A Community Health Worker Intervention to Address Adverse Pregnancy Outcomes

Purpose

United States maternal mortality and preterm birth rates are among the highest among high-income countries due in part to a combination of racial, regional and socioeconomic disparities in access to care and overall health. The research proposed focuses on adapting and expanding a perinatal community health worker intervention for Black postpartum patients with preeclampsia (PE) and other adverse pregnancy outcomes (APOs). Investigators will partner with a community-based organization that trains and deploys community health workers. Investigators will test an intervention for urban and rural Black postpartum patients with APOs to 1) enhance blood pressure control postpartum and 2) promote long-term cardiovascular disease prevention for this underserved population. This pilot study will determine if randomizing and implementing a community health worker intervention tailored to pregnant people experiencing preeclampsia is feasible and found to be acceptable by participants.

Conditions

  • Preeclampsia Postpartum
  • Adverse Pregnancy Outcomes

Eligibility

Eligible Ages
Between 16 Years and 56 Years
Eligible Genders
Female
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  • Self Identifies as Black - Between 16-56 years old - Experiencing adverse pregnancy outcomes defined as hypertensive disorders of pregnancy, preterm birth, placental abruption, pregnancy loss (loss at greater or equal to 14 weeks gestation), gestational diabetes, delivering a small for gestational age infant - Planning to deliver at UAB Hospital - Speaks and writes in English

Exclusion Criteria

  • Declines Randomization - Speaks or writes in languages other than English - Currently incarcerated - Previously enrolled in P3OPPY

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Usual Care
Usual postpartum care
  • Behavioral: usual postpartum care
    Usual clinical and educational postpartum care
Experimental
Usual care and community health worker intervention
Usual postpartum care and community health worker visits and support
  • Behavioral: usual postpartum care + community health worker intervention
    participants will receive routine care and also community health worker support and visits.

Recruiting Locations

The University of Alabama at Birmingham
Birmingham, Alabama 35233
Contact:
Jesse Rattan, PhD, MPH, RN
404-606-3319
jrattan@uab.edu

UAB Medicine
Birmingham, Alabama 35205
Contact:
jesse E Rattan, PhD, MPH, RN
404-606-3319
jesserattan@gmail.com

More Details

Status
Recruiting
Sponsor
University of Alabama at Birmingham

Study Contact

Jesse E Rattan, PhD
205-934-5611
jrattan@uab.edu

Detailed Description

The investigators will adapt a current perinatal community health worker intervention, lead by a leading community health worker organization, Connection Health, to the unique needs of Black postpartum patients with preeclampsia and other adverse pregnancy outcomes. The investigators will conduct a pilot trial to assess the feasibility and acceptability of the intervention. The hypothesis is that it is possible to randomize eligible patients to the feasibility trial, and the intervention will be acceptable to participants. The investigators will randomize Black postpartum patients with preeclampsia or other adverse pregnancy outcomes to either 1) usual care - cardiovascular disease-prevention education before discharge, or 2) intervention - cardiovascular disease prevention education before discharge plus an adapted Connection Health community health worker intervention. Following the completion of this project, the investigators intend to conduct a larger postpartum community health worker intervention trial in patients with preeclampsia or other adverse pregnancy outcomes powered to detect a difference in clinically meaningful outcomes, as informed by our existing community advisory board.