PCORI Funds Four Studies on Maternal Health Equity

Nov. 28, 2023
Dual principal investigators from research institutions and community organizations will co-lead assessments of approaches to addressing challenges that impact maternal health in different communities

The Patient-Centered Outcomes Research Institute (PCORI) announced funding awards totaling $80.5 million to support four patient-centered comparative clinical effectiveness research (CER) studies focused on both the healthcare and social factors that contribute to inequities in maternal morbidity and mortality. 

Awarded through a PCORI funding opportunity known as “Partner” for its focus on partnering research institutions and community organizations to pursue novel approaches to health equity research, these four studies will focus on populations disproportionately experiencing adverse maternal health outcomes, including Black people, Hispanic and Latin American individuals, those living in rural areas and individuals with lower incomes.

A combination of elements distinguishes the four studies from standard clinical trials. For each study, dual principal investigators from research institutions and community organizations with established and meaningful local relationships will co-lead assessments of approaches intended to address the complex health challenges that impact 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.

“The usual approaches to health research and healthcare have not sufficiently addressed the alarming and worsening national crisis of maternal death and severe illness,” said PCORI Executive Director Nakela L. Cook, M.D., M.P.H., in a statement. “Patient-centered comparative clinical effectiveness research that responds to the many challenges concurrently facing pregnant individuals and those who care for them has the capacity to answer questions about which combinations of approaches can best resolve some of these complex maternal healthcare challenges that have for too long defied solutions.”

The 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 the South. They will compare a range of practice-level and community- and home-based interventions that address common, frequent challenges facing pregnant individuals and new mothers.

Two studies will address maintaining a healthy maternal weight to prevent delivery or postpartum complications among primarily low-income patients in Arkansas and New York City, respectively. Interventions that the studies will compare include patient-selected social needs supports, such as grocery delivery or transportation to medical appointments, and social service navigation driven by community-health-workers.

A third study to be undertaken in 10 counties in North Carolina will track the results of a multi-pronged program that includes home-based blood pressure monitoring, provider education and support for community health workers to reduce hypertensive disorders of pregnancy, one of the major causes of serious health problems among birthing individuals.

A fourth study will focus on mood and anxiety disorders that affect one in five pregnant and postpartum individuals and compare how well a practice-level intervention and a peer support program improve symptoms of depression and anxiety among patients receiving care in the perinatal period at clinics in seven states.

Each of these studies will generate evidence to inform which approaches work best, for whom and in what circumstances. 

“These funding awards mark an important advancement of PCORI’s longstanding leadership in engaging patients and those who care for them in all aspects of comparative clinical effectiveness research to ensure that results are relevant, useful and impactful,” said PCORI Deputy Executive Director for Patient-Centered Research Programs Harv Feldman, M.D., in a statement. “We look forward to seeing the impact the studies’ 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.

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