Maternal and Child Health Research Program

Advancing Applied MCH Research

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Maternal and Child Health Research Network on Pregnancy-related Care: The Collaborative Ambulatory Research Network (CARN)

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Project Number: UA6 MC 19010-03
Grantee: American College of Obstetricians and Gynecologists
Department/Center: Research Department
Project Date: 09/01/2010

Final Report


Principal Investigator

Jay Schulkin, PhD
Director of Research
409 12th St SW
Washington, DC  20024
Phone: 202-863-2504


  • Maternal
  • Prenatal


Problem: Obstetrician-gynecologists are the principal health care providers for women during pregnancy and the perinatal period. The Collaborative Ambulatory Research Network (CARN) project assesses the clinical care patterns and educational needs of health care providers to women in order to support efforts to improve health care for mothers and their children. Study findings are disseminated within ACOG to inform the College's educational efforts, and are published in peer reviewed journals. Goals and Objectives: The goals of the CARN project are: 1) Assess the opinions, knowledge, clinical practice, and educational needs of physicians regarding areas of clinical medicine relevant to maternal and child health. 2) Assess the efficacy of ACOG clinical practice guidelines. 3) Inform and support ACOG educational efforts. 4) Disseminate results of the CARN studies to as broad an audience as possible. 5) Monitor the training, recruitment, and retention of health care professionals into maternal and child health, especially under-represented minorities. 6) Assess patient perceptions of care provided by physicians 7) Encourage interaction among different health care professionals, researchers, and policy analysts to study critical issues in maternal and child health. 8) Train and mentor students and young researchers. Methodology: The CARN is the only existing national collective of practicing obstetrician-gynecologists who have been recruited to participate in survey studies. CARN study questionnaires are designed to generate descriptive data pertaining to: obstetrician-gynecologists' practice patterns, clinical experiences, basic knowledge, professional training, access to resource materials, and educational needs. CARN studies are often developed in conjunction with the production or revision of ACOG clinical practice guidelines in order to assess the extent to which ACOG Fellows are aware of and following recommended best practices. The CARN project also supports workshops and symposia, production of review articles, and the training of students. Coordination: Survey studies are constructed with consultation with ACOG Fellows, the Child and Maternal Health Branch of HRSA, other federal agencies, and US universities and research institutions. CARN-sponsored workshops are another means by which the CARN project interacts and coordinates with the broader community of maternal and child health researchers and policy makers. Evaluation: The results from survey studies are published in peer reviewed journals. Periodically, review articles outlining the important findings of multiple CARN studies are produced. This serves the purpose of disseminating the information regarding current practice patterns in obstetrics and gynecology as widely as possible among obstetrician-gynecologists and health care policy researchers and decision makers. Annotation: The Collaborative Ambulatory Research Network (CARN) assesses the clinical care patterns and educational needs of health care providers by conducting studies on a wide range of critical topics related to women's health. The results of CARN studies inform health care providers and medical education efforts.


Listed is descending order by year published.

Anderson BL, Pearlman M, Griffin J, Schulkin J. Conflicting and changing breast cancer screening recommendations: survey study of a national sample of ob-gyns after the release of the 2009 USPSTF guidelines. J Healthc Qual. 2013;35:25-35.

Anderson BL, Williams S, Schulkin J. Statistical literacy of obstetrics-gynecology residents. J Grad Med Educ. 2013;June:272-275.

Farrow VA, Goldenberg RL, Fretts RC, Schulkin J. Psychological impact of stillbirths on obstetricians. J Matern Fetal Neonatal Med. 2013;26:748-52.

Farrow VS, Anderson B, Chescheir NC, Schulkin J. Sex differences among obstetrican-gynecologists: a review of survey studies. Obstet Gynecol Surv. 2013;68:235- 253.

Fuller E, Anderson BL, Leddy M, Schulkin J. Obstetrician-gynecologists‘ knowledge, attitudes and practices regarding major depressive disorder. J Psychosom Obstet Gynaecol. 2013;34:34-8.

Goldenberg RL, Farrow V, McClure EM, Reddy UM, Fretts RC, Schulkin J. Stillbirth: Knowledge and Practice among U.S. Obstetrician-Gynecologists. Am J Perinatol. 2013 Jan 17. [Epub ahead of print] PubMed PMID: 23329563.

Perkins RB, Anderson BL, Sheinfeld Gorn S, Schulkin J. Challenges in cervical cancer prevention: a survey of obstetrician-gynecologists. Am J Prev Med. 2013;45:175-181.

Power ML, Henderson Z, Behler JE, Schulkin J. Attitudes and practices regarding late preterm birth among American obstetrician-gynecologists. J Womens Health. 2013;22:167-72.

Power ML, Wilson E, Hogan S, Loft J, Williams J, Mersereau P, Schulkin J. Patterns of preconception, prenatal and postnatal care for diabetic women by obstetrician-gynecologists. J Reprod Med. 2013;58:7-14.

Raglan GB, Anderson BL, Lawrence H, Schulkin J. Obstetrics and gynecology practices and patient insurance type. Womens Health Issues. 2013;23:e161-5.

Vink J, Anderson B, Fuchs K, Schulkin J, D'Alton ME. Opinions and practice patterns of obstetricians-gynecologists in the United States regarding amniocentesis in twins. Prenat Diagn. 2013 May 22:1-5. doi: 10.1002/pd.4164. [Epub ahead of print] PubMed PMID: 23703651.

Wright JD, Silver RM, Bonanno C, Gaddipati S, Lu YS, Simpson LL, Herzog TJ, Schulkin J, D'Alton ME. Practice patterns and knowledge of obstetricians and gynecologists regarding placenta accreta. J Matern Fetal Neonatal Med. 2013 May 17. [Epub ahead of print] PubMed PMID: 23565991.

Anderson BL, Carlson R, Anderson J, Hawks D, Schulkin J. What factors influence obstetrician-gynecologists to follow recommended HIV screening and testing guidelines? J Womens Health (Larchmt). 2012; 21(7), 762-8.

Anderson BL, Gigerenzer G, Parker S, et al. Statistical literacy in obstetricians and gynecologists. Journal of Healthcare Quality. 2012. doi: 10.1111/j.1945-1474.2011.00194.x. [Epub ahead of print.]

Anderson BL, Gigerenzer G, Parker S, Schulkin J. Statistical literacy in obstetricians and gynecologists. J Healthc Qual, doi: 10.1111/j.1945-1474.2011.00194.x [Epub ahead of print].

Anderson BL, Schulkin J, Lawrence HC. Academic workforce trends in community hospitals. Journal of Community Hospital Internal Medicine Perspectives. 2012;2(1):17361.

Byams VR, Anderson BL, Grant AM, Atrash H, Schulkin J. Evaluation of bleeding disorders in women with menorrhagia: a survey of obstetrician-gynecologists. Am J Obstet Gynecol. 2012; 207(4), 269.e1-5.

Farrow VA, Lawrence H, Schulkin J. Women's healthcare providers' range of services and collaborative care. J Healthc Qual. 2012 [Epub ahead of print.]

Green DR, Anderson BL, Burke MF, Griffith J, Schulkin J. Obstetric providers' knowledge, awareness, and use of CDC'S HIV testing recommendations and One Test. Two Lives. Martern Child Health J. 2012; 16(5), 1113-1119.

Leddy MA, Farrow VA, Joseph GF, Schulkin J. Obstetrician/gynecologists and postpartum mental health: differences between CME course takers and nontakers. Journal of Continuing Education in the Health Professions. 2012;32(1):39–47.

Morgan MA, Anderson BL, Lawrence H, Schulkin J. Well-Woman Care among Obstetrician-Gynecologists: Opportunity for Preconception Care. J Matern Fetal Neonatal Med. 2012; 25(6), 595-9.

Obrecht NA, Chapman G, Anderson BL, Schulkin J. Retrospective frequency formats promote consistent experience-based Bayesian judgments. Applied Cognitive Psychology. 2012; 26 (30), 436-440.

Power ML & Schulkin J. Maternal obesity, metabolic disease, and allostatic load. Physiol Behav. 2012; 106(1), 22-8.

Queenan J, Power ML, Farrow V, Schulkin J. U.S. obstetrician-gynecologists' estimates of their patients' breastfeeding rates. Obstet Gynecol. 2012; 119(4): 838-44.

Rasmussen SA, Power ML, Jamieson DJ, Williams J, Schulkin J, Kahn EB, Zhang Y, Macfarlane K, Kissin DM. Practices of obstetrician-gynecologists regarding nonvaccinerelated public health recommendations during the 2009 H1N1 influenza pandemic. Am J Obstet Gynecol. 2012; 207(4), 294.e1-7.

Wenstrom K, Erickson K, Schulkin J. Are obstetrician-gynecologists satisfied with their maternal-fetal medicine consultants? A survey. Amer J Perinatol. 2012; 29(08), 599-608.

Anderson BL, Obrecht NA, Chapman G, Driscoll DA, Schulkin J. Physicians' Communication of Down Syndrome Screening Test Results: The Influence of Physician Numeracy. Genetics in Medicine. 2011; 13(8), 744-749.

Anderson BL, Schulkin J. Physicians' Perceptions of Patients' Knowledge and Opinions Regarding Breast Cancer: Associations with Patient Education and Physician Numeracy. Breat Care. 2011; 6(4), 285-288.

Anderson BL, Strunk AL, Schulkin J. Study on defensive medicine practices among obstetricians and gynecologists who provide breast care. Journal for Healthcare Quality. 2011; 33(3), 37-43.

Burwick RM, Schulkin J, Cooley SW, Janakiraman V, Norwitz ER, Robinson JN. Recent Trends in Continuing Medical Education Among Obstetrician–Gynecologists. Obstetrics & Gynecology. 2011; 117(5), 1060-4.

Dalton VK, Harris LH, Bell JD, Schulkin J, Steinauer J, Zochowski M, Fendrick AM. Treatment of early pregnancy failure: does induced abortion training affect later practices? Am J Obstet Gynecol. 2011; 204(6):493.e1-6.

Farrow VA, Leddy MA, Lawrence H, Schulkin J. Ethical concerns and career satisfaction in obstetrics and gynecology: a review of recent findings from the Collaborative Ambulatory Research Network. Obstet Gynecol Surv. 2011; 66(9):572-9. PubMed PMID: 22088234.

Kissin DM, Power ML, Kahn EB, Williams JL, Jamieson DJ, MacFarlane K, Schulkin J, Zhang Y, Callaghan WM. Attitudes and practices of obstetrician-gynecologists regarding influenza vaccination in pregnancy. Obstet Gynecol. 2011 Nov;118(5):1074-80. PubMed PMID: 22015875.

Leddy M, Haaga D, Gray J, Schulkin J. Postpartum mental health screening and diagnosis by obstetrician-gynecologists. J Psychosom Obstet Gynaecol. 2011; 32(1), 27-34.

Link-Gelles R, Chamberlain AT, Schulkin J, Ault K, Whitney E, Seib K, Omer SB. Missed opportunities: a national survey of obstetricians about attitudes on maternal and infant immunization. Matern Child Health J. 2011. [Epub ahead of print]

Matteson K, Anderson BL, Pinto SB, Lopes V, Schulkin J, Clark MA. Practice patterns and attitudes about treating abnormal uterine bleeding: A national survey of obstetricians and gynecologists. Am J Obstet Gynecol. 2011; 205(4), 32.e1-8.

Matteson KA, Anderson BL, Pinto SB, Lopes V, Schulkin J, Clark MA. Surveying ourselves: examining the use of a web-based approach for a physician survey. Evaluation and Health Professions. 2011; 34(4), 448-63.


Pregnancy, Primary Care, Clinical Practice, Health Education & Family Support, Labor & Delivery, Preterm, Screening

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