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A Community Health Worker Intervention to Address Adverse Pregnancy Outcomes

Not Applicable
Not yet recruiting
Conditions
Preeclampsia Postpartum
Adverse Pregnancy Outcomes
Interventions
Behavioral: usual postpartum care + community health worker intervention
Behavioral: usual postpartum care
Registration Number
NCT06353256
Lead Sponsor
University of Alabama at Birmingham
Brief Summary

United States maternal mortality and preterm birth rates are among the highest among high-income countries due in part to a combination of racial, regional and socioeconomic disparities in access to care and overall health. The research proposed focuses on adapting and expanding a perinatal community health worker intervention for Black postpartum patients with preeclampsia (PE) and other adverse pregnancy outcomes (APOs). Investigators will partner with a community-based organization that trains and deploys community health workers. Investigators will test an intervention for urban and rural Black postpartum patients with APOs to 1) enhance blood pressure control postpartum and 2) promote long-term cardiovascular disease prevention for this underserved population. This pilot study will determine if randomizing and implementing a community health worker intervention tailored to pregnant people experiencing preeclampsia is feasible and found to be acceptable by participants.

Detailed Description

The investigators will adapt a current perinatal community health worker intervention to the unique needs of Black postpartum patients with preeclampsia and other adverse pregnancy outcomes. The investigators will conduct a pilot trial to assess the feasibility and acceptability of the intervention. The hypothesis is that it is possible to randomize eligible patients to the feasibility trial, and the intervention will be acceptable to participants. The investigators will randomize Black postpartum patients with preeclampsia or other adverse pregnancy outcomes to either 1) usual care - cardiovascular disease-prevention education before discharge, or 2) intervention - cardiovascular disease prevention education before discharge plus an adapted community health worker intervention. Following the completion of this project, the investigators intend to conduct a larger postpartum community health worker intervention trial in patients with preeclampsia or other adverse pregnancy outcomes powered to detect a difference in clinically meaningful outcomes, as informed by our existing community advisory board.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
Female
Target Recruitment
60
Inclusion Criteria
  • Self Identifies as Black
  • Between 16-56 years old
  • Experiencing adverse pregnancy outcomes defined as hypertensive disorders of pregnancy, preterm birth, placental abruption, pregnancy loss, gestational diabetes, small for gestational infant
  • 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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Usual care and community health worker interventionusual postpartum care + community health worker interventionUsual postpartum care and community health worker visits and support
Usual Careusual postpartum careUsual postpartum care
Primary Outcome Measures
NameTimeMethod
Acceptability12 weeks

Participant satisfaction with postpartum support received as part of the study (scaled from 1 to 10).

Secondary Outcome Measures
NameTimeMethod
Patient satisfaction with CHW intervention6-12 weeks postpartum

Patient satisfaction with CHW intervention using Sekhon Questionnaire to Assess the Acceptability of Healthcare Interventions, 1-5 scale with 1 being the lowest acceptability to 5 being the highest acceptability.

Secondary Outcome Measure: Primary Care Visit Scheduled6-12 weeks postpartum

Participant reports at least one visit is scheduled with a primary care provider

Secondary Outcome Measure: Mean Blood Pressure6-12 weeks postpartum

Mean blood pressure at 6-12 weeks postpartum

Trial Locations

Locations (2)

UAB Medicine

🇺🇸

Birmingham, Alabama, United States

The University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

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