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Objective: In response to the unacceptable racial disparities in US obstetric outcomes, our health system established a formal goal to reduce maternal morbidity for black women. Here, we describe our process for meeting this equity-focused goal in the context of diverse implementation climates at 5 inpatient sites.
Study Design: To meet the system goal, we established a collaborative of multidisciplinary, site-based teams. The validated 18-question Implementation Climate Scale (ICS) was distributed to site clinicians at baseline. Sites focused on haemorrhage, performing case reviews of black women meeting morbidity criteria. Comparing cases by site, site-specific areas for improvement in haemorrhage risk assessment, prevention and management emerged. Evidence-based practices (EBPs) were then selected, tailored and implemented by site. Monthly system-wide team meetings included (1) metric tracking and (2) site presentations with discussions around barriers/facilitators to EBP implementation. Maternal morbidity rates among black women were compared the year before goal development (1 July 2019-30 June 2020) to the year after (1 July 2020-30 June 2021).
Results: Mean ICS scores for inpatient obstetric units differed by site (p=0.005), with climates more supportive of implementation at urban/academic hospitals. In response to case reviews, sites reported implementing 2 to 8 EBPs to meet the goal. Despite different ICS scores, this process was associated with significant reductions in maternal morbidity for black women from pregoal to postgoal development overall and at sites 1, 2 and 3, with non-statistically significant reductions at sites 4 and 5 (overall: -29.4% reduction, p<0.001).
Conclusions: A health system goal of reducing maternal morbidity for black women led to a data-driven, collaborative model for implementing site-tailored interventions. If health systems prioritise equity-focused goals, sites can be supported in implementing EBPs that improve care.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670954 | PMC |
http://dx.doi.org/10.1136/bmjoq-2022-002061 | DOI Listing |
Sex Transm Dis
December 2024
Department of Epidemiology, School of Public Health, and the Center for AIDS and STD, University of Washington, Seattle, WA.
Objectives: Women who report sex with women are thought to have lower risk for Chlamydia trachomatis (CT) infection than women who report sex with men only (WSM-only), but comparisons of lifetime burden are limited.
Methods: Among 1,418 sexually-experienced women aged 18-39 years participating in the National Health and Nutrition Examination Survey (2013-2016), we estimated weighted CT seroprevalence and Wald-based 95% confidence intervals (CI) in women who reported ever having sex with a woman (all reported having sex with men also) (WSWM) compared to WSM-only. We defined seropositivity as detection of Pgp3 antibodies and used stratified Poisson regression with robust standard errors to estimate prevalence ratios.
Front Psychiatry
December 2024
Department of Informatics and Health Data Science, University of Miami Miller School of Medicine, Miami, FL, United States.
Background: Maternal mental health is vital to overall well-being, particularly among expectant and postpartum Black and Latina women who experience higher stress levels and mental health challenges. Traditional healthcare systems often fail to meet these needs, underscoring the need for innovative and accessible interventions. NurtureVR, a digital maternal mental health and educational program, leverages virtual reality to offer mindfulness, relaxation, and guided imagery to support these women.
View Article and Find Full Text PDFFront Allergy
December 2024
Section of Allergy and Immunology, Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Introduction: Penicillins and other beta-lactam antibiotics are used in greater than one-third of pregnant women as treatment for Group B Streptococcus colonization and prophylaxis for Caesarean sections. Penicillin allergy labels have been associated with increased morbidity in the pregnant population, and penicillin allergy evaluation during pregnancy is now recognized as safe and effective. Yet, demographic characteristics associated with having a penicillin allergy label during pregnancy have not been studied.
View Article and Find Full Text PDFJ Perinat Med
December 2024
Department of Population Health and Social Medicine Charles E. Schmidt College of Medicine, 1782 Florida Atlantic University, Boca Raton, USA.
Objectives: Cannabis use disorder (CUD) among pregnant women is increasing, yet limited information exists on admissions for treatment in this population. This study examined trends in CUD admissions among pregnant women in publicly funded U.S.
View Article and Find Full Text PDFAm J Prev Med
December 2024
Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA; Women's Health Unit, Section of General Internal Medicine, Boston Medical Center, Boston, MA; Department of Epidemiology, Boston University School of Public Health, Boston, MA; Section of General Internal Medicine, Yale School of Medicine, New Haven, CT.
Introduction: Ongoing care after pregnancy is recommended. Health-related social needs (HRSNs) are recognized barriers to care, yet their pregnancy-related prevalence and associations with care are unknown. Researchers sought to assess (1) the prevalence of HRSNs during pregnancy-based care, and (2) their associations with ongoing care after pregnancy.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!