Providing an Optimized and Empowered Pregnancy for You (POPPY) Aim 3: Randomized Controlled Trial

Purpose

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 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. In this trial, 400 non-Hispanic Black participants will be randomized to see if 2 promising interventions (digital health interventions and community health workers) reduce adverse pregnancy outcomes.

Conditions

  • Pregnancy Complications
  • Maternal Distress
  • Adverse Birth Outcomes
  • Infant Conditions

Eligibility

Eligible Ages
Between 16 Years and 49 Years
Eligible Genders
Female
Accepts 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 - Participated in POPPY Pilot

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Intervention Model Description
Study is a randomized trial (n=400) randomizing eligible participants to usual care (n=100), or usual care plus a digital health intervention (n=100), or usual care plus a community health worker intervention (n=100), or usual care plus both a digital health intervention and a community health worker intervention (n=100).
Primary Purpose
Prevention
Masking
Single (Care Provider)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
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.
  • Behavioral: Digital Health intervention
    Health care information delivered via a link in a text message that is then opened in a secure browser.
    Other names:
    • DHI
Experimental
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 12 weeks postpartum. The intervention has been modified by the POPPY Study Team and Community Advisory Board
  • Behavioral: Community Health Worker
    Health care information delivered via CHW.
    Other names:
    • CHW
Experimental
DHI Plus CHW
This group will receive routine prenatal care services. Additionally, this group will receive both DHI and CHW interventions.
  • Behavioral: Digital Health Intervention plus Community Health Worker
    Health care information delivered via DHI plus CHW
    Other names:
    • DHI plus CHW
No Intervention
Usual Care
This group will receive routine prenatal care services.

Recruiting Locations

University of Alabama at Birmingham
Birmingham, Alabama 35233
Contact:
Rosylen Quinney
205-934-1309
rquinney@uabmc.edu

More Details

Status
Recruiting
Sponsor
University of Alabama at Birmingham

Study Contact

Rosylen "Roz" Quinney
205.934.1309
rquinney@uabmc.edu

Detailed Description

The aim of this trial is to assess whether an existing Digital Heath Intervention (DHI) and/or a Community Health Worker (CHW) Intervention will reduce adverse maternal and perinatal outcomes. A 2 x 2 factorial randomized controlled trial of Non-Hispanic Black (NHB) patients living in high area deprivation index (ADI) communities will be conducted. Participants (n=400) will be randomized 1:1:1:1 to one of 4 arms: 1) standard prenatal care (PNC) alone, or 2) standard PNC plus DHI, or 3) standard PNC plus CHW, or 4) standard PNC, plus DHI and CHW. 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.