Maternal Health Multilevel Intervention/s for Racial Equity (MIRACLE) Center

孕产妇保健种族平等多层次干预 (MIRACLE) 中心

基本信息

批准号：
10755548
负责人：
JENNIFER E JOHNSON
金额：
$ 268.72万
依托单位：
HENRY FORD HEALTH + MICHIGAN STATE UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-17 至 2030-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10755548
关键词：
Academic support Address Affect African American Area Basic Science Birth Black race Caring Cessation of life Communication Communities Community Health Community Health Aides Community Healthcare County Data Data Analytics Data Set Development Discipline Discipline of Nursing Disparity Economics Education Emergency Medicine Epidemiology Equity Family Financial Support Goals Health Health system Hispanic Hispanic Populations Home visitation Hospitals Inequity Institution Interdisciplinary Study Intervention Intervention Studies Link Maternal Health Maternal Mortality Maternal health equity Measures Medicaid Medicaid eligibility Methods Michigan Morbidity - disease rate Mothers Observational Study Outcome Outpatients Participant Patients Persons Phase Policies Population Postpartum Period Pregnancy Provider Psychology Public Health Public Policy Quality of Care Racial Equity Recording of previous events Records Research Risk Rural Population Science Secure Services Sociology Source Structure System Technology Testing Text Training Translations Work antenatal brief motivational intervention checkup examination clinical care community center community engagement community organizations community partnership community setting comorbidity cost effectiveness data harmonization design digital digital platform disparities in morbidity effectiveness evaluation effectiveness research health administration health equity hospital care implementation research implementation science implementation trial improved innovation mHealth maternal morbidity maternal safety mobile computing mortality mortality disparity multiple chronic conditions novel strategies pregnancy associated death pregnant programs rural area rural setting scale up screening severe maternal morbidity statistics trial design urban setting

项目摘要

SPECIFIC AIMS (Overall). The goal of the proposed Multilevel Interventions to Advance Maternal Health Equity (MIRACLE) Center is to reduce pregnancy-related and pregnancy-associated maternal morbidity and mortality (PRAMM) disparities in African American, Hispanic, and rural populations through innovative and culturally rel- evant community-partnered effectiveness and implementation research. This Center will address the need for multilevel, community-centered, equity-focused interventions developed and tested with an emphasis on scala- bility and sustainment to address PRAMM disparities. The proposed MIRACLE Center is innovative because it: (1) tests complementary, multilevel pregnancy-to-postpartum interventions operating across multiple health sys- tems and settings; (2) addresses and measures a wide range of PRAMM conditions (including non-severe mor- bidity and pregnancy-associated mortality, which are less commonly measured), as well as severe maternal morbidity (SMM) and pregnancy-related mortality; (3) analyzes main effects within each project and synergistic effects across projects, which target different levels and sources of disparities; (4) uses a statewide linked Med- icaid dataset (claims, vital records, screening data) to evaluate common outcomes, allowing for data harmoni- zation across projects and with other Centers nationally; and (5) focuses on the understudied implementation science concepts of scale-up and sustainment. The Center is significant because it: (1) develops and tests novel approaches to addressing determinants of inequities at multiple levels and in multiple systems, (2) tests these population-level equity-focused interventions in 20 Michigan counties, covering a population of >7 million; and (3) uses an equitably partnered Center structure, with academic and health system or community PIs of the Center and of each component. All these features enhance utility and impact of the proposed work. Through three R01-scope projects implementing and testing multilevel interventions, and Community Partnership and Training Components the Center will accomplish the following Aims: (1) Evaluate effectiveness, cost-effective- ness, implementation, and population-wide impact of innovative and culturally relevant multilevel interventions to eliminate PRAMM disparities through three R01-scope projects; (2) Generate and scale innovative ap- proaches & partnerships for eliminating PRAMM disparities; (3) Maximize scalability, sustainability, cultural rel- evance, and broad dissemination of identified approaches; (4) Increase research, practice, and policy capacity for eliminating PRAMM disparities. This Center is rooted in a culturally informed multi-disciplinary Research Community with involvement of longstanding community, health, and policy partners in all phases of the Center’s work, and partnership with Black and Hispanic Medicaid-eligible mothers and their families in urban and rural settings. With in-kind financial support from academic and health institutions, the Center will generate scalable and sustainable approaches for saving maternal lives and ending preventable and unequal maternal suffering.

具体目标（总体）。拟议的促进孕产妇健康公平的多层次干预措施的目标。 (MIRACLE) 中心旨在降低与妊娠相关的孕产妇发病率和死亡率（PRAMM）通过创新和文化关系，非洲裔美国人、西班牙裔和农村人口之间的差异 evant 社区合作的有效性和实施研究该中心将满足以下需求。制定并测试了多层次、以社区为中心、注重公平的干预措施，重点是逐步拟议的 MIRACLE 中心具有创新性，因为它： (1) 测试跨多个卫生系统运行的补充性、多层次的妊娠至产后干预措施 (2) 解决并测量广泛的 PRAMM 状况（包括非严重死亡）产妇死亡率和妊娠相关死亡率（较少测量），以及严重的孕产妇死亡率发病率（SMM）和妊娠相关死亡率；（3）每个项目内的主要影响和协同作用跨项目的影响，针对不同水平和差异来源；（4）使用共同关联的医学- icaid 数据集（索赔、重要记录、筛查数据）来评估常见结果，从而实现数据协调跨项目以及与全国其他中心的合作；(5) 重点研究未充分研究的实施情况；该中心具有重要意义，因为它：(1) 开发和测试新颖的产品。在多个层面和多个系统中解决不平等决定因素的方法，(2) 测试这些在密歇根州 20 个县开展以人口层面公平为重点的干预措施，覆盖人口超过 700 万； (3) 采用平等合作的中心结构，具有学术和卫生系统或社区 PI 所有这些功能都增强了拟议工作的实用性和影响力。实施和测试多层次干预措施的三个 R01 范围项目以及社区伙伴关系和培训内容该中心将实现以下目标： (1) 评估有效性、成本效益- 创新性和文化相关的多层次干预措施的本质、实施和对人群的影响通过三个 R01 范围项目消除 PRAMM 差异；(2) 生成并扩展创新应用程序；消除 PRAMM 差异的方针和合作伙伴关系；(3) 最大限度地提高可扩展性、可持续性、文化相关性；（四）提高研究、实践和政策能力该中心植根于文化背景下的多学科研究，旨在消除 PRAMM 差异。长期社区、卫生和政策合作伙伴参与中心各个阶段的社区工作以及与城乡符合资格的黑人和西班牙裔医疗补助母亲及其家人的伙伴关系在学术和卫生机构的实物财政支持下，该中心将产生可扩展的规模。拯救孕产妇生命并结束可预防和不平等孕产妇痛苦的可持续方法。