Maternal Health Research Collaborative for Minority-Serving Institutions

U.S. Black women experience disproportionate maternal mortality and morbidity with two to four times higher risk compared to other racial/ethnic groups to which California is no exception. Maternal health risks are compounded with Sickle Cell Disease or Trait (SCD/T); complications include miscarriage pre-eclampsia preterm labor and low birth weight stillbirth placental abruption and maternal death-especially if SCD/T is not proactively managed. Early screenings and comprehensive medical management are crucial particularly as individuals transition from pediatric to adult care. Adolescents/young adults with SCD/T in their formative years have a condition that impacts reproductive decisions. Barriers to receiving comprehensive maternal healthcare include lack of preconception education for persons with SCD/T and their partners and early genetic counseling to help guide complex decisions. This proposal aims to increase reproductive planning and improve maternal health outcomes among people with SCD/T to decrease maternal health disparity. Goal 1: Expand maternal health disparity research and develop community-based solutions in partnership with community-based organizations (CBOs). Objective 1.1: Conduct a mixed methods study using a Community-Based Participatory Research (CBPR) approach to determine disparities in maternal mortality and severe morbidity in adolescent/young adult women of color with SCD/T population. Objective 1.2: Develop reproductive awareness and educational materials for adolescent/young adult people of color with SCD/T and their romantic partners. Objective 1.3: Conduct an intervention study using SCD/T educational materials + Community Resilience Model (CRM) skills. Goal 2: Increase maternal health disparity research capacity at LLUH. Objective 2.1: Develop a SCT Carriers Database from newborn screening (CDPH) for future outreach and prevention. Objective 2.2: Develop a Perinatal Care Protocol for maternal health screening and care for females of reproductive age with SCD/SCT depression and/or social needs. Objective 2.3: Develop a parallel Perinatal Pathway of Care for patients with SCD/SCT. Objective 2.4: Train maternal health care teams in the implementation of SCD/SCT awareness and education + CRM and the Perinatal Care Protocol and guide patients to utilize the Perinatal Pathway of Care. Mixed method study design guided by Life Course theory and components of Integrated Behavioral Model and Social Determinants of Health using a CBPR approach. Qualitative findings analyzed for emerging themes and input from CBO partners and our advisory board will inform the developmental-age-adjusted reproductive health education program followed by intervention testing development of a patient Pathway of Care and training materials and development of a Perinatal Care Protocol using a Delphi process with content experts. Longitudinal quantitative data will be analyzed to determine intervention effectiveness in impacting reproductive planning behavior. Tracking Number:GRANT13910521 Funding Opportunity Number:HRSA-23-112 Received Date:Jun 08 2023 07:33:57 PM EDT Presentations and publications of study results and project activities; grant proposals including at least one for funding from HRSA's Maternal and Child Health Bureau; SCT Carriers Database; Perinatal Care Protocol; and Perinatal Pathway of Care. Formative program development process and outcome evaluations will include tracking the number of participants across all grant activities; progress/completion of activities products; efficacy of training as indicated by knowledge of reproductive health; informed decision-making; confidence and ability to implement integrated care; and maternal health outcomes. Health Disparities; Perinatal; African American/Black; Youth with Special Health Care Needs Transition to Adulthood