Using Participatory Complex Systems Approaches to Develop an Interactive Policy Analysis Simulator to Address Cardiovascular Severe Maternal Morbidity in Black Women

The rate of severe maternal morbidity (SMM) among non-Hispanic Black women (NHBW) is more than double that of other racial/ethnic groups. Cardiovascular severe maternal morbidity (CSMM) has increased substantially over the last 10 years and is associated with increased risk of maternal mortality in NHBW. Current approaches to understanding and addressing maternal health disparities focus on proximal risk factors largely overlooking the complex array of distal risk factors that reciprocally shape proximal factors and subsequent CSMM disparities. As a result and despite the breadth of existing preventive strategies prolonged maternal health disparities specifically CSMM suggest that current efforts alone are insufficient for achieving health equity at the population-level. Therefore alternate approaches are needed to transform the relevant knowledge base and generate breakthroughs.

Goals and objectives:

The goal is to apply complex systems approaches specifically participatory system dynamics (SD) group model building (GMB) and SD modeling techniques to generate a holistic understanding of the dynamically complex systems underlying disparate CSMM outcomes among NHBW and then translate this understanding into a novel interactive policy simulator for use among community members and policy makers. The objectives are to: 1) plan and implement interdisciplinary maternal health disparities research that applies participatory SD GMB approaches and SD modeling over the next five years; 2) disseminate research findings to diverse audiences in multiple formats including at least 5 open-access journal articles during the project period; 3) submit at least one federal grant proposal by project year 4; 4) demonstrate increased maternal health disparity research capacity through mentorship training and sustainability planning over the next five years; 5) develop and disseminate a stakeholder-informed interactive policy analysis simulator for public use by project year 5. METHODS: The project will engage diverse community stakeholders through five phases: 1) using SD GMB to create a qualitative SD model of the dynamically complex systems that generate CSMM among NHBW; 2) engaging in primary data collection among NHBW with previous history of CSMM; 3) translating the qualitative SD model into a quantitative SD simulation model; 4) using participatory learning lab sessions and existing intervention data to identify evaluate and enhance the effectiveness of existing and plausible interventions that can reduce disparate CSMM outcomes among NHBW; and 4) translating the quantitative SD model into a public-facing interactive policy analysis simulator for dissemination to community members stakeholders and researchers aiming to reduce CSMM among NHBW.

Products:

We will produce a public-facing interactive policy analysis simulator and deliver training sessions for community and policy stakeholders to holistically evaluate the effectiveness of policies and interventions. We will publish at least 5 open-access journal articles based on the empirical and solution-based insights gained.

Evaluation:

We will conduct a process and outcome evaluation of the Research Center project activities. We will measure effectiveness based on the achievement of our stated objectives. We will access additional technical assistance and evaluation support from the Coordinating Center.