The Patient-Centered Outcomes Research Institute (PCORI) announced funding grants totaling $80.5 million to support four patient-centered comparative clinical effectiveness research (CER) studies focusing on social factors and health care that contribute to inequalities in maternal morbidity and mortality.
Awarded through a PCORI funding opportunity known as “Partner” for its focus on partnering with research institutions and community-based organizations to pursue novel approaches to health equity research, these four studies will focus on populations that disproportionately experience outcomes adverse effects on maternal health, including black, Hispanic, and Latin American individuals, those living in rural areas, and people with lower incomes.
A combination of elements distinguishes the four studies from standard clinical trials. For each study, two principal investigators from research institutions and community organizations with established and meaningful local relationships will co-lead evaluations of approaches aimed at addressing the complex health challenges affecting maternal health in different communities. Recognizing that these challenges are influenced by factors beyond clinical care, these studies will evaluate multicomponent interventions that address both healthcare and social determinants of health. Each of these studies will have a planning phase of up to one year and a research phase of up to five years.
“Business-as-usual approaches to research and health care have not sufficiently addressed the alarming and growing national crisis of maternal death and serious illness,” PCORI Executive Director Nakela L. Cook, MD, MPH, said in a statement. . “Patient-centered comparative clinical effectiveness research that responds to the many challenges that pregnant women and their caregivers face simultaneously has the capacity to answer questions about what combinations of approaches can best resolve some of these complex health care challenges.” maternal that have been present for too long. “challenged solutions”.
Studies will be conducted across a broad swath of the United States, including rural and urban areas and states in the Northeast, Midwest, Mid-Atlantic, and South. They will compare a variety of practice-level, community-based, and home-based interventions that address common and frequent challenges faced by pregnant people and new mothers.
Two studies will address maintaining a healthy maternal weight to prevent birth or postpartum complications among primarily low-income patients in Arkansas and New York City, respectively. Interventions that the studies will compare include support for patient-selected social needs, such as grocery delivery or transportation to medical appointments, and social service navigation driven by community health workers.
A third study to be conducted in 10 North Carolina counties will track the results of a multiple program that includes home blood pressure monitoring, provider education, and support for community health workers to reduce hypertensive disorders of pregnancy, one of the main causes of serious health problems among people who give birth.
A fourth study will focus on mood and anxiety disorders that affect one in five pregnant and postpartum people and compare how well a practice-level intervention and a peer support program improve depression symptoms and anxiety among patients receiving care in the perinatal period in clinics in seven states.
Each of these studies will generate evidence to inform which approaches work best, for whom, and under what circumstances.
“These funding awards mark an important advancement of PCORI’s long-standing leadership in engaging patients and their caregivers in all aspects of comparative clinical effectiveness research to ensure that results are relevant, useful and impactful,” he said. PCORI’s deputy executive director for Patient Centered. Research Programs Harv Feldman, MD, in a statement. “We look forward to seeing the impact the study findings will have for maternal health across the United States, particularly among populations that continue to disproportionately experience adverse outcomes.”
With these latest awards, PCORI has invested more than $4.5 billion to fund patient-centered CER and support other projects.
