacy to support perinatal care for CHWs |
| turnover intention | Annually during the trial | Interest in leaving the CHW workforce |
| Patient engagement | Postpartum (7-84 days after delivery) | Patient Activation Measure |
| Preterm Birth | At delivery | \<37 weeks gestational age |
| Depression | Postpartum (7-84 days after delivery) | PHQ-9 |
| Social Service Connections | From client enrollment to 6 months postpartum | Completed referrals through the Hub pathways |
| Turnover | Annually during the trial | The number of CHWs that leave a Hub |
Contacts
CONTACTLaura Binkley, PhD, MSc, MPH
PRINCIPAL_INVESTIGATORDaniel Walker, PhD, MPH
Ohio State University
Outcome results
None listed