A5071049144- Maternal and Perinatal Health Interventions
- Maternal and fetal healthcare
- Global Maternal and Child Health
- Emergency and Acute Care Studies
- Pregnancy and preeclampsia studies
- Racial and Ethnic Identity Research
- Grief, Bereavement, and Mental Health
- Migration, Health and Trauma
- COVID-19 Impact on Reproduction
- Prenatal Substance Exposure Effects
- COVID-19 epidemiological studies
- Reproductive Health and Technologies
- Nursing Roles and Practices
- Healthcare Systems and Challenges
- Food Security and Health in Diverse Populations
- Mobile Health and mHealth Applications
- COVID-19 and healthcare impacts
- Health Services Management and Policy
- Health Policy Implementation Science
- Primary Care and Health Outcomes
- Reproductive Health and Contraception
- Public Health Policies and Education
- ICT in Developing Communities
- Data-Driven Disease Surveillance
- Urban, Neighborhood, and Segregation Studies
University of California San Diego Medical Center
2023-2025
University of California, San Diego
2022-2024
Brigham and Women's Hospital
2015-2024
University of Houston
2024
Community Link
2020-2023
Tufts University
2017-2023
Creative Commons
2023
University of Alabama at Birmingham
2023
March of Dimes
2021
Harvard University
2019-2020
OBJECTIVE: To assess whether application of a standard algorithm to hospitalizations in the prenatal and postpartum (42 days) periods increases identification severe maternal morbidity (SMM) beyond analysis only delivery event. METHODS: We performed retrospective cohort study using data from PELL (Pregnancy Early Life Longitudinal) database, Massachusetts population-based system that links records birth certificates hospital discharge nonbirth for all birthing individuals. included...
The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency requiring significant changes in obstetric and gynecologic care delivery to minimize the risk of transmission healthy patients workers. Although these are necessary, they will differentially affect way that highlights exacerbates existing inequities access outcomes. Socially vulnerable groups already disproportionately affected by COVID-19 infection more likely experience severe morbidity mortality. Some reasons...
Group-based health services can improve maternal and newborn outcomes. Group antenatal care participatory learning action cycles (PLA) with women's groups have been cited by the WHO as systems interventions that lead to improvements in adherence outcomes pregnancy postpartum period.We used a mixed-methods approach assess feasibility of light touch group-based support intervention using WhatsApp text-messaging platform. Pregnant women were enrolled at Jacaranda Health (JH), maternity center...
Abstract Background Black-White inequities in severe maternal morbidity the United States are extreme and growing. Maternal safety bundles (MSBs) have been associated with closing racial equity gaps health some states. The objective of this study was to explore clinician perspective experiences implementing an Equity bundle across five hospitals Massachusetts address perinatal care birth outcomes. Methods Focus group discussions interviews were conducted Fall 2022 2023 (before after MSB...
Abstract Background COVID-19 inequities are abundant in low-income communities of color. Addressing vaccine hesitancy to promote equitable and sustained vaccination for underserved requires a multi-level, scalable, sustainable approach. It is also essential that efforts acknowledge the broader healthcare needs these including engagement preventive services. Methods This hybrid type 3 effectiveness-implementation study will include longitudinal, mixed-methods data collection approach designed...
It is estimated that 50,000–60,000 pregnant people in the United States (US) experience severe maternal morbidity (SMM). SMM includes life-threatening conditions, such as acute myocardial infarction, renal failure, amniotic fluid embolism, disseminated intravascular coagulation, or sepsis. Prior research has identified both rising rates through 2014 and wide racial disparities SMM. While reducing death been a global goal for past several decades, limited progress made US achieving this goal....
ObjectivesAmong those with a severe maternal morbidity (SMM) event and subsequent birth, we examined how the risk of second SMM varied by patient characteristics intrapartum hospital utilization.MethodsWe used Massachusetts population-based dataset that longitudinally linked in-state births, discharge records, prior non–birth-related utilizations for birthing individuals their children from January 1, 1999, to December 31, 2018, representing 1,460,514 births 907,530 people. We restricted our...
OBJECTIVE: To examine demographic and clinical precursors to pregnancy-associated deaths overall when pregnancy-related are excluded. METHODS: We conducted a retrospective cohort study based on Massachusetts population–based data system linking from live birth fetal death certificates corresponding delivery hospital discharge records birthing individual's nonbirth contacts associated records. Exposures included maternal demographics, severe morbidity (without transfusion), hospitalizations...
Structural racism is embedded within the structure and function of academic medical institutions. Although many institutions have begun to incorporate racial justice medicine, it needs be integral every discipline all aspects education, research, health system practice. Guidance lacking, however, on how create sustain department-level action shift culture encourage antiracist work.To address culture, uphold justice, challenges in medicine with dynamic innovative solutions, Department...
Objective: The aim of this study was to assess the impact a revolving loan fund (RLF) on timing device insertion and long-acting reversible contraception (LARC) access among high-risk urban population at 3 Boston community health centers. Design: Three centers were identified implement RLF. Each clinic received $5000 from RLF purchase LARC devices. Data collected through medical record review retrospectively 1 year prior start prospectively for thereafter included patient demographics, type...
INTRODUCTION: Nationally, Black birthing individuals face a disproportionate burden of maternal mortality and severe morbidity. Although there is growing research interest in tackling these inequities, significant gap exists incorporating the insights perspectives interprofessional front-line clinicians. This study sought to learn experiences viewpoints physicians, certified nurse-midwives (CNMs), registered nurses (RNs) identify strategies for addressing care inequities. METHODS: In...
INTRODUCTION: The Perinatal Neonatal Quality Improvement Network (PNQIN) of Massachusetts engaged hospital teams in a statewide improvement initiative to address maternal morbidity from obstetric hemorrhage (OB HEM) through support implementation and adherence best practices screening for diagnosis OB HEM. METHODS: Alliance Innovation on Maternal Health (AIM) HEM bundle was adapted implemented across hospitals June December 2021. Each month, participating joined educational webinars, learned...
Abstract Background Successful containment strategies for SARS-CoV-2, the causative virus of COVID-19 pandemic, have involved widespread population testing that identifies infections early and enables rapid contact tracing. In this study, we developed a inexpensive RT- qPCR pipeline population-level SARS-CoV-2 detection, used to establish clinical laboratory dedicated at University California San Diego (UCSD) with processing capacity 6,000 samples per day next-day result turnaround times....
Background: Successful containment strategies for SARS-CoV-2, the causative virus of COVID-19 pandemic, have involved widespread population testing that identifies infections early and enables rapid contact tracing.In this study, we developed a inexpensive RT-qPCR pipeline population-level SARS-CoV-2 detection, used to establish clinical laboratory dedicated at University California San Diego (UCSD) with processing capacity 6,000 samples per day next-day result turnaround times.Methods...
INTRODUCTION: A survey of family planning departments in Boston community health centers indicated difficulty purchasing and maintaining Long Acting Reversible Contraception (LARC) supplies, resulting longer wait times decreased access. METHODS: Three pilot sites were identified to implement a revolving loan fund (RLF). Each clinic received $4,800 from the RLF purchase LARC devices. Data was collected through chart review retrospectively one year prior start prospectively year. included...
INTRODUCTION: Measuring patient experience is core to understanding and addressing inequities in obstetric care quality. METHODS: People who gave birth at one of five hospitals Massachusetts identified as non-Hispanic Black (NHB) or White (NHW) were invited complete a structured survey 7–16 weeks postpartum, from February September 2022. The included two validated instruments: the Mothers on Respect index, dichotomized “very respectful” not Autonomy Decision Making scale, “high autonomy”...