GOOD AFTERNOON AND
WELCOME, EVERYONE.
WE ARE SO
EXCITED THAT YOU'RE HERE TO JOIN
US FOR THIS RESEARCH SHOWCASE.
FOR CONNECTING THE COMMUNITY AND
MATERNAL HEALTH CHALLENGE. LET
ME INTRODUCE MYSELF, MY NAME IS
THOM MARTIN AND I'M WITH A
COMPANY CALLED FED TECH AND I
WILL BE ONE OF THE MCS TODAY AND
I HAVE 30 YEARS OF RESEARCH AND
STRATEGY EXPERIENCE. AND I HAD
THE GREAT FORTUNE OF BEING PART
OF A TEAM THAT LED THE AFFECTING
THE COMMUNITY OF THE MATERNAL
HEALTH CHALLENGE AND I'M ALSO
JOINED TODAY WITH DR. JENNIFER
WISDOM, JENNIFER
>> JENNIFER: HI, I'M A CLINICAL
PSYCHOLOGIST AND RESEARCHER AND
I ALSO HAVE BEEN DELIGHTED TO BE
PART OF THIS TEAM. PART OF WHAT
I DID WITH THE TEAM WAS TO
PROVIDE AND COORDINATE TRAININGS
FOR THEM ON RESEARCH AND THEN
PROVIDED COACHING TO ASSIST THEM
THROUGHOUT THE PROCESS BUT MAKE
NO MISTAKE ALL THE GOOD STUFF IS
ON THEM, THEY DID FANTASTIC W
WORK.
>> THOM: AWESOME, WELL, THANK
YOU, JENNIFER AND A BIG THANKS
TO THE TEAM AT NIH AND NIHCD FOR
THE AMAZING SUPPORT ON THIS
GROUP TODAY WE'LL DO A QUICK
INTRODUCTIONS AND OVERVIEW.
WE'RE THEN GOING TO WELCOME
DR. ALISON CERNICH THEN JUMP
RIGHT INTO PRESENTATIONS. WITH
A LITTLE BREAK IN BETWEEN THE
MIDDLE PART OF THE
PRESENTATIONS. WE'RE GOING TO
HAVE A Q&A SESSION FOR ABOUT TEN
MINUTES. AND THEN DR. BALL KEY
IS AN IS GOING TO PROVIDE SOME
REFLECTIONS ON THIS CHALLENGE.
SO A COUPLE OF LITTLE NOTES.
WE ARE RECORDING THIS WEBINAR
TODAY. BY WE REALLY REQUEST
THAT YOU DO NOT RECORD, TAKE
SCREENSHOTS OR REPLICATE. WE'RE
GOING TO BE ACCEPTING QUESTIONS
IN THE Q&A TAB AT THE BOTTOM OF
THE PAGE AND LOOK BELOW YOU'LL
SEE Q&A TAB IS CHAT, CHAT IS
DISABLED, Q&A WORKS. WE'LL HOLD
THOSE QUESTIONS UNTIL THE Q&A
SESSION. WE HAVE A GREAT TEAM
WITH AMY WHO WILL HELP US IN THE
EVENT THAT YOU HAVE ANY
TECHNICAL DIFFICULTIES.
JENNIFER, WOULD YOU LIKE TO LEAD
THE INTRODUCTION?
>> JENNIFER: SO TO SAY A LITTLE
BIT ABOUT THE IMPROVED
INITIATIVE OF IMPROVING THE
OUTCOMES VISION FOR EVERYONE.
THIS IS A REALLY IMPORTANT
INITIATIVE. ON AVERAGE ABOUT
700 PEOPLE DIE EACH YEAR OF
PREGNANCY RELATED CAUSES IN THE
U.S. AND UNFORTUNATELY, THE
RACIAL, ETHNIC AND SOCIOECONOMIC
DISPARITIES IN THESE MATERNAL
DEATHS ARE STARK. FOR EXAMPLE,
AMERICAN INDIAN, ALASKAN NATIVE
AND BLACK WOMEN ARE TWO TO THREE
TIMES AS LIKELY TO DIE FROM A
PREGNANCY CAUSE COMPARED TO
WHITE WOMEN. THIS INCLUDES
AFRICAN AMERICAN BLACK, AMERICAN
INDIAN, ALASKAN NATIVE, NATIVE
PACIFIC ISLANDER MEANS ENGAGING
THE COMMUNITIES IN THIS PROCESS
TO MAKE SURE THEIR NEEDS ARE
CAPTURED THAT IS WHAT THIS
PROJECT IS ALL ABOUT.
>> THOM: GREAT, THANK YOU,
JENNIFER. AND LET ME GIVE YOU A
LITTLE BIT OF INSIGHT INTO THE
CONNECTING THE COMMUNITY FOR
MATERNAL HEALTH CHALLENGE THIS
WAS OPEN TO COMMUNITY BASED AND
COMMUNITY ORIENTED 5013C
ORGANIZATIONS AND THE REAL GOAL
WAS TO HELP THESE TEAMS BUILD
INFRASTRUCTURE CAPABILITIES TO
ENABLE THEM TO PURSUE THE
MATERNAL HEALTH RESEARCH IN THE
AREAS THAT IMPACT IN THEIR
SPECIFIC COMMUNITIES. WE KNOW
IN THIS AREA OF WORK, WE HAVE TO
BE LOCAL. AND THAT IS WHAT
THESE TEAMS REALLY SET OUT TO
DO. SO THERE WAS FOUR PHASES OF
THE CHALLENGE. AND THIS HAS
BEEN GOING ON FOR CLOSE TO TWO
YEARS. WE STARTED WITH A NUMBER
OF INFORMATIONAL INTERVIEWS
HOSTED BY THE TEAM AND WITH FED
TECH AND NIH. AND DURING A FOUR
WEEK PERIOD WE HAD A LOTS OF --
WEBINARS, AND WE RECEIVED 90
APPLICATIONS. FROM THERE, WE
SELECTED 50 ORGANIZATIONS AND
THEN WE STARTED OUR TRAINING AND
ONE-ON-ONE COACHING. THE TEAMS
DEVELOPED OUT A SCOPING AND AN
APPROACH DOCUMENT THAT WAS
REVIEWED BY SOME OF THE ESTEEMED
FOLKS AT THE NIH AND THE NIHCD.
AND 15 ORGANIZATIONS WERE
SELECTED TO BE IN THEM. OVER A
TEN WEEK PERIOD OF VIRTUAL
WORKSHOPS, SUBJECT MATTER EXPERT
TALKS, ONE-ON-ONE COACHING AND
NETWORKING OPPORTUNITIES THEN
SUBMITTED THEIR PROPOSALS. NINE
ORGANIZATIONS WERE SELECTED TO
CONTINUE LAST JUNE. SO FOR THE
LAST YEAR, THEY'VE BEEN BUILDING
THEIR INFRASTRUCTURE AND
CONDUCTING THEIR WORK. WE AT
FED TECH, HERO X AND NIHCD TEAM
HAVE BEEN PROVIDING WEEKLY
WORKSHOPS ON PROJECT MANAGEMENT,
REPORT WRITING, AND WE'RE
PROVIDING SUBJECT MATTER EXPERTS
AND A NUMBER OF GREAT SPEAKERS
AND ONE-ON-ONE COACHING
THROUGHOUT THE WHOLE PROGRAM.
SO IT'S A VERY ROBUST AND A WELL
SUPPORTED PROGRAM TO HELP THESE
TEAMS SUCCEED. I THINK AS YOU
SEE THE PRESENTATIONS, YOU CAN
SEE THEY'VE DONE JUST A GREAT
JOB.
>> JENNIFER: YEAH, ABSOLUTELY IT
TOOK SO MANY PEOPLE TO MAKE THIS
WORK. A HUGE TEAM AT NIH HAS
DONE A FANTASTIC JOB OF
SHEPHERDING THIS THROUGH AND
PROVIDING THEIR EXPERTISE EVERY
STEP OF THE WAY AND MANY OF
THESE FOLKS ARE HERE WITH US
TODAY SO BIG THANKS TO NIH. FOR
THE NEXT SLIDE, PLEASE. WE
WOULD ALSO LIKE TO THANK OUR
GUEST SPEAKERS. WE HAD EXPERTS
FROM THE CDC, FROM HRSA, FROM
OTHER PARTS OF NIH AND
RESEARCHERS ACROSS THE COUNTRY
TO HELP RESEARCHERS DEVELOP WHAT
THEY'RE DOING AND THINK MORE
BROADLY ABOUT THE IMPACT OF
MATERNAL HEALTH AND THE PROGRAM
TEAM AS THOM MENTIONED WE HAVE A
WHOLE CAST HERE FROM HERO X,
NASA, WISDOM CONSULTING ANDED A
VAR RAH WHO HELPED WITH EVERY
ASPECT OF GETTING THE TECHNICAL
PIECES DONE.
GETTING THE WEBINARS DONE ON
TIME AND COMMUNICATING WITH THE
SITE. THANKS TO EVERYONE WHO
MADE THIS A FANTASTIC ADVENTURE.
AND OF COURSE, A SPECIAL THANK
YOU TO THE COMMUNITY
ORGANIZATIONS THAT TOOK PART,
YOU HAVE BEEN ABSOLUTELY
AMAZING. AND WE'RE ALL SO
EXCITED TO HEAR FROM YOU TODAY.
SO NEXT UP WE HAVE DR. CERNICH
IS WITH US. DR. ALISON CERNICH.
SHE BECAME THE DEPUTY DIRECTOR
OF THE EUNICE KENNEDY SH LIVER
NATIONAL INSTITUTE OF CHILD
DEVELOPMENT IN 2019 AND ASSISTS
THE DIRECTOR IN SUPPORTING
RESEARCH ON CHILD DEVELOPMENT,
DEVELOPMENTAL BIOLOGY,
NUTRITION, HIV, AIDS,
INTELLECTUAL AND DEVELOPMENTAL
DISABILITIES, POPULATION
DYNAMICS, WOMEN'S HEALTH,
REPRODUCTIVE BIOLOGY,
CONTRACEPTION PREGNANCY AND
MEDICAL REHABILITATION. SHE
ALSO REPRESENTS NICHD ON
WIDE-RANGING INITIATIVES IN
DIVERSITY, EQUITY INCLUSION AND
ACCESSIBILITY. MATERNAL HEALTH,
DATA SCIENCE, NEURAL SCIENCE,
AND SOCIAL DETERMINANTS OF
HEALTH AND PAIN. DR. CERNICH IS
A SOUGHT AFTER COLLABORATOR AND
LEADS OR CONTRIBUTES TO THE
DEPARTMENT OF HEALTH AND WORKING
SERVICES GROUPS ON REPRODUCTIVE
CARE AND PATIENT CENTERED
OUTCOME. WELCOME, DR. CERNICH
AND WE ARE SO DELIGHTED TO HEAR
FROM YOU.
>> ALISON: WELL, FIRST OFF, JEN,
THANK YOU, THOM, THANK YOU THE
TEAM, YOU KNOW, I JUST WANT TO
EXTEND MY WELCOME SO THE
IMPROVED CONNECTING THE RESEARCH
SHOWCASE. WE HAVE BEEN WITH
THIS PROGRAM SINCE IT WAS AN
IDEA ON A PIECE OF PAPER BEFORE
WE EVER ENTERED INTO AN
AGREEMENT WITH NASA EVER MET OUR
TEAM AT HERO X AND FED TECH AND
EVER CONVENED ALL OF OUR NIH
EXPERTS AND HAVE BEEN WORKING
WITH US AS WELL AS OUR EXTERNAL
TECHNICAL ADVISORS FROM THE
MARCH OF DIMES, FROM
COMMONWEALTH FUND AND ELSEWHERE
THAT HAVE REALLY WORKED WITH US.
AND THESE EIGHT INCREDIBLE
COMMUNITY ORGANIZATIONS THAT
YOU'RE GOING TO HEAR FROM TODAY.
THAT HAVE ADVANCED TO BE
FINALISTS IN THE RESEARCH PHASE
OF THIS CHALLENGE AND I WANT TO
ACKNOWLEDGE THE FOLKS THAT
PARTICIPATED THROUGHOUT THAT
TOOK TIME, IT TOOK EXPERTISE AND
IT SHOWS YOUR DEDICATION TO
IMPROVING HEALTH OUTCOMES. AND
WE TALKED ABOUT THE REASONS WE
LAUNCHED THIS CHALLENGE BETWEEN
OUR INSTITUTE. WE ARE
CO-LEADING THE IMPROVE
INITIATIVE WITH THE NATIONAL
INSTITUTE OF NURSING RESEARCH
AND THE OFFICE OF RESEARCH ON
WOMEN'S HEALTH AND WE COORDINATE
AND COLLABORATE ACROSS THE NIH
ON THIS PROGRAM TO REDUCE
PREVENTABLE CAUSES OF MATERNAL
DEATH AND IMPROVE HEALTH OF
WOMEN BEFORE, AFTER AND DURING
DELIVERY. WE KNOW THAT ONE OF
THE THINGS WE NEED TO DO TO MAKE
A DIFFERENCE IN MATERNAL
MORBIDITY IS ENGAGE COMMUNITIES.
AND THESE ARE THE COMMUNITIES WE
REPRESENT. AND WE NEED YOU TO
MAKE THESE DIFFERENCES AND TO BE
QUITE HONEST OFTEN WE RELY ON
OUR ACADEMIC INSTITUTIONS, ON
HOSPITALS, BY THE RESPONSE TO
THIS PROGRAM ANNOUNCEMENT SHOWED
THAT COMMUNITIES WERE READY TO
TAKE ON THIS RESEARCH CHALLENGE
AND I THINK THAT REFLECTED THE
LEVEL OF CONCERN AND COMMITMENT
COMMUNITIES HAVE THAT AFFECT
PEOPLE WHERE THEY RIVLIVE. WE
WANTED TOME POWER COMMUNITY
BASED ORGANIZATIONS TO CONDUCT
AND PARTICIPATE IN RESEARCH BY
HELPING THEM DEVELOP THE
RESOURCES AND CAPABILITIES
NECESSARY TO CONDUCT MATERNAL
HEALTH RESEARCH AND COMPETE FOR
FEDERAL FUNDING. SO I KNOW THAT
YOU ALL HAVE BEEN GETTING
TRAINING FOR A LONG TIME. AND
ENGAGING WITH REALLY AMAZING
EXPERTS AND I WANT TO THANK ALL
OF THEM AND ESPECIALLY JEN FOR
LEADING MOST OF THEM WITH OUR
NIH TEAM AND GETTING ALL THE
MATERIALS DEVELOPED OUT. I HOPE
THOSE HAVE BEEN VALUABLE AND
EQUIPPED YOU WITH THE TOOLS YOU
NEED TO CONTINUE YOUR WORK AFTER
THIS PROGRAM ENDS. AND BEFORE I
TURN IT OVER, I JUST REALLY NEED
TO TAKE A MOMENT TO THANK OUR
TEAM, ESPECIALLY OUR CHALLENGE
COLEADS FROM NICHD. DOCTORS
MAURICE DAVIS AND JUANITA CHINN.
MAURICE AND JUANITA SAID YES TO
AN IDEA THAT HAD NOT BEEN TESTED
AND I'M SUPER GRATEFUL TO THEM.
THIS WAS A SECOND TIME MAURICE
SAID YES TO ME WHEN I HAD AN
IDEA AND I AM GRATEFUL FOR HIM
TO JUMP IN AND JUANITA TO LEARN
THIS PROCESS AND HUGE THANK YOU
TO PARTNERS FOR ALWAYS BEING
THERE AND THINKING WITH US AND
REALLY CRITIQUING OUR PROCESS
AND OUR PROGRAM. OUR CONTRACT
TEAM. OUR IRB TEAM. AND
FINALLY, OUR WONDERFUL
PARTICIPANTS FOR THEIR
CONTRIBUTIONS AND INVOLVEMENT.
BUT I WANT TO THANK ALL OF YOU
FOR YOUR DEDICATION, YOUR
CREATIVITY AND YOUR HARD WORK.
I'M SO PROUD OF WHAT THIS
PROGRAM IS DOING. TO MAKE THE
DIFFERENCE IN THE LIVES OF
PREGNANT AND POSTPARTUM PEOPLE
RIGHT WHERE YOU LIVE AND I
REALLY AM EXCITED TO HEAR ABOUT
THIS. THIS IS SOMETHING THAT I
HAVE BEEN TRACKING FROM ITS VERY
BEGINNING. AND THIS IS GOING TO
BE REALLY FUN FOR ME TO HEAR
WHERE WE ARE NOW. SO I WILL
TURN IT BACK TO THE TEAM, BUT
THANK YOU ALL SO MUCH FOR GIVING
ME THE OPPORTUNITY TO SAY THANK
YOU. THIS HAS BEEN A REALLY
WONDERFUL JOURNEY.
>> THOM: THANK YOU DR. CERNICH
AND NOW ONTO OUR EIGHT
PRESENTATIONS. SO JUST A QUICK
REMINDER, NO RECORDING, NO
SCREENSHOTS, AND NO
REPLICATIONS. I WANT TO MAKE A
SPECIAL NOTE THAT THE TEAM ARE
BUSY WITH THEIR WORK BUT STILL
CONDUCTING THEIR RESEARCH SO
THESE ARE PRELIMINARY FINDINGS
SO WE APPRECIATE THE NO
SCREENSHOTS OR REPLICATIONS.
PLEASE REMEMBER TO PUT YOUR
QUESTIONS IN THE TAB AND WE WILL
GET GOING. SO WITH THAT
JENNIFER WOULD YOU LIKE TO
SURPRISE THE FIRST TEAM?
>> JENNIFER: ABSOLUTELY.
WELCOME TO THE ABUNDANCE
PROJECT. MS. MICHELE HOLLAND IS
THE FOUNDER OF THE PROJECT THAT
PROVIDES ACCESS, EDUCATION AND
ADVOCACY FOR DOULA CARE TO
MOTHERS IN NEED BY REMOVING
ETHIC DISPARITIES IN MATERNAL
HEALTH CARE. SHE HAS OVER THREE
DECADES OF EXPERIENCE AS A
CHAMPION AND HAS A BOOK ON
PRENATAL MASSAGE THERAPY.
JESSICA HAN LYNN IS CO-OWNER OF
SANCTU
SANCTUARY DOULAS, SHE IS A
MOTHER, POSTPARTUM DOULA AND
PERINATAL HEALTH THERAPIST. WE
LOOK FORWARD TO YOUR
PRESENTATION.
>> THANK YOU, I WANT TO THANK
THE NIH LEADERS. WE'RE SO
HONORED TO HAVE BEEN CHOSEN AS
ONE OF THE EIGHT FINALISTS IN
CONNECTING AND COMMUNITY AND WE
EXTEND OUR GRATITUDE TO THE
OTHER SEVEN NONPROFITS
PRESENTING TODAY. AS JENNIFER
MENTIONED, THE ABUNDANCE PROJECT
IS LOCATED IN BEAUTIFUL BOULDER
COUNTY, KROO KRO WE PROVIDE
ADVOCACY FOR DOULA CARE WITH
SPONSORSHIPS WITH ACADEMIC
CHALLENGES.
SANCTUARY DOULAS AND FAMILY CARE
IS COLORADO'S LARGEST INFANT
CARE TEAM AND I HAVE HAD THE
PRIVILEGE OF WORKING WITH BOTH
JESSICA AND THE CO-OWNER ALISON
SINCE 2018 IN A LOVELY COMMUNITY
PARTNERSHIP THAT MAKES THE
FUNDING AND THIS POSTPARTUM
DOULA CARE POSSIBLE IN OUR
COMMUNITIES. OUR RESEARCH TEAM
HAS ALSO ADDED TWO REMARKABLE
UNIVERSITY MATERNAL HEALTH
RESEARCH EXPERTS. ELIZABETH
GREEN WE'LL AND LAUREL HICKS
WITH THE CROWN INSTITUTE OF THE
UNIVERSITY OF COLORADO-BOULDER,
NEXT SLIDE, PLEASE.
OUR RESEARCH EXAMINES THE IMPACT
OF POSTPARTUM DOULAS ON MENTAL
HEALTH AND HYPERTENSION IN BIPOC
MOTHERS. DEPRESSION, ANXIETY
AND HYPERTENSION ARE THE LEADING
FACTORS CONTRIBUTING TO MATERNAL
MORBIDITY AND MORTALITY IN THE
UNITED STATES, ESPECIALLY AMONG
BLACK, INDIGENOUS AND PEOPLE OF
COLOR BIPOC POSTPARTUM MOTHERS
IS POSTPARTUM DOULA CARE
EFFECTIVE IN REDUCING SYMPTOMS
OF DEPRESSION AND HYPERTENSION?
TWO, WHAT IS THE ACCEPTABILITY
AND FEASIBILITY OF POSTPARTUM
DOULA CARE AS AN INTERVENTION?
AND THREE HOW DOES POSTPARTUM
DOULA CARE IMPACT THE POSTPARTUM
EXPERIENCE. THE SUMMARY OF OUR
PROJECT IS WE EMPLOYED A
LONGITUDINAL PILOT STUDY TO
EXPLORE THE EFFECTS OF THIS
NON-MEDICAL INTERVENTION THE
STUDY'S INTERVENTION CONSISTED
OF A SERIES OF IN-HOME
POSTPARTUM CARE VISITS, 24 HOURS
TOTAL GENERALLY OFFERED IN SIX
VISITS OF FOUR HOURS EACH
PROVIDED TO THE STUDY
PARTICIPANTS WITHIN THE FIRST
YEAR POSTPARTUM. OUR PROJECT
TIMELINE BEGAN IN SEPTEMBER 2023
AND WILL CONCLUDE IN 2024 UPON
REACHING OUR INTENDED SAMPLE
SIZE WITH THE REEVALUATION AT
THAT TIME OF BEST NEXT STEPS.
JESSICA WILL SHARE OUR NEXT
RESEARCH FINDINGS. NEXT SLIDE,
PLEASE.
>> OUR STUDY WAS ORIGINALLY
DESIGNED AS A RANDOMIZED CONTROL
TRIAL BUT WE HAD SLOW
RECRUITMENT AND TIME
CONSTRAINTS. OUR INTERVENTION
EQUALS 24 HOURS OF POST PARTUM
DOULA CARE. WE COLLECTED DATA
THROUGH ELECTRONIC FORMS OF
(READING). WE'VE ENROLLED 20
PARTICIPATION UP FROM 16. WHICH
IS GREAT. NEXT SLIDE, PLEASE.
IN LOOK AT OUR PRELIMINARY
RESEARCH FINDINGS WE HAVE USED
THE SOFTWARE SPSS TO CONDUCT OUR
ANALYSES THUS FAR WE COLLECTED A
WIDE ARRAY OF DESCRIPTIVE
CHARACTERISTICS AND FOUND SOME
TRENDS AS A MAJORITY OF OUR
PARTICIPANTS WERE RECEIVING
MEDICAID BENEFITS. ALSO NOTE WE
ADDED A FEW MORE PARTICIPANTS
WHOSE PRIMARY LANGUAGE IS
SPANISH AND WE ARE EAGER TO
REACH MORE IN THE MONTHS TO
COME. AS YOU CAN SEE HERE IN
FIGURE ONE OUR PARTICIPANT
SCORES FOR DEPRESSION THROUGH
THE PHQ-9 AND ANXIETY THROUGH
THE GAD-7 THUS FAR HAVE
DECREASED WE USE THESE TEST FOR
DEPRESSION AND ANXIETY AS WELL
FOR BLOOD PRESSURE READINGS.
OUR PRELIMINARY RESULTS
ANTICIPATE STRONG ENGAGEMENT AND
SATISFACTION WITH THE
INTERVENTION. NEXT SLIDE,
PLEASE. CONCLUSIONS DRAWN AT
THIS POINT IN THE STUDY INDICATE
PARTICIPATION IS ASSOCIATED WITH
A REDUCTION IN ANXIETY SYMPTOMS.
EARLY RESULTS BEGIN TO PROVIDE
EVIDENCE THAT POSTPARTUM CARE
COULD ADDRESS THE MORBIDITY AND
MORTALITY. AND POTENTIALLY ALSO
FOR MATERNAL HYPERTENSION AS
WELL. THE IMPLICATIONS OF OUR
FINDINGS INCLUDE OPPORTUNITY FOR
EARLY REFERRAL FOR MEDICAL
ATTENTION FOR MOTHERS RECEIVING
POSTPARTUM CARE. WE HAVE THE
OPPORTUNITY TO HELP BRIDGE THE
GAP FOR BIPOC FAMILIES AND
REBUILDING TRUST WITH THE
MATERNAL HEALTH SYSTEM THERE'S A
SIGNIFICANT NEED FOR MEDICATION
FOR THOSE IN POSTPARTUM CARE AND
FUNDING IN THIS CASE IS
IMPORTANT FOR ACCESS AND
AWARENESS. OUR PRELIMINARY
FINDINGS CONTRIBUTE TO A GROWING
BODY OF LITERATURE ON MENTAL
HEALTH AND PHYSICAL WELLNESS AND
HIGHLIGHTS THE VALUE OF A
SERVICE WITH RACIALIZED
POSTPARTUM MOTHERS. NOW BACK TO
MICHELE FOR NEXT STEPS.
>> THANKS, JESSICA, I AM
DELIGHTED TO REPORT THAT OUR
PARTICIPATION IN THE IMPROVE
INITIATIVE HAS LEAD EXTENSIVE
GROUNDWORK OUR PROJECT'S
IMMEDIATE NEXT STEPS ARE
CONTINUING TO COLLECT DATA WITH
THE GOAL OF REACHING OUR SAMPLE
SIZE OF 30 AND IMPLEMENT OUR
PLANNED COLLABORATION WITH
TECHNOLOGY PARTNER CARETAKER
MEDICAL, INITIATIVE WINNER
THROUGH THE TECH FOR MATERNAL
HEALTH CHALLENGE AFTER THAT
WE'LL DECIDE WHETHER TO EXPAND
OUR SAMPLE SIZE OR END THIS
STUDY AND PUBLISH OUR FINDINGS
IN PEER-REVIEWED MATERNAL HEALTH
JOURNALS WE'RE EAGER TO EXPLORE
FURTHER NIH STATE-LEVEL AND
FOUNDATION FUNDING OPTIONS TO
CONTINUE OUR COMMUNITY BASED
RESEARCH. INCLUDING RO 3 AND R
21 RESEARCH GRANT APPLICATIONS
IN 2025. WE REALLY WANT TO
CONTINUE IN THIS AREA OF
INTEREST. WE BELIEVE POSTPARTUM
DOULA CARE IS AN INTEGRAL PART
OF THE SYSTEM ESPECIALLY FOR
MARGINALIZED MOTHERS. NEXT
SLIDE, PLEASE. IT'S IMPERATIVE
TO STUDY THE IMPACTS OF THE
OUTCOMES. ESPECIALLY THOSE WHO
HAVE MENTAL HEALTH DISPARITIES
BECAUSE OF THEIR RACE, ETHNICITY
AND GEOGRAPHY. THESE LESSONS
ARE IN FOUR PRIMARY AREA. WE
WANT TO NAVIGATE THE FORMAL
RESEARCH PARTNERSHIPS EARLIER,
TWO, FOR OUR STUDY RECRUITMENT
CHALLENGES, AND STUDY DESIGN,
RELYING ON COMMUNITY BASED
ORGANIZATION VERSUS MEDICAL
PROVIDER REFERRALS, EXPANDING
OUR ELIGIBILITY CRITERIA BOTH
WITH TIMEFRAME AND DIAGNOSTIC
CRITERIA AND CHANGING FROM OUR
PILOT, RANDOMIZED CONTROL TRIAL
TO A LONGITUDINAL PILOT
INTERVENTION STUDY. THREE, WE
ALSO LEARNED THAT FOR OUR STUDY
PROCEDURES LOGISTICS TO BE MORE
STRICT TO USE FINITE DETAIL ON
LESS RESTRICTIVE CRITERIA AND
LASTLY FOR OUR DATA COLLECTION,
INSTEAD OF USING OUR EXISTING
SOFTWARE, USE AN ESTABLISHED
TOOL SUCH AS RED CAP. NEXT
SLIDE, PLEASE.
THANK YOU, SO MUCH. PLEASE STAY
IN TOUCH WITH US. AS WE
CONTINUE OUR RESEARCH.
>> JENNIFER: THANK YOU SO MUCH
MICHELE AND JESSICA AND TO THE
WHOLE ABUNDANCE PROJECT. YOU
HAVE DONE SUCH AMAZING WORK. AS
WE GET SET UP FOR THE ATLANTA
BIRTH CENTER LET ME TELL YOU
ABOUT THE CENTERS. MOLLY JOB
HAS WORKED IN COMMUNETY HEALTH
AND IN HOSPITAL AND PRIVATE
PRACTICE SETTINGS. SHE HAS
TRAINING IN THE COMMUNITY
RESILIENCY MODEL, TRAUMA
INFORMED CARE AND PERINATAL
MENTAL HEALTH. HANNAH WALTERS
WORKED IN AUGUSTA UNIVERSITY AND
FOCUSED ON PUBLIC HEALTH AND
WORKS AT THE FEMINIST CENTER AND
HANNAH AIMS TO GROUND HER
PRACTICE IN REPRODUCTIVE JUSTICE
HOLDING SPACE FOR INDIVIDUAL
HUMAN EXPERIENCES, INTUITION AND
AUTONOMY. WELCOME TO THE
ATLANTA BIRTH CENTER, WE ARE SO
EXCITED TO HEAR ABOUT YOUR
PROJECT.
>> THANK YOU, JEN. SO THE TITLE
OF OUR PROJECT WAS WELLNESS
WITHIN, PROMOTING HEALING
CENTERED TOOLS FOR PREGNANCY,
BIRTH AND BEYOND. YOU CAN GO TO
THE NEXT SLIDE. SO THIS PROJECT
TOOK PLACE IN COLLABORATION WITH
ATLANTA BIRTH CENTER OR WE CALL
IT ABC. SO ABC IS A NONPROFIT.
IT'S ATLANTA'S ONLY FREESTANDING
BIRTH CENTER AND ONE OF THREE IN
THE STATE OF GEORGIA. WE
PROVIDE FULL SCOPE MIDWIFERY
CARE TO NURTURE THE LIVES OF
PEOPLE AND THEIR FAMILIES OF
FAMILY CENTERED, EQUITABLE AND
HOLISTIC CARE. NEXT SLIDE. SO
AS MIDWIVES WE'RE VERY ATTUNED
TO THE PSYCHOSOCIAL NEEDS OF OUR
CLIENTS AND ALSO VERY AWARE OF
THE BARRIERS THAT PREVENT PEOPLE
TO HAVING ACCESS TO QUALITY
COMPASSIONATE MENTAL HEALTH CARE
AND SUPPORT SO FOR THIS PROJECT
WE SOUGHT TO FIND A SIMPLE
SUSTAINABLE WAY TO MITIGATE THE
RISK OF PERINATAL OR POSTPARTUM
MOOD AND ANXIETY DISORDERS. OUR
HYPOTHESIS WAS THAT BY
IMPLEMENTING THE SKILLS TAUGHT
IN THE RESILIENCY MODEL INTO
PRENATAL CARE WE WOULD IMPROVE
WELL-BEING AND RESILIENCE AND
DECREASE DEPRESSION. OUR THREE
AIMS WERE FIRST, TO ASSESS THE
IMPACT OF CRM ON DEPRESSION,
WELL-BEING AND RESILIENCY WITHIN
A PREDOMINANTLY BLACK COHORT OF
PREGNANT PEOPLE. TWO, TO
COMPARE PREGNANCY CONDITIONS AND
CLINICAL OUTCOMES BETWEEN OUR
CRM COHORT AND A HISTORICAL
COMPARISON GROUP AND THIRD TO
EVALUATE IF SOCIAL DETERMINANTS
OF HEALTH FACTORS AFFECT
DEPRESSION, WELL-BEING AND
RESILIENCY. NEXT SLIDE. SO
THIS IS AN OVERVIEW OF OUR
PROJECT TIMELINE SO FIRST WE
SPENT TIME SETTING UP THE
INFRASTRUCTURE OF OUR PROJECT.
NEXT, OUR ELIGIBLE PARTICIPANTS
FOR INTERVENTION GROUP WERE
RECRUITED BY OUR AMAZING PROJECT
COORDINATOR. PARTICIPANTS THEN
ENROLLED IN A TWO OUR CRM COURSE
AND THIS WAS LED BY FACILITATORS
NAMELY TRACY WHO ARE ALSO
CHILDBIRTH EDUCATORS WITH US AT
THE BIRTH CENTER. PARTICIPANTS
ALSO SCHEDULED A 30 MINUTE CHECK
IN WITH A NURSE-MIDWIFE THAT WAS
COMPLETED AFTER THE CRM CLASS TO
REINFORCE THE CRM SKILLS.
SCREENINGS FOR DEPRESSION, AND
WELL-BEING AND RESILIENCY WERE
COLLECTED PRIOR AND THAT ONE
WEEK POST INTERVENTION AND AT
SIX WEEKS POST PAR TIM IN
ADDITION, WE ALSO SCREENED FOR
TRAUMA EXPOSURE, DOMESTIC
VIOLENCE AND EXPERIENCES OF
DISCRIMINATION PREINTERVENTION
AND FOR DOMESTIC VIOLENCE AT SIX
WEEKS POSTPARTUM.
AND THEN WHILE ALL THIS WAS
GOING ON, WE REVIEWED OUR
HISTORICAL CHARTS FOR THE
COMPARISON GROUP DATASET. NEXT
SLIDE. THANK YOU. SO OUR FINAL
SAMPLE SIZE FOR OUR STUDY WAS
3
382 THIS INCLUDED OUR
INTERVENTION GROUP WHICH WAS 45
PARTICIPANTS WHO ARE CURRENT
CLIENTS. THEY COMPLETED THE
INTERVENTION AS WELL AS
POSTPARTUM FOLLOW UP AND THE
HISTORICAL GROUP WHICH WAS 334
CLIENTS WHO RECEIVED PRENATAL
CARE IN 2022. WHO HAD COMPLETED
DEPRESSION SCREENING BOTH
PRENATALLY AND POSTPARTUM. SO
FOR AIM ONE WE FOUND WHEN
ASSESSING FOR THE IMPACT OF CRM,
DEPRESSION SCORES WERE NOT
SIGNIFICANTLY DIFFERENT BETWEEN
TIME POINTS BUT THEY DID TREND
DOWNWARDS FROM PREINTERVENTION
TO POSTPARTUM FOR WELL-BEING,
AGAIN, THESE SCORES WERE NOT
SIGNIFICANTLY DIFFERENT BETWEEN
TIME POINTS BUT WE DID SEE A
TREND UPWARDS FROM
PREINTERVENTION TO POSTPARTUM
BUT THEN FOR RESILIENCE WE DID
SEE THE SCORES IMPROVE AND THEY
WERE SIGNIFICANTLY IMPROVED FROM
OUR PREINTERVENTION TO ONE WEEK
POST INTERVENTION AND THAT
IMPROVEMENT WAS MAINTAINED
THROUGH THE SIX WEEK POSTPARTUM
TIME POINT. NEXT SLIDE. SO FOR
AIM TWO THIS IS WHERE WE WERE
COMPARING PREGNANCY CONDITIONS
AND CLINICAL OUTCOMES BETWEEN
THE CRM COHORT AND OUR
HISTORICAL COMPARISON GROUP AND
SO THERE WERE THREE MAIN
TAKEAWAYS HERE. FIRST, WAS THAT
PARTICIPANTS WHO RECEIVED THE
CRM INTERVENTION HAD SIMILAR
RATES OF OUTCOMES, CLINICAL
OUTCOMES SO WE LOOKED
SPECIFICALLY AT HOSPITAL
TRANSFER, DEVELOPMENT OF
PREECLAMPSIA, NICU ADMISSION,
THERE WERE NO DIFFERENCES IN
DEPRESSION SCORES DURING
PREGNANCY OR EARLY POSTPARTUM
AND THE MAJOR DIFFERENCES WERE
THAT THE GROUP HAD HIGHER
PROPORTIONS OF PARTICIPANT WHO
IS SELF-IDENTIFIED AS BLACK AND
HAVING THEIR FIRST PREGNANCY.
WE STILL DIDN'T SEE A DIFFERENCE
IN CLINICAL OUTCOMES. AND THEN
FOR AIM THREE WE SOUGHT TO
EVALUATE A SOCIAL DETERMINANTS
OF HEALTH AFFECTED DEPRESSION
WELL-BEING OR RESILIENCY AND
SPECIFICALLY WE WANTED TO LOOK
AT SELF-REPORTED EXPERIENCES OF
DISCRIMINATION USING A KRIEGER
SCALE SO WE DID A SUBANALYSIS
THAT EXPERIENCED THE GREATEST
BURDEN OF DISCRIMINATION SO THIS
WAS 15 OF OUR PARTICIPANTS AND
FOUND THAT IN THIS GROUP THE CRM
INTERVENTION WAS ASSOCIATED WITH
SIGNIFICANTLY LOWER SCORES FROM
PREINTERVENTION TO POSTPARTUM AS
WELL AS TIM PROVED RESILIENT
SCORE FROM PREINTERVENTION TO
POSTPARTUM. JUST IN TERMS OF
UTILIZATION ABOUT 95% OF OUR
PARTICIPANTS REPORTED THAT THE
SKILLS WERE USEFUL TO THEM AND
YOU CAN SEE THE SKILLS THEY USED
THE MOST AND WE'RE HAPPY TO
EXPLAIN THE SKILLS IN THE Q&A
BUT OUR MAJOR CONCLUSIONS WERE
AGAIN, ONE THAT CRM EXPOSURE WAS
ASSOCIATED WITH IMPROVED
RESILIENCE, IT DID NOT
NEGATIVELY IMPACT ANY OUTCOME WE
MEASURED. CRM COULD BE
ESPECIALLY USEFUL FOR PEOPLE
EXPERIENCING HIGHER LEVELS OF
DISCRIMINATION AND OVERALL WE --
WE BELIEVE THAT CRM IS A
SUSTAINABLE AND EFFECTIVE
INTERVENTION THAT SHOWS A LOT OF
PROMISE FOR HELPING PROMOTE
RESILIENCY IN PREGNANT PEOPLE
AND MAYBE PARTICULARLY HELPFUL
FOR PREGNANT PEOPLE WITH
DISCRIMINATION AND WE'RE REALLY
EXCITED AND FEEL FUTURE RESEARCH
IS NEEDED TO SEE HOW THIS MIGHT
TRANSLATE INTO LONG-TERM MENTAL
HEALTH IN THE TRANSITION TO
PARENTHOOD. NEXT SLIDE. SO OUR
NEXT STEPS AND ADDS -- AS WE
MENTIONED WE WANTED AN
INTERVENTION THAT WE COULD
INCORPORATE INTO CARE AT THE
BIRTH CENTER.
RIGHT NOW WE'RE WORKING WITH ABC
LEADERSHIP AND STAFF TO
INCORPORATE CRM INTO OUR
CHILDBIRTH EDUCATION TO CREATE
CRM SUPPORT GROUPS. WE'RE ALSO
REALLY EXCITED TO WORK WITH THE
NEWLY FORMED RESEARCH COMMITTEE
AT THE BIRTH CENTER. ONE WAY IS
WE HOPE TO KEEP EXPANDING THIS
RESEARCH IS DOING ONE SECONDARY
DATA ANALYSIS USING SOME OF THE
DATA WE ALREADY HAVE AND ALSO
WE'RE REALLY EAGER TO DO FURTHER
RESEARCH LOOKING AT RESPECT IN
OBSTETRIC HERE. SO IN THIS
STUDY WE MEASURED SELF-REPORTED
RESPECTFULNESS DURING PRENATAL
CARE OR THE CRM GROUP AT SIX
WEEKS POSTPARTUM USING THE
MOTHERS ON RESPECT INDEX. AND
OUR INTERVENTION GROUP HAD
SCORES OF 83 REGARDLESS OF
SELF-IDENTIFIED RACE WHICH IS A
NEARLY PERFECT SCORE AND ABOUT
TEN POINTS HIGHER THAN THE
SIMILAR STUDIES SO MIDWIFE LED
OUT OF HOSPITAL CARE IS REALLY
UNIQUE IN THE SOUTH AND SO WE
REALLY HOPE TO CONTINUE TO LEAD
STUDIES THAT INCORPORATE THIS
INTO OTHER SETTINGS SO HIGH RISK
POPULATIONS AND HOSPITAL
PRACTICES. AND THEN NEXT SLIDE.
LASTLY, OUR KEY TAKEAWAYS, ONE,
EVERYTHING TOOK LONGER THAN
ANTICIPATED SO A LOT MORE TIME
UPFRONT. FOR GETTING THINGS
SET, INFRASTRUCTURE-WISE. WE
ALSO HAD SOME CHALLENGES WITH
OBSTRUCTION FOR HISTORICAL AND
INTERVENTION GROUPS SO
DEFINITELY ADVOCATING MORE TIME
TOWARDS THIS AND I THINK
PROBABLY ONE OF OUR OTHER MAIN
TAKEAWAYS AND SOMEONE OF OUR
FAVORITE PARTS OF THIS WAS
HEARING EXPERIENCES DURING THIS
VISIT. SO WE HOPE WE CAN
CONCRETELY CAPTURE THIS AND THEN
LASTLY, WE COULD NOT HAVE DONE
THIS PROJECT WITHOUT OUR
COMMUNITY ACCOUNTABILITY BOARD.
SO THIS WAS A GROUP OF COMMUNITY
STAKEHOLDERS LED BY ONE OF OUR
STUDIES, AMANDA AND THEY WERE
ESSENTIAL IN HELPING US DEVELOP
OUR STUDY NAME AND ARE
CONTINUING TO HELP US WORK AS WE
INCORPORATE CRM INTO CARE AT THE
BIRTH CENTER. NEXT SLIDE.
AGAIN, THANK YOU, ALL, SO MUCH,
JEN, IMPROVE INITIATIVE, ALL OF
OUR COMMUNITY.
SUPPORTERS. JUST THIS HAS BEEN
AN AMAZING EXPERIENCE AND WE'RE
SO EXCITED TO KEEP DOING THIS
WORK.
>> JENNIFER: THANK YOU SO MUCH
AND THANKS FOR A FANTASTIC
PRESENTATION. REALLY EXCITED
ABOUT YOUR WORK. AS A REMINDER
TO EVERYONE PLEASE SUBMIT YOUR
QUESTIONS IN THE Q&A AND OUR
FIRST TWO PRESENTERS ARE ALREADY
ANSWERING QUESTIONS. SO
QUESTIONS ARE BEING ANSWERED AND
THEN WE'LL HAVE A LITTLE BIT OF
TIME AT THE END FOR GENERAL
QUESTIONS AS WELL. SO PLEASE
PUT YOUR QUESTIONS IN THE Q&A.
OUR NEXT TEAM. BUFFALO PRENATAL
PERINATAL NETWORK. PRESENTER
LUANN BROWN HAS A BS IN NURSING
ADMINISTRATOR. AND ESTABLISHES
BETTER LINKAGES BETWEEN EXISTING
PROGRAMS AND ENSURING FAMILIES
HAVE ACCESS TO THE FULL RAKE OF
RESOURCES IN ERIE COUNTY NEW
YORK, MICKEY IS AN EXPERIENCED
PROFESSOR AT THE BUFFALO SCHOOL
OF SOCIAL WORK AND WORKS WITH
THE TRAUMA ON PEOPLE'S CHILD
BEARING AND POSTPARTUM
EXPERIENCES AND OUTCOMES. SHE
DEVELOPS INTERVENTIONS FOR
SEXUAL VIOLENCE AND OTHER TRAUMA
AND POSITIONING THESE OTHER
INTERVENTIONS AND FOSTERING
THEIR SUCCESS. WELCOME LUANN
AND MICKEY. WE LOOK FORWARD TO
YOUR PRESENTATION.
>> THANK YOU. NEXT SLIDE.
>> YEAH. YOU CAN GO TO THE NEXT
SLIDE. NEXT SLIDE.
>> WELCOME, AND THANK YOU SO
MUCH FOR HAVING US. OUR
PROGRAM'S CENTERED ON A TRIAL OF
THE SURVIVOR MOMS' COMPANION.
THIS IS MALTREATMENT, CYCLES OF
ABUSE AND VULNERABILITY HOWEVER
TREATMENTS HAVE TYPICALLY
CENTERED ON DEPRESSION WITH
LIMITED ATTENTION TO TRAUMA AND
PTSD. VERY FEW RESOURCES ARE
BASED ON FRONTLINE PROGRAMS. WE
HYPOTHESIS THAT UTILIZING THE
MSC WHICH IS A PSYCHOEDUCATIONAL
PROGRAM THAT PROVIDES
INFORMATION, SKILL BUILDING AND
EMOTIONAL SUPPORT FROM A TRAINED
TUTOR WOULD HELP PREGNANT
PERSONS WITH PTSD NAVIGATE THE
CHILDBEARING YEAR. OUR OVERALL
OBJECTIVE WAS SO CONDUCT A
PARTICIPATION IN THE MSC AND
EXAMINE WHETHER THE PROGRAM WAS
FEASIBLE TO DELIVER, UTILIZING
CULTURALLY CONGRUENT HEALTH
WORKERS AS TUTORS AND WAS
ASSOCIATED WITH MENTAL HEALTH.
AFTER A PERIOD OF START-UP
ACTIVITIES WHICH TOOK LONGER
THAN EXPECTED, SIMILAR TO THE
OTHER GROUPS, WE RECRUITED
PARTICIPANTS FROM DECEMBER 2023
TO MAY 2024. NEXT SLIDE, PL
PLEASE.
>> SO WE DEDICATED THREE
COMMUNITY HEALTH WORKERS TO
SERVE AS TUTORS FOR THE SMC AND
TRAIN IN THE SMC MODEL.
OVERSIGHT COMPLIANCE INCLUDED
IRB APPROVAL, ENCORE CLINICAL
TRIALS.GOV. WE RECRUITED
PARTICIPANTS, WE CONDUCTED THE
ASSESSMENTS. WE RANDOMIZED THE
WAITLIST CONTROL GROUP.
AND PROVIDED A MINIMUM OF FOUR
SMC SESSIONS WITH A TUTOR. WE
DID PIVOT TO INCREASE EQUITY BY
PROCURING SPANISH LANGUAGE
TRANSLATIONS WE ACTUALLY WROTE A
SMALL GRANT IN ORDER TO DO THIS
BECAUSE WE FELT IT WAS MORE
EQUITABLE TO HELP INCREASE THE
SAMPLE SIZE AND INCLUDING
PARTICIPANTS IN THE POSTPARTUM
PERIOD AS WELL. AND THEN WE
CONDUCTED THE ANALYSIS. NEXT
SLIDE.
>> WE RECRUITED A SAMPLE OF
FOLKS IN THEIR 20S. WITH THE
HIGH SCHOOL EQUIVALENCE. AND A
HOUSEHOLD INCOME OF LESS THAN
25,000 DOLLARS. THIS WAS AN
OVERALL MEAN SCORE OF 5.9 ON THE
ACE AND NOTE THAT IN A LARGE
BODY OF RESEARCH SCORES OF FOUR
OR MORE ON THE ACE CONFIRM MAJOR
CONCERN FOR MENTAL HEALTH
INDICATORS. ALSO IN OUR SAMPLE
A SIGNIFICANT NUMBER, NEARLY 79%
MET THE PROVISIONAL PTSD
DIAGNOSIS. AND 91% HAD AT LEAST
MILD DEPRESSION, WITH SCORES OF
FIVE OR MORE PER THE PHQ-9
ALMOST 64% HAD BOTH PTSD AND
DEPRESSION. WE PROVIDED A
MINIMUM OF FOUR OF THE S MC
MODELS TO THE SMC GROUP.
THAT WERE 17 IN THAT GROUP AND
ALSO TO THE CONTROL GROUP.
THERE ARE 14, FOLLOWING THE
PRETEST. POSTTEST. OUR
ANALYSES WERE MORE LIMITED THAN
PLANNED DUE TO SAMPLE SIZE
CONSTRAINTS. HOWEVER, WE NOW
ANALYZE FEASIBILITY AND
ACCEPTABILITY DATA AND CONDUCT A
PAIRED SAMPLES TESTS ON THE
INTENTION TO TREAT SAMPLE AS YOU
CAN SEE HERE IN TABLE ONE ALL
MEAN SCORES ON OUR MENTAL HEALTH
INDICATORS IMPROVED OVER THE
STUDY PERIOD WITH STATISTICALLY
SIGNIFICANT REDUCTIONS IN PTSD
AS WELL AS SENSITIVITY SYMPTOMS.
NEXT SLIDE, PLEASE.
>> SO WE FOUND THE PROGRAM WAS
FEASIBLE TO BE DELIVERED BY
COMMUNITY HEALTH WORKERS. IT
WAS ALSO VERY ACCEPT TO BELIEVE
PARTICIPANTS THEY RATED IT
HIGHLY ON THE CLIENT
SATISFACTION SCALE AND ONE
PARTICIPANT ACTUALLY SHARED --
SHE SAID I LIKE IT ALL. I LIKED
THE WHOLE PROGRAM ITSELF BECAUSE
IT HELPED ME LEARN FROM BIRTH TO
AFTER BIRTH AND IT GOES ON FROM
THERE. I AM GOING BACK TO MY
GOOD FUTURE AND GO FROM THERE.
OUR ANALYSIS SHOWED TO REDUCE
PTSD AND REDUCE PERSONAL
SENSITIVITY. NEXT SLIDE.
>> WE ARE PLANNING FUTURE
RESEARCH TOGETHER AND THIS
INCLUDES OUR INTENTION TO HIRE A
COMMUNITY HEALTH WORKER WHO IS
DEDICATED TO SERVING AS THE SMC
TUTOR ON A FULL-TIME BASIS.
HIRING A PART-TIME, EITHER
LICENSED MENTAL HEALTH COUNSELOR
OR AN LMSW TO PROVIDE THE
CLINICAL SUPERVISION AND ALSO TO
DO THE INTAKES AND ASSESSMENTS.
WE DO SEE A NEED TO EXPAND OUR
REFERRAL NETWORK TO OTHER AREA
AGENCIES WHO ARE SERVING
PREGNANT PERSONS AND WORK WITH
DISASSOCIATION MORE ROBUST BLI
DURING THE POSTPARTUM PERIOD.
AND ALSO THE SCORES ON
DISSOCIATIVE SCALE WE ALSO SEE A
NEED TO ADD A MEASURE OF
STRUCTURAL RACISM.
THE ACE DOES NOT EXACTLY GET AT
PERVASIVE EFFECTS OF
DISCRIMINATION AND SO WE WANT TO
EXPLORE THAT FURTHER. WE ALSO
SEE THE NEED ADD THE UPTAKE TO
ALL THE PARTICIPANTS AND ADD AN
OUTSIDE EVALUATION COMPONENT TO
ENRICH OUR EVALUATION GOING
FORWARD. BECAUSE PTSD IN THE
CHILDBEARING YEAR IS A RISK
FACTOR FOR ADVERSE MATERNAL AND
INFANT OUTCOMES AND BECAUSE WE
SEE THE BURDENS THAT OUR CLIENTS
BEAR, WE'RE DEDICATED TO
ADVANCING TREATMENT FOR PTSD
DURING PREGNANCY AND DISRUPTING
THE TWIN CYCLE OF ABUSE AND
VULNERABILITY. WE'RE SO
GRACIOUS FOR THOSE WHO WERE
DEDICATED TO THIS PROJECT AND WE
LOOK FORWARD TO BUILDING ON
THOSE CONTRIBUTIONS.
>> LESSONS LEARNED. WE LEARNED
SEVERAL INCLUDING THAT WE NEED
TO ADEQUATELY FUND FUTURE
PRODUCTS AND PROVIDE AMPLE TIME
FOR COMPLETION. WE WILL
PRIORITIZE COMMUNICATION AND
ONGOING INSERVICE WE WANT TO
NAVIGATE RESEARCH PRIORITIES TO
INCREASE EQUITABLE PRACTICES
LIKE WHEN WE INCREASE THE
SPANISH SPEAKERS. WE NEED TO
INCREASE OUR REFERRAL STREAM
FROM AGENCIES EXTERNAL TO BPPN
AND TO EXPLORE THE FINDINGS
RELATED TO DISASSOCIATION,
INCREASED TRACKING AND ADD A
DIRECT MEASUREMENT OF STRUCTURAL
RACISM TO OUR SUITE OF MEASURES.
WE'RE THANKFUL FOR THE GUIDANCE
IMPLEMENTERS, IT'S BEEN
INVALUABLE AND WE APPRECIATE ANY
ONGOING INFORMATION ABOUT
POTENTIAL COLLABORATORS AND
FUNDERS FOR THIS RESEARCH. MANY
THANKS TO JEN, ESPECIALLY FOR
HER ENTHUSIASTIC AND SUPPORTIVE
GUIDANCE. THANK YOU.
>> JENNIFER: THANKS SO MUCH.
THANK YOU, TEAM, YOU, LUANN AND
MICKEY DID A FANTASTIC JOB ON
THIS. THANK YOU, REMINDER,
THERE ARE QUESTIONS IN THE Q&A
AND SOME OF THE QUESTIONS ARE
FOR YOU BUFFALO TEAM. NEXT UP,
WE HAVE CENTRAL JERSEY FAMILY
HEALTH CONSORTIUM. DR. CHERYL
MCFARLAND IS THE DIRECTOR OF
EVALUATION AND ANALYTICS AND HAS
SERVED AS THE LEAD EVALUATOR
INCLUDING FOR THE CARE AND KIDS
PROGRAM AND THE NEW JERSEY
COLLABORATIVE. WELCOME, CHERYL.
>> THANK YOU VERY MUCH. THANK
YOU FOR THE INTRODUCTION AND
TODAY I AM GOING TO BE
PRESENTING ON OUR WORK ON THE
DEVELOPMENT OF A PREPREGNANCY
MATERNAL MORBIDITY RISK
ALGORITHM. NEXT SLIDE. SO WE
ARE THE CENTRAL JERSEY FAMILY
HEALTH CONSORTIUM OUR MISSION IS
TO PROMOTE AN EQUITABLE AND
HEALTHY FUTURE FOR FAMILIES
THROUGH SERVICES, ADVOCACY,
EDUCATION AND COLLABORATION.
THIS GIVES YOU AN IDEA OF THE
PROGRAMS WE OFFER AND SOME OF
THE WORK THAT WE DO AND FOR MORE
INFORMATION ON BOTH THE
ORGANIZATION AND MY TEAM, THE
WEBSITE IS AVAILABLE. NEXT
SLIDE. SO WE WANTED TO
UNDERSTAND THE INCIDENCE OF
SEVERE MATERNAL MORBIDITY OVER
TIME, LOOK AT FACTORS THAT
INFLUENCE SEVERE MATERNAL
MORBIDITY AND ALSO ASSESS RISK
OF HAVING AMAH TERNL MORBIDITY
UTILIZING A CLAIMS DATA PRIOR TO
PREGNANCY AND COMBINING THAT TO
DETERMINE THE RISK BURDEN THAT
PEOPLE HAVE IN RELATION TO RISK
OF SEVERE MATERNAL MORBIDITY.
NEXT SLIDE. SO OUR RESEARCH
ACTIVITY STARTED WITH GETTING
OUR IRB APPROVED. AND REACHING
OUT TO THE NEW JERSEY MEDICAID
FOR DATA USE AGREEMENT.
HOWEVER, DUE TO CONSTRAINTS IN
TIMING WE WERE UNABLE TO GET A
DATA USE AGREEMENT. SO WE
EXPLORED ALTERNATIVE SOURCES OF
ADMINISTRATIVE DATA AND
ULTIMATELY, DECIDED ON USING THE
TRIF YAN MARKET SCAN DATA WHICH
IS -- WAS MADE AVAILABLE TO US
THROUGH A MEMORANDUM OF
UNDERSTANDING WITH RIT GER'S
UNIVERSITY.
AND IT IS ACTUALLY A NATIONAL
DATASET.
SO WE WERE ABLE TO LOOK AT OUR
ANALYSIS NATIONALLY. PRIOR TO
OBTAINING THE DATA WE DEVELOPED
AN ALGORITHM USING INTEGRATING
PRIOR CHRONIC DISEASE ALGORITHMS
AND THEN WE TESTED THE
FUNCTIONALITY OF OUR CODE USING
OTHER SOURCES OF DATA AVAILABLE
SO THAT WHEN WE WERE ABLE TO GET
THE ADMINISTRATIVE DATA WE
WERE -- WE HIT THE GROUND
RUNNING. WE ALSO REVIEWED AND
DETERMINED THE BEST METHODS OF
MACHINE LEARNING TO CREATE OUR
PREDICTION ALGORITHM. OVERALL,
OUR TOTAL SAMPLE SIZE FOR THE
ALGORITHM IS ONE MILLION EIGHTY
EIGHT THOUSAND BIRTHS AND FIGURE
ONE PROVIDES DESCRIPTION OF THE
FLOW AND EXCLUSION CRITERIA.
NEXT SLIDE. SO OVERALL WE HAD
FOUR AIMS FOR OUR PROJECT, OR WE
HAD THREE AIMS FOR OUR PROJECT.
AIM ONE WAS TO LOOK AT THE RATES
OF MATERNAL MORBIDITY OVER TIME.
WE FOUND THAT OVERALL, THERE HAS
BEEN AN INCREASE IN MATERNAL
MORBIDITY. THAT INCREASE VARIES
BY INSURANCE TIME SUCH THAT
THOSE ON MEDICAID ARE 1.8 TIMES
HIGHER RATES OF SEVERE MATERNAL
MORBIDITY THAN THOSE THAT ARE
COMMERCIALLY INSURED AND YOU
WILL NOTICE THAT IT HAS
STABILIZED IN THE LAST TEN YEARS
OR SO WHILE THE MEDICAID DATA
INCREASES. AIM TWO WAS TO LOOK
AT WHAT PREDICTED THE ODDS OF
SEVERE MATERNAL MORBIDITY AND WE
FOUND THAT AGE AND MEDICAID
STATUS INCREASED, THE ODDS OF A
SEVERE MATERNAL MORBIDITY HAVING
DECREASED FAMILY UNITY INCREASED
THE ODDS OF HAVING A SEVERE
MATERNAL MORBIDITY AND INCREASES
IN OVERALL COMMUNITY HEALTH AND
INSTITUTIONAL HEALTH DECREASED
THE ODDS OF HAVING AMAH TERNL
MORBIDITY AND THESE ARE BASED ON
STATE-LEVEL INDICATORS.
THE FINAL AIM AND THE CRUX OF
THIS PRESENTATION IS THE
DEVELOPMENT OF THE ALGORITHM.
SO WE TRAINED MODELS, USING 80%
OF OUR SAMPLE THAT 1. -- THAT
LITTLE OVER ONE MILLION PEOPLE,
WE TRAINED THE MODEL ON 80% AND
THEN ON 20% WE TESTED TO MAKE
SURE OUR ALGORITHM WAS A VALID
ALGORITHM FOR PREDICTING
MATER
MATERNAL MORBIDITY APPROXIMATELY
307,000 INDIVIDUALS WERE
EXCLUDED BECAUSE OF NO PRIOR
PREPREGNANCY CLAIMS. HOWEVER,
THEY DO HAVE A HIGHER BURDEN OF
SEVERE MATERNAL MORBIDITY AND
ALTHOUGH WE COULDN'T INCLUDE IT
IN THE MODEL, NOT HAVING PRIOR
CLAIMS IS A RISK FACTOR IN AND
OF ITSELF OF MATERNAL MORBIDITY.
NEXT SLIDE. SO THIS DESCRIBES
THE DIFFERENT MODELS THAT WE
TESTED. THE RANDOM FOREST IN
THE EXTREME GRADIENT BOOSTING
MODELS ARE MACHINE LEARNING
MODELS THAT USE THOUSANDS OF
DECISION TREES TO DETECT COMPLEX
RELATIONSHIPS AMONG OUR
PREDICTORS SO USING ALL OF THE
PREPREGNANCY DIAGNOSES.
STATE-LEVEL FACTORS, IT DETECTS
THE COMPLEX RELATIONSHIP BETWEEN
ALL OF THESE THINGS. AS YOU
WILL NOTICE, THE EXTREME
GRADIENT BOOSTING T LAST LINE OF
THIS TABLE.
SHOWS THAT THAT IS THE BEST
MODEL AT PREDICTING SEVERE
MATERNAL MORBIDITY, THE
SENSITIVITY OR THE ABILITY TO
DETECT TRUE POSITIVES WAS NEARLY
80% AND THE OVERALL ACCURACY IS
94.8%. THIS MEANS THAT THE
OVERALL ACCURACY MEETS THE
THRESHOLD FOR BEING USED IN
CLINICAL SETTINGS AND SETS US UP
TO START USING THIS TOOL AS A
DATA-DRIVEN TOOL FOR DEVELOPING
DATA-DRIVEN TOOL FOR DECISIONS
IN DEVELOPING PROGRAMS TO
ADDRESS RISK. NEXT SLIDE. SO
OUR PRELIMINARY RESEARCH
FINDINGS, THERE HAS BEEN AN
INCREASE IN SEVERE MATERNAL
MORBIDITY OVER TIME. BUT NOT
AMONG ALL PREGNANT PEOPLE.
THERE IS -- IT'S HIGHER AMONG
THOSE ON MEDICAID. IT IS
DIFFICULT TO PREDICT SEVERE
MATERNAL MORBIDITY AMONG THOSE
WITHOUT ROBUST MEDICAL RECORDS.
THIS, HOWEVER, IS A -- IN AND OF
ITSELF A PREDICTOR OF SEVERE
MATERNAL MORBIDITY RISK. Z
CODES OR THE ICD 10 DIAGNOSTIC
CODES ASSOCIATED WITH SOCIAL
DETERMINANTS OF HEALTH WERE AN
INFLUENTIAL PREDICTOR IN OUR
MODELS AND ACTUALLY IN SOME
INSTANCES, WERE MORE PREDICTIVE
OF SEVERE MATERNAL MORBIDITY
THAN MEDICAL DIAGNOSES WHICH
SUGGESTS A NEED FOR IMPROVED
TRACKING OF THESE SOCIAL
DETERMINANTS OF HEALTH
DIAGNOSTIC CODES IN MEDICINE
MORE BROADLY BUT SPECIFICALLY IN
MATERNAL AND CHILD HEALTH. THE
FINDINGS SUGGEST THAT IT IS
POSSIBLE TO DEVELOP A CLINICALLY
USEFUL ALGORITHM TO ASSESS
SEVERE MATERNAL MORBIDITY RISK
USING PREPREGNANCY MEDICAL
RECORDS AND THIS HAS THE
POTENTIAL TO INFLUENCE THE
MATERNAL HEALTH LANDSCAPE AS IT
ALLOWS FOR US TO HAVE
DATA-DRIVEN DECISION ON THE
DEVELOPMENT OF PROGRAMS
ADDRESSING THESE TYPES OF RISK.
IT ALIGNS WITH THE IMPROVE
INITIATIVE AND OUR ULTIMATE
GOAL, NEXT SLIDE, OUR IT GOAL
ONCE WE FINALIZE AND ENHANCE OUR
PERFORMANCE OF OUR MODEL IS TO
INCORPORATE GEOGRAPHIC
INDICATORS WE KNOW THAT
COMMUNITIES HAVE AN INFLUENCE ON
OUTCOMES AND TO COLLABORATE ON
THE DEVELOPMENT OF A PROGRAM
THAT OFFERS SERVICES STRATIFIED
BY LEVELS OF RISK AND CONDUCT A
CLUSTER OF RANDOMIZED CONTROL
TRIAL AMONG THIS -- WITH THIS IN
COLLABORATION WITH THIS HOSPITAL
SYSTEM IN ORDER TO TEST THE
EFFICACY OF THE ALGORITHM AND
ALSO USE IT TO POTENTIALLY
PREVENT OR INTERVENE EARLY WITH
MORE SEVERE MATERNAL MORBIDITY
AND ULTIMATELY PREVENT MATERNAL
MORTALITY.
>> JENNIFER: WE NEED TO STOP
RIGHT NOW BECAUSE WE'RE OVER
TIME AND WE HAVE TO MOVE ONTO
THE NEXT ONE, THANK YOU SO MUCH
FOR THE PRESENTATION IF YOU
COULD MOVE AHEAD WE ARE -- IT IS
NOW TIME FOR THE INTERMISSION.
THANK YOU SO MUCH CENTRAL JERSEY
FAMILY HEALTH CONSORTIUM. SORRY
TO CUT YOU OFF BUT WE HAVE TO
KEEP ON OUR SCHEDULE HERE. WE
WILL HAVE A TWO MINUTE
INTERMISSION WE WILL HAVE A
COUPLE MINUTES HERE IF SOMEONE
NEEDS TO RUN AND GET A DRINK OF
WATER AND RUN TO THE RESTROOM
NOW IS THE TIME.
>> THOM: IT'S NICE TO SEE AI AND
MACHINE LEARNING BEING LEVERAGED
TO HELP THE FUTURE HERE. SO,
BUT JEN I WANTED TO ASK YOU A
COUPLE QUESTIONS WHILE WE'RE ON
THIS QUICK INTERMISSION. YOU
SPENT A LOT OF TIME WITH THE
TEAMS. COULD YOU SHARE A LITTLE
MORE ABOUT THE PROCESS THAT YOU
USED?
>> JENNIFER: ABSOLUTELY, ONE OF
THE WONDERFUL THINGS ABOUT THIS
CHALLENGE IS THAT IT INCLUDED
COACHING. A LOT OF TIMES
PROGRAMS THAT AIM TO TEACH
PEOPLE STUFF, THEY PROVIDE THE
TRAINING AND THEN THERE'S NO
FOLLOW UP. SO REALLY LOVE THAT
THIS PROGRAM INCLUDED COACHING
AND I HAD THE WONDERFUL HONOR OF
COACHING SITES. WE BASICALLY
OPENED IT UP TO ANYTHING THE
SITES WANTED TO TALK ABOUT AND
THERE WERE CHALLENGES IN EVERY
AREA THAT YOU CAN IMAGINE FOR
ANYONE WHO HAS DONE RESEARCH,
YOU KNOW WHERE THESE COME FROM,
CHALLENGES RELATED TO THE IRB
AND HOW YOU MANAGE THOSE
SITUATIONS. THAT WAS BRAND NEW
FOR SOME OF THE SITES AND FIRST
IRB RIDE IS ALWAYS A BIT BUMPY,
THERE WERE QUESTIONS ABOUT
PROJECT MANAGEMENT OR STAFF
TURNOVER ABOUT HOW DO YOU PIVOT
IN A STUDY. WHAT ARE YOU
ALLOWED TO DO? WHAT DO YOU NEED
TO GET APPROVAL TO DO TO CHANGE
THINGS WHEN THINGS AREN'T GOING
AS PLANNED? SUCH AS A COUPLE OF
SITES MENTIONED THAT THEY HAD
DIFFICULTY RECRUITING FOR THE
SAMPLE THEY IDENTIFY SO HOW DO
YOU PIVOT AND WHAT DOES THAT
LOOK LIKE? WE TALKED ABOUT WAYS
TO MOVE FORWARD BEYOND THIS
CHALLENGE. SO SOME SITES ARE
ALREADY WORKING ON OR HAVE
ALREADY SUBMITTED A GRANT
PROPOSAL. SOME OF THEM HAVE
REACHED OUT TO SOME OF OUR
FANTASTIC PRESENTERS FROM EITHER
AGENCIES OR FUNDED RESEARCHERS
AT UNIVERSITIES TO FIND OUT HOW
THEY CAN COLLABORATE. IT'S BEEN
REALLY AMAZING AND, AGAIN, I
WOULD SAY ONE MORE PIECE IS
QUESTIONS ABOUT SPECIFIC
RESEARCH SKILLS SO HOW DO WE
STRUCTURE OUR DATA CAPTURE. HOW
DO WE CONDUCT QUALITATIVE
ANALYSIS? HOW DO WE BALANCE AIM
ONE AND AIM TWO AND THAT SORT OF
THING. SO IT'S BEEN REALLY
WONDERFUL.
>> THOM: THANK YOU, AGAIN, AS
YOU HEARD FROM THE TEAMS THEY
REALLY APPRECIATED ALL THE
SUPPORT AND WE REALLY APPRECIATE
IT. I THINK BECAUSE WE'RE
RUNNING A TAD BEHIND SCHEDULE
WHY DON'T WE MOVE ONTO THE NEXT
PRESENTATION? SO JENNIFER, DO
YOU HAVE A QUICK INTRODUCTION TO
COLLAR RIS HEALTH MOTHER OF
FACT.
>> JENNIFER: YES, THIS IS EMILY
SYLVESTER A PEDIATRIC
REGISTERED. AND ALSO LISA
FOCUSED ON EQUITABLE AND
CULTURALLY APPROPRIATE NUTRITION
CARE FOR MOMS AND BABIES. MS.
LISA IS A CERTIFIED MIDWIFE AND
NURSE-PRACTITIONER AND WORKS IN
CLINICAL SETTINGS INCLUDING
COLLAR RIS HEALTH AND WERE WE
ARE VERY MUCH LOOKING FORWARD TO
YOUR PRESENTATION TODAY.
>> HI, THERE, CAN YOU HEAR ME
OKAY? GREAT WE WILL TALK ABOUT
MOTHER OF FACT AND CLARIS HEALTH
FOR PREGNANT INDIVIDUALS AT RISK
FOR GESTATIONAL DIABETES. IT
HAS BEEN AN ABSOLUTE PLEASURE TO
WORK WITH MOTHER OF FACT AND TO
BRING THIS TO OUR PATIENTS.
WE'RE BASED IN LOS ANGELES
FEATURING A DEDICATED TEAM
MYSELF. I'M A MIDWIFE AND NP.
EMILY SYLVESTER, ALICIA, EHAVE
AED THAT IS A PA, AND ANDREW A
DATA ANALYST.
CLARIS HEALTH WORKS WITH
PARTICIPANTS IN L. COUNTY AND
MOTHER OF ACT IS A HIPAA SECURE
DIGITAL PLATFORM WITH ON DEMAND
MESSAGING (READING)A COUNTY AND
MOTHER OF ACT IS A HIPAA SECURE
DIGITAL PLATFORM WITH ON DEMAND
MESSAGING (READING). COUNTY AND
MOTHER OF ACT IS A HIPAA SECURE
DIGITAL PLATFORM WITH ON DEMAND
MESSAGING (READING) SO MINORITY
POPULATIONS WITH LOW INCOME, LOW
HEALTH LITERACY AND OBESITY FACE
HIGHER RATES OF GESTATIONAL
DIABETES LEADING TO POOR
PREGNANCY OUTCOMES AND MEDICAID
PATIENTS OFTEN LACK ACCESS TO
REGISTERED DIETICIANS TO HELP
MANAGE DIABETES RISK. OUR
RESEARCH AIMS TO INVESTIGATE
ENROLLMENT TRENDS, ENGAGEMENT
PATTERNS AND THE RELATIONSHIPS
BETWEEN THE CHARACTERISTICS AND
ENGAGEMENT METRICS AMONG MOTHERS
WHO ENGAGE WITH AN
EVIDENCE-BASED NUTRITION DIGITAL
HEALTH PLATFORM. THIS SINGLE
ARM UNBLINDED PILOT STUDY
CONDUCTED VIA TO LOS ANGELES
HEALTH CENTERS ASSESS THE IMPACT
OF NUTRITIONAL EDUCATION AND
TELEHEALTH MEDICAL NUTRITION
THERAPY ON PREGNANT INDIVIDUALS
WITH GESTATIONAL DIABETES.
PARTICIPANTS USE A MOBILE APP TO
MESSAGE DIETITIANS, LOG
NUTRITION DATA, ASSESS
EDUCATIONAL RESOURCES, AND
ATTEND MONTHLY TELEHEALTH VISITS
OUR STUDY RAN FROM DECEMBER 2023
TO MAY 2024 AND NEXT SLIDE AND
YOU'LL HEAR FROM EMILY.
>> HELLO, WE ARE EXCITED TO DIVE
INTO OUR RESEARCH ACTIVITIES
FROM JULY TO SEPTEMBER WE
ATTENDED THE NIH WORKSHOPS WHICH
WERE AMAZING: EXPANDING OUR
OBJECTIVES AND DEVELOPED A
PLATFORM E-MAIL KCUSTOMIZATION
AND THEN WE CONDUCTED STAFF
TRAININGS WITH THE MIDWIVES AND
CLINICAL TEAM TO THE PREGNANCY
CARE. AND CREATED ELIGIBILITY
CHECKLIST AND ALSO SUBMITTED TO
THE IRB OF NOTE SUBMITTING TO
THE IRB WAS DELAYED BY THREE
MONTHS AS THERE WERE SOME
RETEAMING NEEDS THAT WERE REALLY
OUT OF OUR CONTROL AND THEN FROM
DECEMBER 2023 TO MAY WE WERE
EXCITED TO RECRUIT PATIENTS AND
INITIATING DAILY INTERACTIONS
AND MAINTAINING WITH THE
RECRUITMENT SITES. IN APRIL WE
ONBOARDED A DATA ANALYTICS
CONSULTANT, CONDUCTED ANALYSIS
AND ACTUALLY PRESENTED EARLY
RESULT TO TWO NATIONWIDE
WORKSHOPS INCLUDING THE HRSA
ADVISORY COMMITTEE ON INFANT AND
SOCIAL DETERMINANTS OF HEALTH
WORKGROUP AND THEN AS OF MAY
31ST, 2024 WE STOPPED DATA
COLLECTION FOR THIS REPORT BUT
FINAL OUTCOMES ASSESSMENT IS SET
TO BEGIN IN APRIL 2025 AFTER
INTERVENTION RUNS THROUGH SIX
WEEKS POSTPARTUM FOR OUR
PARTICIP
PARTICIPANTS NEXT SLIDE. WE
ENROLLED 93 PARTICIPANTS. WE
CONDUCTED 51 NUTRITIONAL
APPOINTMENTS. ACHIEVING A RATE
OF 91%. WITH OUR STUDY SAMPLE
SIZE FOR THIS ANALYSIS AT 23 THE
ETHNIC COMPOSITION WAS 22%
AFRICAN AMERICAN AND 52%
HISPANIC LATINO AND THEN IN THE
RED BOXES YOU CAN SEE
SIGNIFICANT STRONG POSITIVE
CORRELATIONS WERE OBSERVED
BETWEEN THE FOLLOWING ENGAGEMENT
MEASURES. TOTAL NUTRITION
EDUCATION MODULES COMPLETED AND
NUMBER OF -- SO TEXT MESSAGES
BETWEEN SESSIONS. JOURNAL
ENTRIES. AND TOTAL NUTRITION
EDUCATION MODEL -- MODULES
COMPLETED. AND NUMBER OF TEXT
MESSAGES BETWEEN SESSIONS AND
NUMBER OF JOURNAL ENTRIES IN THE
APP. ADDITIONALLY, A
SIGNIFICANT NEGATIVE CORRELATION
WAS FOUND BETWEEN SESSION LENGTH
SO THE TELEHEALTH SESSION AND
TOTAL NUTRITION EDUCATION
MODULES COMPLETED. WITH A
MODERATE NUMBER OF SESSIONS AND
LENGTH. THESE ENGAGEMENT
SUGGESTS THAT THIS WAS USED IN
VARIOUS WAYS WITH SOME DURING
SESSIONS AND SOME AFTER
SESSIONS. NEXT SLIDE, PLEASE.
WE RECOGNIZE THIS IS A SMALL
SAMPLE SIZE BY WE SEE
PARTICIPANTS ACTIVELY ENGAGING
WITH THE PROGRAM, CONSISTENTLY
ATTENDING, ONCE GIVEN ACCESS TO
CARE THEY DEMONSTRATED HIGH
ENGAGEMENT AND FULL UTILIZATION
OF RESOURCES DESPITE SYSTEMIC
BARRIERS WE OBSERVED DISTINCT
ENGAGEMENT PATTERNS WITH SOME
PARTICIPANTS HAVING LONG
SESSIONS AND LAST, BETWEEN
SESSION ENGAGEMENT WHILE OTHERS
HAD SHORTER SESSIONS WITH MORE
BETWEEN SESSION ENGAGEMENT AND
THESE HIGHLIGHT THE NEED FOR
CULTURALLY AND SOCIOECONOMICALLY
TAILORED EDUCATION FOR
UNDERSTOOD SERVED COMMUNITIES,
WITH THE MATERNAL CARE JOURNEY
ADDRESSING DISPARITIES IN
MATERNAL HEALTH BY IMPROVING
ACCESS TO CARE CAN BE CRITICAL,
PRELIMINARY DATA SHOWS THAT THIS
APPROACH MAY BUILD TRUST AND
ASSIST IN CONTINUED MONITORING
AND CARE FOR AT RISK
PREGNANCIES: NEXT STEPS IS
GETTING NOR DATA WITH OUTCOMES
RELATED TO GESTATIONAL DIABETES.
WITH INITIAL DATA SHARED IN
PRESENTATIONS AND UPCOMING
CONFERENCE SESSIONS. AFTER
FINAL ANALYSIS SO NEXT YEAR WE
WILL SUBMIT TO ONE OR TWO
MANUSCRIPTS TO DISSEMINATE OUR
FINDINGS TO THE CLINICAL
KNOWLEDGE BASE ON MATERNAL
NUTRITION AND HEALTH. AND WE
HAVE BIG NEWS. WE HAVE
SUBMITTED A NEW IRB APPLICATION
AND BEGUN PATIENT RECRUITMENT
THIS MONTH UNDER A CONTINUATION
PROJECT UNDER AN INSTITUTE
HEALTH CARE ADVANCEMENT GRANT
WITH THE INTENTION TO CONTINUE
GROWTH IN THIS PROJECT AND TO
COMBINE DATA FOR COMPREHENSIVE
IMPACT ASSESSMENT. WE ARE ALSO
ASSESSING PLANS TO HAVE THIS SIX
MONTHS POSTPARTUM AND LONG-TERM
INSIGHTS -- TO GET LONG-TERM
INSIGHTS TO DIVERSIFY OUR
POPULATION SAMPLE. SO WHAT DID
WE LEARN HI HERE? OUR FLEXIBILY
FOR PLANS AND BUDGETS, KEEPING
THE PROJECT ON TRACK EARLY AND
CONTINUOUS WORKSHOPS.
PRODUCTIVE USE OF DOWN TIME LED
TO THE DEVELOP ON THE OF
NUTRITION PLATFORM HIGHLIGHTING
THE IMPORTANCE OF CULTURALLY
APPROPRIATE STAFF.
EFFECTIVE COMMUNICATION AND
TRUST BUILDING THROUGH ADAPTED
REFERRAL STRATEGIES,
SIGNIFICANTLY IMPROVED
ONBOARDING AND ENGAGEMENT RATES
AND DEPTH OF STUDY DATA, AND
INSIGHTS FROM A SMALLER SAMPLE
SIZE UNDERSCORED THE IMPORTANCE
OF COMMUNITY DEMOGRAPHICS.
WITHIN THE ASSESSMENTS AND
UNDERSTANDING THE VARIED
ENGAGEMENT PREFERENCES WITHIN
HEALTH LITERACY AND FINALLY,
INTEGRATING DATA ANALYTICS WITH
A DEDICATED CONSULTANT, ENSURED
ANALYSIS LEADING TO EXPANDED
OPPORTUNITIES AND ADDITIONAL
FUNDING WE THANK YOU SO MUCH FOR
THIS OPPORTUNITY. IT'S BEEN
AMAZING. IT'S BEEN A PLEASURE
WORKING WITH MANY OF YOU HERE.
AND WE'RE EXCITED TO CONTINUE
THIS PROJECT.
>> JENNIFER: THANK YOU.
REMINDER TO PUT QUESTIONS IN THE
Q&A AND ALL THE PRESENTERS ARE
IN THE Q&A LOOKING AT YOUR
QUESTIONS NOW. NEXT UP WE HAVE
DOULA CO-OP OF NEVADA. EMILY
WORKS WITH THE DOULA, CONSULTANT
AND EDUCATOR IN NEVADA AND
ACROSS THE U.S. SHE COFOUNDED
THE NONPROFIT ORGANIZATION DOULA
CO-OP OF NEVADA WHERE SHE
ADVOCATES FOR SUSTAINABLE ACCESS
FOR DOULA SERVICES AS THE
DIRECTOR AND THEN JOYCE IS THE
DIRECTOR OF RESEARCH AT THE
DOULA CO-OP OF NEVADA. SHE WAS
PROGRAM OFFICER OVERSEEING
NEVADA'S MATERNAL AND CHILD
HEALTH TITLE V GRANT AND WORKED
WITH THE HEALTH EDUCATION TO
YOUTH IN KENYA. WELCOME DOULA
CO-OP OF NEVADA AND WE LOOK
FORWARD TO YOUR PRESENTATION.
ARE A
>> THANK YOU, TRUE TO OUR ROOTS,
DCNV IS A 103 ORGANIZATION. WE
HAVE DR. KRISTEN BASED IN LAS
VEGAS AS WELL AS TIARA FLYNN,
AND JOYCE IS AN HONORARY DOULA
AS SHE WILL BE COMPLETING HER
DOULA TRAINING THIS COMING FALL.
AT THE TIME WE ENTERED THIS
RESEARCH CHALLENGE THE DOULA
CO-OP WAS ONLY TWO MONTHS OLD
AND WE JUST CELEBRATED OUR
SECOND BIRTHDAY. WE HAVE GROWN
INTO A STATEWIDE HUB FOR
SUPPORT, EDUCATION AND ADVOCACY.
DCNV PROVIDES ACCESS FOR DOULAS
TO ENSURE THEIR CONTINUED
PRESENCE FOR THE MOTHERS AND
FAMILIES WHO DESERVE THEIR
SUPPORT. THANKS TO
PARTICIPATING IN THIS CHALLENGE,
WE ARE ALSO EQUIPPED TO DO
COMMUNITY BASED RESEARCH WHILE
CREATING SUSTAINABLE PATHWAYS
FOR COMMUNITY BASED RESEARCH
WHILE ADVANCING THE PATHWAYS FOR
END OF LIFE CARE AND MATERNAL
HEALTH. NEXT SLIDE, PLEASE.
>> TODAY WE'RE GOING TO BE
DISCUSSING OUR STUDY ENTITLED
CULTURALLY CONGRUENT DOULA CARE.
PERINATAL MOOD ANXIETY
DISORDERS, PMADS, SIGNIFICANTLY
AFFECT MATERNAL HEALTH.
UNTREATED THESE CONDITIONS CAN
PROFOUNDLY IMPACT BOTH MOTHERS
AND BABIES OUR STUDY ADDRESSED A
RESEARCH GAP IN CULTURALLY
CONGRUENT CARE WITH THE IMPACT
ON SATISFACTION AMONG NEVADA
MEDICAID BIRTHING POPULATIONS.
THIS ALIGNS THE ETHNIC RACIAL
LANGUAGE OF DOULAS AND CLIENTS.
WE HYPOTHESIZE THAT MEDICAID
BIRTHING PARTICIPANTS RECEIVING
CULTURALLY CONGRUENT DOULA CARE
WOULD HAVE FEWER PMADS SYMPTOMS
COMPARED TO THOSE NOT RECEIVING
THIS CARE. ADDITIONALLY WE
EXPECTED HIGHER CHILDBIRTH
SATISFACTION AMONG PARTICIPANTS
WITH CULTURALLY CONGRUENT
DOULAS. OUR STUDY EXAMINED THE
PMAD OUTCOMES AND MATERNAL
SATISFACTION DURING CHILDBIRTH
AND TO ASSESS DOULAS' EXPERIENCE
WITH ENROLLMENT AND CARE AND
EFFECTIVENESS DURING THE PERIOD
OF JULY 22023 TO JUNE 2024. WE
HAD FOUR AREAS FIRST WE
ESTABLISHED OUR ORGANIZATIONS
RESEARCH INFRASTRUCTURE AND
SUBMITTED ALL OF OUR STUDY
MATERIAL TO THE IRB. SECOND,
AFTER RECEIVING OUR IRB APPROVAL
WE RECRUITED FOR DOULA
PARTICIPANTS WHICH WE CONTINUE
FOR SEVEN OF THE TWELVE MONTHS
OF OUR STUDY TIMELINE IN TOTAL
WE RECRUITED 16 BIRTHING
PARTICIPANTS FROM NEVADA TO
TRAIN ON MEDICAID PROCESSES AND
PROVIDE THE INTERVENTION
TREATMENT. THIRD, WE BEGIN
ACTIVITIES RELATED TO OUR FIRST
RESEARCH AIM. BY CONDUCTING OUR
INTERVENTION OF DOULA SERVICES.
WHICH CONSISTED OF TWO PRENATAL
VISITS AND ATTENDING BIRTH FROM
CERTIFIED MEDICAID PROVIDER DUE
L.A. WE RANDOMIZED BIRTHING
PARTICIPANTS INTO ONE AND TWO
GROUPS TO RECEIVE CULTURALLY
CONGRUENT DOULA CARE. WE PAIRED
DOULA AND BIRTHING PARTICIPANTS
BASED ON THEIR SUBGROUP
ASSIGNMENTS. DURING THREE TIME
POINTS. ONCE IN PREGNANCY AND
TWICE AFTER PARTICIPANTS GAVE
BIRTH AFTER WEEK ONE AND TWO
WEEKS POSTPARTUM. AFTER THE
VISITS WERE COMPLETE 0, WE
FACILITATED SEMI-STRUCTURED
INTERVIEWS WITH EACH PARTICIPANT
TO ADDRESS OUR SECOND RESEARCH
AIM OUR FINAL ACTIVITIES IN THIS
AREA WERE DEVELOPING AND
DISTRIBUTING A STATEWIDE SURVEY
TO ALL KNOWN ACTIVITY BIRTH
DOULAS IN THE STATE OF NEVADA TO
UNDERSTAND THE RISK BARRIERS.
THIS FOCUSED ON THE EVALUATION
AND THE ANALYSIS OF OUR DATA.
THIS INCLUDED QUANTITATIVE
ANALYSIS OF BIRTHING PARTICIPANT
PMAD AND CHILDBIRTH SATISFACTION
SURVEYS AS WELL AS STATEWIDE
DOULA SURVEY AND QUALITATIVE
ANALYSIS OF THE DOULA
PARTICIPANT INTERVIEWS TO
IDENTIFY COMMON THEMES. NEXT
SLIDE, PLEASE. 55 DOULAS
PARTICIPATED IN OUR STATEWIDE
SURVEY TO ASSESS DOULAS
WORKFORCE AND THEIR DEDICATION.
THIS SURVEY IS THE FIRST KIND IN
NEVADA. WE ENROLLED 13
PARTICIPATES IN THE STUDY. 7 IN
THE DOULA GROUP AND 6 IN THE
CULTURALLY CONGRUENT DOULA
GRIPE. -- GROUP.
THERE WERE FIVE AS TWO OR MORE
ETHNICITIES. EIGHT WERE FIRST
TIME MOTHERS AND ALL SPOKE
ENGLISH AT THEIR PRIMARY
LANGUAGE. 13 DOULAS TOOK PART
IN INTERVIEWS REVEALING THREE
MAIN THEMES, NUMBER ONE CULTURAL
BACKGROUNDS DRIVE DOULA WORK.
TWO LIMITED MENTAL HEALTH
RESOURCES AND TRAINING AND THREE
CHALLENGES WITH THE MEDICAID
ENROLLMENT. TABLE THREE AS YOU
CAN SEE ON THE RIGHT, DISPLAYS
RESULTS FROM THE EDINBURGH
POSTNATAL DEPRESSION SCALE. FOR
THE ANXIETY SCREENING CHILD AND
THE CHILD INSPECTION SCALE.
WHILE PMAD SYMPTOMS DID NOT
CHANGE SIGNIFICANTLY AMONG
INTERVENTION GROUPS THOSE IN THE
CULTURALLY CONGRUENT GROUP SH
SHOWED SATISFACTION SCORES.
THERE WAS MEDICAID ENROLLMENT
AND REIMBURSEMENT PROCESSES.
FINDINGS INDICATE THAT 75% OF
DOULAS AGREE THAT REIMBURSEMENT
WAS STRAIGHTFORWARD. NEXT
SLIDE, PLEADS.
>> THIS PILOT STUDY DOESN'T
PROVIDE ENOUGH EVIDENCE TO DRAW
CONCLUSIONS ABOUT THE IMPACT OF
CULTURALLY CONGRUENT CARE ON
MATERNAL HEALTH IN THE
POSTPARTUM PERIOD BECAUSE OUR
CAPACITY TO RECRUIT BIRTHING
PARTICIPANTS RELIED HIV LY --
HEAVILY ON THE WORKFORCE.
SO EVEN THOUGH THAT WAS THE CASE
WE OBSERVED THAT THE
PARTICIPANTS IN THE GROUP
REPORTED SIGNIFICANTLY HIGHER
SATISFACTION. WITH THEIR CHILD
CARE EXPERIENCES ESPECIALLY WITH
THE SUBSCALES. THIS FINDING
COULD BE INTERESTING FROM THE
DOULA ADVOCACY AND
COMMUNICATION. FURTHER RESEARCH
IS ABSOLUTELY NECESSARY TO
EXPLORE THESE POTENTIAL BENEFITS
ESPECIALLY FOR BLACK BIRTHING
MOTHERS AND PEOPLE WHO FACE
SIGNIFICANT HEALTH DISPARITIES
LINKED TO SYSTEMIC RACISM. THIS
RESEARCH COULD SHED LIGHT ON HOW
DOULAS SHED LIGHT ON THIS WITH
BETTER COMMUNICATION AND
EXPERIENCE: SO FOLLOWING OUR
RESEARCH DCNV.
WE PLAN TO EXPAND THE CULTURALLY
APPROPRIATE WORKFORCE IN NEVADA.
WHICH IS CRUCIAL FOR PEOPLE OF
COLOR DURING CHILDBIRTH AS WELL
AS ALL MEDICAID BIRTHING
INDIVIDUALS. WE ARE DEVELOPING
A STATEWIDE SPECIFIC CURRICULUM
DUE TO THE LIMITED OPTIONS
LIMITED IN OUR STATE. WE HAVE
SECURED TWO GRANTS FOR WORKFORCE
DEVELOPMENT SCHOLARSHIPS AS WELL
AS IN THE NEVADA ACADEMIC
INSTITUTIONS WITH ONE GRANT
CRA
CREATING A SPANISH LANGUAGE
PROGRAM WHICH IS COAUTHORED FROM
VIRGINIA. OUR UPCOMING STEPS
INCLUDE PRESENTING OUR
PRELIMINARY RESEARCH FINDINGS AT
THIS YEAR'S CONFERENCE AND
ADDITIONALLY WE WILL CONDUCT
FURTHER RESEARCH USING THE HUMAN
GEOGRAPHY PERSPECTIVE. THIS
EFFORT AIMS TO GAIN PLACE BASED
EXPERIENTIAL KNOWLEDGE AND HOW
DOULAS CAN IMPACT THIS
POPULATION. NEXT SLIDE, PLEASE.
>> WE LEARNED THAT OUR FINDINGS
ARE MORE CONSISTENT WITH THOSE
TYPICALLY OBSERVED IN A PILOT
STUDY TO THE MEDICAID PROVIDED
ENROLLMENT INHIBITING THE
PARTICIPANT RECITEMENT IN ORDER
TO BETTER ADDRESS OUR ORIGINAL
HYPOTHESIS A TWO YEAR TIMELINE
IS MORE APPROPRIATE. WE ALSO
LEARNED THAT THE ENROLLMENT AND
REIMBURSEMENT PROCESSES MUST BE
STREAMLINED IN ORDER TO REDUCE
BARRIERS FOR DOULAS ENTERING THE
WORKFORCE THROUGH THIS PATHWAY.
THIS SHOWS THAT ADEQUATELY
ADDRESS OUR FIRST RESEARCH AIM,
THERE MUST BE A DRASTIC INCREASE
IN THE TOTAL NUMBERS OF THE
DOULA MEDICAID PROVIDER
WORKFORCE.
>> JENNIFER: I'M SORRY, I'M
GOING TO NEED TO CUT YOU OFF.
WE'RE AT TIME, THANK YOU SO MUCH
FOR THE GREAT PRESENTATION. AND
SORRY I HAD TO CUT YOU OFF AND
WONDERFUL PICTURE. LOVE IT.
THANK YOU, EMILY AND JOYCE.
LET'S MOVE ONTO OUR NEXT ONE.
HEALTH CONNECT ONE. REMINDER TO
PUT YOUR QUESTIONS IN THE Q&A
AND REMINDER TO THE SITE TO
PLEASE ANSWER QUESTIONS IN THE
Q&A. THERE ARE GREAT QUESTIONS
GOING IN THERE. HEALTH CONNECT
ONE, WE HAVE CANAAN BRENT IS A
COMMUNITY HEALTH ADVOCATE, A
CENTRAL TEAM MEMBER ON THE
HEALTH CONNECT ONE'S NIH PROJECT
AND CHRISTINA IS A CHILD HEALTH
RESEARCHER,ED A VEE CAT,
NONPROFIT COFOUNDER AND
CONSULTANT AND SHE PARTNERED
WITH HEALTH CONNECT ONE THROUGH
HER ROLE AT THE EVALUATION
SERVICES. TAKE IT AWEI.
>> HELLO. WE WILL TALK ABOUT
COMMUNITY DOULAS TO REDUCE PE
PERINATAL MOOD AND ANXIETY
DISORDERS AND I WILL CALL PMADS.
A QUICK OVERVIEW OF OUR RESEARCH
TEAM. OUR RESEARCH TEAM IS
COMPRISED OF TWYLA DILLON, THE
RESEARCH PROJECT MANAGER,
MYSELF, AND CHRISTINA'S TEAM AND
A LITTLE BIT ABOUT HEALTH
CONNECT ONE. WE ARE A TRAINING
AND ADVOCACY ORGANIZATION BASED
OUT OF CHICAGO ILLINOIS. AND
OUR VISION IS TO SEE EVERY BABY,
MOTHER AND FAMILY THRIVE IN A
HEALTHY COMMUNITY AND ACHIEVE
THIS THROUGH AN EQUITY APPROACH
SUPPORTING THE FIRST THOUSAND
DAYS FOR BIRTHING FAMILIES. WE
HAVE EMPLOYEES ALL OVER THE
COUNTRY. I WILL SPEAK OFF SLIDE
HERE. OUR PROBLEM STATEMENT WAS
LOOKING AT THE PREVALENCE OF
LACK AT PMADS, ONE OF THE
LEADING CAUSES OF MATERNAL
MORTALITY AND AFFECT 15%. 43%
OF WOMEN AROUND THE UNITED
STATES SO IT'S AN EXTREMELY
CHALLENGING ISSUE AND IT'S
GROWING. NOTABLY PMADS ARE MORE
PREVALENT AMONG POPULATIONS OF
COLOR. SPECIFICALLY BLACK,
BROWN AND INDIGENOUS BIRTHING
PEOPLE. AND THIS IS FOR A FEW
DIFFERENT REASONS. SOME OF
WHICH ARE THAT THESE INDIVIDUALS
ARE LESS LIKELY TO RECEIVE
MENTAL HEALTH SCREENINGS
POSTPARTUM. AND ARE ALSO LESS
LIKELY TO RECEIVE TREATMENT.
THERE'S ALSO A SHORTAGE OF
CULTURALLY COMPETENT TREATMENT
OPTIONS AND THERE'S MORE
MISTRUST IN THE HEALTH CARE
SYSTEMS FROM THESE COMMUNITIES
WHICH ADD TO BARRIERS FOR
RECEIVING HEALTH DIAGNOSIS AND
TRA
TRAININGS. THESE HAVE AN EFFECT
ON THE MOTHER, FAMILY AND BABY.
THIS WILL BE MORE LIKELY TO
INITIATE CONVERSATIONS ON MENTAL
HEALTH, AND ENCOURAGE
PROFESSIONAL HEALTH FOR DOULAS
WHO HAVE NOT RECEIVED FIRST AID
TRAINING. AND NOW I WILL GIVE
IT OVER TO CHRISTINA. NEXT
SLIDE, PLEASE.
>> GREAT, OUR DATA WAS PURELY
QUALITATIVE. WE CONDUCTED FOCUS
GROUPS WITH COMMUNITY BASED
DOULAS OF FOUR OF THE
PARTICIPATING SITES. WE
ORIGINALLY WERE GOING TO DO
CONTROL SITES THROUGHOUT THE
INTERVENTION, HOWEVER, EVERYBODY
WANTED TO BE TRAINED IN MENTAL
HEALTH FIRST AID TRAINING SO
THREE OF THE SITES RECEIVED THE
TRAINING AND THEN WE RECRUITED
ONE CONTROL SITE THAT DID NOT
RECEIVE THE TRAINING BUT
PARTICIPATING IN A FOCUS GROUP
AFTER THE INTERVENTION PERIOD.
AND BECAUSE THIS IS SUCH A
SERIOUS ISSUE WE ALSO FELT THAT
IT WAS EQUITABLE AND JUST TO
OFFER THE INTERVENTION TO AS
MANY GROUPS AS POSSIBLE. SO I
WAS THE PROJECT MANAGER ON THE
AMA KA CONSULTING SIDE.
WE CODED ALL OF THE FOCUS GROUP
TRANSCRIPTS USING QUALITATIVE
SFATIST CALENDAR SOFTWARE AND WE
FOUND FOUR THEMES.
NEXT SLIDE. SO THEME ONE,
ADDITIONAL MENTAL HEALTH
TRAINING IS NEEDED AMONG THE
COMMUNITY DOULA WORKFORCE AND I
THINK WE HAVE HEARD THAT A LOT
TODAY. SO JUST ONE QUOTE HERE I
TALK TO MY CLIENTS ABOUT BABY
PLUS VERSUS MOOD DISORDERS.
THEME TWO, THIS TYPE OF TRAINING
AND MENTAL HEALTH FIRST SAID IS
AN ACCEPTABLE OFFERING FOR
FURTHER PROFESSIONAL DEVELOPMENT
OF COMMUNITY DOULAS. A QUOTE
HERE AS WELL, I WOULD LOVE TO
SEE A TRAINING THAT EXPLORED
MORE ALSO ABOUT THE STIGMA WITH
MENTAL HEALTH AND SUPPORT FACING
BIPOC FAMILIES. NEXT SLIDE.
THEME THREE THIS TYPE OF
TRAINING REQUIRES SPECIFIC
ADAPTATIONS TO BE CULTURALLY
CONGRUENT AND RELEVANT TO THE
WORKFORCE. SECOND QUOTE THERE
READS, WE'RE GIVEN RESOURCES
THAT MAYBE RESOURCES THAT ARE
MAYBE MORE SPECIFIC TO THE
PERINATAL PERIOD WOULD HAVE BEEN
HELPFUL LIKE PERINATAL MENTAL
HEALTH RESOURCES AND THAT'S FROM
THE FACT THAT FIRST AID TRAINING
GENERALLY FOCUSES ON ALL STAGES
OF LIFE AND WE ARE HOPING FOR IT
TO BE ACCEPTABLE AND ADAPTED TO
THIS PARTICULAR POPULATION. AND
THEN THE LAST THEME INCLUSION OF
MENTAL HEALTH VERSUS TRAINING
AND DOULA CARE INCLUDES SUPPORT
AND INTERACTIONS. I WILL READ
BOTH QUOTES BECAUSE I THINK
THEY'RE EXCELLENT. I HAVE
CONNECTIONS TO (READING). NEXT
SLIDE. SO THE PRELIMINARY
RESEARCH FINDINGS IS WE -- WE
WOULD CONTINUE TO HAVE MORE
TOUCHPOINTS WITH THE DOULAS
THROUGHOUT THE PROCESS, NOT ONLY
IN THE TRAINING BUT CLOSE FOLLOW
UP AND MANY DOULAS EMPHASIZED
THAT BECAUSE MENTAL HEALTH IS AN
ONGOING ISSUE THEY WOULD LIKE
MORE FREQUENT TRAININGS. I'M
SORRY, NOT TRAININGS, MAYBE
TRAININGS TOO BUT DEFINITELY
TOUCHPOINTS THAT, YES, IT DID
INCREASE CONFIDENCE AMONG THE
DOULAS, I FEEL MORE COMFORTABLE.
I USED TO HAVE A FEAR OF GOING
OUTSIDE THE SCOPE. CULTURAL
RELEVANCE IS PRIMARY TO ADAPTING
THIS MODEL. TRAINING THAT
EXPLORED MORE ABOUT THE STIGMA
OF MENTAL HEALTH AMONG
COMMUNITIES WHICH WE HEARD
EARLIER. IMPROVED CLIENT
SUPPORT, TRAINING, DOULAS
ABILITY TO WORK WITH DOULAS
FURTHER. THE LIKELY OUTCOME IS
EARLY IDENTIFICATION, REDUCED
STIGMA AND STRONGER NETWORKS AND
THIS ALIGNS WITH THE IMPROVE
OBJECTIVES BECAUSE IT FOCUSES ON
REDUCING HEALTH DISPARITIES AND
PROMOTING AWARENESS. NEXT SL
SLIDE.
>> SO OUR NEXT STEPS IN TERMS OF
FURTHERING OUR RESEARCH ANALYSIS
AND PUBLICATIONS, WE HOPE TO
SCALE THE PROJECT AND EXPAND
MENTAL HEALTH FIRST AID TRAINING
FOR DOULAS AND TO HELP SUPPORT
THIS, WE ARE LOOKING TO APPLY
FOR A LARGER GRANT AND YOU CAN
SEE OUR ESTIMATED BUDGET THERE
AND IT'S IMPORTANT THAT WE FOCUS
ON CENTERING BIPOC VOICES OF
BOTH THE BURDENED PEOPLE AND
THEIR FAMILIES SINCE I SAID
EARLIER PMADS DO AFFECT THE
BROADER COMMUNITY AND IN
ADDITION TO THIS WE WILL WANT TO
LOOK AT THE IMPACT ON LOCAL
COMMUNITIES AND THROUGH YOU ARE
A DATA WANT TO INFLUENCE STATE
AND NATIONAL MATERNAL HEALTH
PRACTICES AND AS ALWAYS WE WANT
TO MAKE SURE WE ARE FOCUSING ON
SUSTAINABILITY OF OUR TRAININGS
AND MAKE SURE THIS IS
PROFESSIONAL DEVELOPMENT FOR OUR
COMMUNITY BASED DOULAS. NEXT
SLIDE, PLEASE. AND FINALLY, IN
THE LAST, LIKE 20 SECONDS THAT
WE HAVE OUR LESSONS LEARNED.
ONE OF OUR BIGGEST LESSONS IS
THAT WE HAD SOME UNFORESEEN
STOCKING CHANGES. MOVING
FORWARD WE WANT TO PARTNER WITH
A CONSULTING TEAM FOR AN
EVALUATION AND ALSO POTENTIALLY
AN ACADEMIC PARTNER TO HELP
PUBLICATIONS AND BRING ON A
MENTAL HEALTH PROFESSIONAL ONTO
THE TEAM WHICH WILL HELP USE
THEIR EXPERTISE SINCE MOST OF
OUR TEAM ARE BIRTH WORK EXPERTS
AND WE WANT TO INCLUDE THE VOICE
OF A MENTAL HEALTH EXPERT AS
WELL AND I BELIEVE WE'RE AT TIME
SO I WILL STOP THERE.
>> JENNIFER: THANK YOU SO MUCH.
I APPRECIATE THAT SO MUCH.
LET'S MOVE TO THE NEXT SLIDE ONE
MORE REMINDER, PUT YOUR
QUESTIONS IN THE Q&A. WE'RE NOT
GOING TO HAVE MUCH TIME AT THE
END FOR Q&A. PLEASE PUT THEM IN
AND FOLKS CAN ANSWER THEM AS
THEY GO. OUR LAST TIME FOR
TODAY, NURTURELY. EMILY LITTLE
IS DIRECTOR AND LEADS PREVENTION
FOCUS RESEARCH TO ELIMINATE
RACIAL INEQUITIES AND INFANT
HEALTH. THE NEWLY DOCTOR.
DR. YA CUE BU IS THE PROGRAM
DIRECTOR AT NURTURELY AND
OVERSEES PROGRAM OPERATION AND
MANAGES RESEARCH.
>> THE STUDENT:ED -- STUDIES.
WELCOME TO YOU BOTH AND TAKE IT
AWAY.
>> THANK YOU SO MUCH. WE'RE SO
HAPPY TO BE HERE TODAY, CARING
FOR THE CULTURE. NEXT SLIDE,
PLEASE. I'M EMILY LITTLE I USE
SHE/HER PRONOUNS, FOUNDER AND
EXECUTIVE DIRECTOR OF NURTURELY
WITH A BACKGROUND IN GLOBAL
PERINATAL HEALTH RESEARCH AND IN
PARTICULAR STUDYING INFANT CARE
FROM A CULTURAL AND
PSYCHOLOGICAL PERSPECTIVE. I'M
LUCKY TO BE JOINED IN THIS
CHALLENGE WITH MY RESEARCH
PARTNER AND COLLEAGUE AVER.
>> YES, I AM PROGRAM DIRECTOR
WITH TEN YEARS EXPERIENCE WITH
STRATEGIC PLANNING AND CHILD
HEALTH.
>> THANKS, NURTURELY IS A SOCIAL
CHANGE ORGANIZATION WHERE THIS
IS A HUMAN RIGHT NOT A PRIVILEGE
AND WE HAVE BEEN LUCKY TO HAVE
BEEN SUPPORTED BY AN AMAZING
GROUP OF HUMANS AT NEUROTURELY
INCLUDING MARIA, AGREE SHA,
REPRESENTING THE LIVED IS
EXPERIENCE AND COMMUNITY BASE
THAT SEEKS UP TO LIFT IN OUR
WORK. NEXT SLIDE, PLEASE. LOW
RATES OF LACTATION AND HIGH
RATES OF DEPRESSION ARE
CONTRIBUTING TO MORTALITY AND
MORBIDITY. BECAUSE OF SYSTEMIC
AND CULTURAL RACISM WE KNOW THAT
BLACK BIRTHING PARENTS ARE AT
THE HIGHEST RISK YET MOST OF
THESE ARE NOT CULTURALLY
REPRESENTATIVE. INFANT CARRYING
OR BABY WEARING IS A POTENTIAL
SOLUTION THAT IN CONTRAST TO
SOME PERCEPTIONS IS NOT A KITE
CRUNCHY TREND THIS IS A GLOBALLY
RELEVANT PRACTICE THAT HAS
EXISTED SINCE THE BEGINNING OF
HUMAN HISTORY AND IS ABSOLUTELY
ESSENTIAL TO THE BLACK
COMMUNITIES AND OUR PREVIOUS
RANDOMIZED CONTROL TRIALS SHOWED
A DECREASE IN DEPRESSION AND AN
INCREASE IN LACTATION WITH A
SIMPLE INFANT CARRYING
INTERVENTION.
>> TO ADDRESS THESE AREAS WE
ANSWERED TWO RESEARCH QUESTIONS.
FIRST, DOES OUR CULTURALLY
INFORMED INFANT CARRYING
TRAINING INCREASE PERINATAL CARE
PROVIDERS KNOWLEDGE AND
CONFIDENCE AND TWO DOES USE OF
AN INFANT CARRIER AFTER BIRTH
DECREASE POSTPARTUM DEPRESSION
AND LACTATION? TO ANSWER THESE
QUESTIONS WE UTILIZED
IMPLEMENTATION SCIENCE RESEARCH
AND AS WELL AS CLINICAL
EFFECTIVENESS RESEARCH TO CREATE
NOVEL TOOLS AND TO BEGIN
RECRUITMENT OF A PILOT STUDY TO
ANSWER THESE QUESTIONS. WHICH
WE'LL TALK ABOUT IN THE NEXT FEW
SLIDES. OKAY. SO WE ADDRESS
THREE DIFFERENT AIMS AND I WILL
START WITH THE FIRST ONE. SO
NURTURELY ALONGSIDE OUR PARTNERS
WE CONDUCTED A SERIES OF
RESEARCH ACTIVITIES WHERE WE
DEVELOPED AND TESTED NOVEL
MEASUREMENT SKILLS THAT WILL
ADVANCE RESEARCHERS' ABILITY TO
UNDERSTAND HOW CULTURAL MODELS
OF PARENT, INFANT INTERACTION
SHAPE INTERVENTION
ACCEPTABILITY, USABILITY, AND
ADOPTION AT THE ORGANIZATIONAL
LEVEL. TWO, TO BETTER TEST AND
UNDERSTAND INFANT CARRYING
IMPLEMENTATION OUTCOMES. AND
THREE, TO ASSESS SELF-REPORTED
PARENTAL RESPONSIVENESS TO
INFANT FEEDING CUES AS A
POTENTIAL IMMEDIATE YAY DOOR OF
INTERVENTION OUTCOMES. AND IN
AIM TWO WE HAD INFANT CARRYING
TRAINING TO TAKE SURVEYS TO
CONDUCT A COMPARISON OF KEY
IMPLEMENTATION OUTCOMES,
SELF-EFFICACY, CONFIDENCE,
KNOWLEDGE, AND USABILITY. AND
THEN OUR THIRD -- IN OUR THIRD
AIM, WE CONDUCTED TRAINING,
TESTED INFRASTRUCTURE, AND BEGAN
THE RECRUITMENT FOR A RANDOMIZED
TWO ARM PARALLEL GROUP TRIAL TO
TEST THE EFFECTIVENESS OF OUR
INFANT CARRYING INTERVENTION IN
IMPROVING POSTPARTUM HEALTH
OUTCOMES. WE IMPLEMENTED THIS
INTERVENTION IN COLLABORATION
WITH TWO PERINATAL CARE
PROVIDERS, HEALTHY START SAN
DIE
DIEGO, SERVING BLACK AND AFRICAN
DIAS IMPORTANT RAN FAMILIES WITH
CULTURALLY MATCHED CARE.
AS WELL AS O VIA, A DIGITAL
PERINATAL CARE APP COMPANY.
NEXT SLIDE.
SO FOLLOWING BEST PRACTICES AND
SCALE DEVELOPMENT TO ANSWER AIM
ONE WE USED A SERIES OF
PROCEDURES BY LOOKING AT IT ALL
AND WE COMPLETED PHASE ONE FOR
ITEM DEVELOPMENT AND BEGAN THE
PROCESS OF ADDRESSING PHASE TWO
FOR SKILL DEVELOPMENT WHERE WE
DID PRETESTING OF QUESTIONS AND
ALSO SAMPLING AND SURVEY
ADMINISTRATION AS WELL AS ITEM
REDUCTION FOR FIVE SCALES LISTED
ON THE SLIDE RELATED TO THE
CULTURAL INCLUSION OF CARRYING
PRACTICES AND THEN ALSO
CONFIDENCE AND KNOWLEDGE OF
UTILIZING INFANT CARRIERS AND
THEN ALSO RESPONSIVENESS TO
INFANT FEEDING CUES: ITEMS WERE
GENERATED BASED ON SUBJECT
MATTER EXPERTISE, BASED ON MORE
THAN TEN YEARS OF PROFESSIONAL
EXPERIENCE STUDYING INSTANT
CARRYING AROUND THE WORLD.
CONTENT VALIDITY WAS ASSESSED
USING ITEM CONTENT VALIDITY
INDEX, NEXT SLIDE. SO FOR AIM
TWO, TRAINING OF DIRECT -- THE
TRAINING OF DIRECT SERVICE
PROVIDERS, HERE ARE RESULTS FROM
THE NURTURELY DEVELOPED. SO AS
YOU CAN SEE, WE DID SEE
SIGNIFICANT DIFFERENCES IN
CONFIDENCE AND KNOWLEDGE BETWEEN
PRE AND POST TRAINING
INTERVENTION. NEXT SLIDE.
>> WE'RE EXCITED TO CONTINUE
THIS WORK TO DEVELOP NOVEL
MEASUREMENT TOOLS AND NEW
APPROACHES TO THE RESEARCH
INVESTIGATING PSYCHOLOGICAL
BENEFITS OF INFANT CARRYING, THE
STRENGTH I WANT TO HIGHLIGHT IS
THAT WE'RE FOCUSING ON
UNDERSTANDING A CULTURAL
PRACTICE, INFANT CARRYING,
CULTURAL PRACTICES HAVE LONG
BEEN NEGLECTED BY THE SCIENTIFIC
COMMUNITIES IN THE UNITED
STATES, AND RESEARCH ON
TRADITIONAL AND CULTURAL
PRACTICES MUST BE SEEN AS AN
URGENT GLOBAL PRIORITY TO HELP
US SOLVE THE PERINATAL HEALTH
CRISIS. WE'RE EXCITED TO
CONTRIBUTE TO THAT PRIORITY.
WE'RE ALSO UNIQUE IN THE
CULTURALLY INFORMED TRAINING AND
A BLACK-LED COMMUNITY CENTERED
INTERVENTION. WE KNOW THAT BOTH
DEPRESSION AND LACTATION ARE
MODIFIABLE HEALTH FACTORS THAT
MAY BE INFLUENCED BY INFANT
CARRYING AND MEASUREMENT TOOLS
LIKE THOSE THAT WE HAVE BEEN
DEVELOPING ARE CRITICAL. NEXT
SLIDE, PLEASE. WE LEARNED SOME
KEY LESSONS THROUGH THIS PROJECT
THAT SERVED US SEEKING TO
CONTINUE DEVELOPING OUR RESEARCH
CAPACITY. OF COURSE ACCOUNTING
FOR DELAYS AS TO BE EXPECTED,
DEVELOPING CON ST -- CONTINGENC
PLANS AND LEANING INTO
MENTORSHIP. WE'RE SO GRATEFUL
FOR THE HELP OF THOSE ON THE
TEAMS TO HELP US LAUNCH STRONG
FOUNDATION FOR OUR RESEARCH
THROUGH THE IMPROVE ENGLISH
INITIATIVE. WE ALSO
STRENGTHENED EXIST
RELATIONSHIPS.
WITH NOT ONLY COMMUNITY BASED
HOME VISITING PROGRAMS BUT ALSO
NATIONAL HEALTH PLATFORMS AND
EVEN INTERNATIONAL
IMPLEMENTATION SCIENCE
ORGANIZATIONS. WE ALSO BUILT
EXTENSIVE INFRASTRUCTURE
INCLUDING A HIPAA COMPLIANT
SOFTWARE SYSTEM. AND WE
SUPPORTED RESEARCH EXCELLENCE
WITHIN OUR ORGANIZATION.
THROUGH TRAINING AND
EVIDENCE-BASED DISSEMINATION
PROGRAMS. AND, AGAIN, SHOUT-OUT
TO AVA WHO SUCCESSFULLY DID THIS
DURING HER CHALLENGE.
>> EMILY, UNFORTUNATELY, WE HAVE
TO --
>> YEP, THANKS, THOM AND I ARE
ON THE SAME PAGE HERE, WE HAVE
TO CUT YOU OFF. WE'RE AT THE
END OF TIME, THANK YOU SO MUCH
EMILY AND AVA, REALLY APPRECIATE
IT. THOM?
>> THOM: GREAT, THANK YOU,
EVERYONE, JUST AMAZING WORK AND
I WANT TO HAVE SOME REFLECTIONS
FROM DR. BALL KEY IS A WHO HAS
BEEN WITH THE OFFICE OF RESEARCH
ON WOMEN'S HEALTH AS A PHYSICIAN
SINCE 2023. AMAZING PERSON TO
WORK WITH. AND DR. WHAT TARA'S
RELIES ON PATIENT-CENTERED CARE
ACROSS THE LIFE SPAN, MATERNAL
AND CHILD HEALTH, STRUCTURAL
DETERMINANTS OF HEALTH AND
GLOBAL HEALTH. I'M REALLY
PLEASED TO WELCOME DR. BALL KEY
IS A.
>> THANK YOU THOM, PARTICIPANTS
AND COLLEAGUES, IT IS MY
PLEASURE TO DELIVER THE CLOSING
PARKS FOR THIS EVENT AS WE
CONCLUDE, I WANT TO EXTEND MY
HEARTFELT APPRECIATION TO EACH
AND EVERY ONE OF YOU FOR JOINING
US TODAY AND MAKING THIS EVENT A
SUCCESS. I WOULD LIKE TO
EXPRESS MY DEEPEST GRATITUDE TO
OUR COMMUNITY ORGANIZATIONS FOR
BEING PART OF THIS INCREDIBLE
JOURNEY WITH US OVER THE PAST
TWO YEARS. YOUR CREATIVITY,
DEDICATION, AND PASSION HAVE
BEEN TRULY INSPIRING. YOU HAVE
DEMONSTRATED THAT BY LEVERAGING
OUR COLLECTIVE STRENGTH FOR THE
CAUSE OF MATERNAL HEALTH, WE CAN
CREATE SOLUTIONS THAT ARE
LOCALLY RELEVANT AND SCALEABLE
NATIONALLY. SO TO ALL OUR
PARTNERS, COLLEAGUES, AND TO OUR
AMAZING COLEADS OF THE
CHALLENGE, YOUR CONTRIBUTION HAS
BEEN INSTRUMENTAL IN THIS ACCESS
OF THIS CHALLENGE. AS WE MOVE
FORWARD, LET US CARRY ON WITH
THE MOMENTUM OF THIS CHALLENGE
TO ENSURE THAT EVERY WOMAN,
EVERY MOTHER, RECEIVES THE CARE
THAT SHE DESERVES AND THE
SUPPORT THAT SHE NEEDS, THANK
YOU, ALL.
>> THOM: GREAT AND WITH THAT WE
WILL CONCLUDE OUR RESEARCH
SHOWCASE ON CONNECTING THE
COMMUNITY FOR MATERNAL HEALTH
CHALLENGE. A BIG THANKS ONCE
AGAIN TO THE ENTIRE TEAM OF --
AT NIH AND ALSO ALL THE
PARTICIPATING TEAMS AND MOST
IMPORTANTLY THE AUDIENCE TODAY.
THANK YOU FOR THE GREAT
QUESTIONS. AND WE WILL BE
POSTING THIS PRESENTATION ONCE
IT'S BEEN APPROVED BY THE
COMMUNICATIONS TEAMS. THANK
YOU, AGAIN, AND HAVE A WONDERFUL
DAY.