Stress management and response training for prenatal evaluation and parenting (smart-prep)

The National Institute for Minority Health and Health Disparities awarded Ponce Medical School Foundation Inc. $751,806 on September 1, 2026, under the Minority Health and Health Disparities Research program (CFDA 93.307) to conduct a randomized controlled trial evaluating virtually delivered prenatal education focused on mindfulness-based childbirth and parenting (MBCP).

The award funds the SMART-PREP (Stress Management and Response Training for Prenatal Evaluation and Parenting) study, which will enroll 300 pregnant individuals receiving prenatal care in Puerto Rico. The trial compares MBCP to standard Lamaze-based instruction and usual care, with the goal of identifying scalable prenatal education strategies for healthcare systems facing service interruptions and logistical challenges. The study measures the impact of structured prenatal education on family adaptability and perinatal health outcomes, and assesses relationships between caregiver prenatal health indicators and early infant health outcomes including gestational age, birth weight, and early infant functioning. Data collection employs validated self-report instruments, an allostatic load index, clinical records, and NIH developmental assessments.

Performance occurs in Puerto Rico with a period of performance from September 1, 2026, through February 28, 2031. Ponce School of Medicine, the recipient's operating name, is a minority-serving and Hispanic-serving educational institution headquartered in Ponce, Puerto Rico, that conducts NIH-funded biomedical research and clinical training.

Abstract

A critical GAP remains in understanding how structured prenatal education can improve perinatal and child outcomes in regions with limited healthcare access. Current clinical practices often lack integration of physiological risk assessment and behavioral support, particularly in settings facing infrastructure instability or overlapping public health challenges. There is a clear unmet need for scalable models that connect perinatal health with infant developmental outcomes. The objective of this randomized controlled trial is to evaluate the long-term effects of a virtually delivered prenatal education program focused on self-regulation- mindfulness-based childbirth and parenting (mbcp)-compared to a standard lamaze-based program and usual care. The study will enroll 300 pregnant individuals receiving prenatal care in puerto rico, where healthcare systems frequently face service interruptions. The long-term goal is to identify replicable strategies that can be implemented across healthcare systems experiencing logistical challenges. The central hypothesis is that structured prenatal education improves outcomes for both caregivers and infants by reducing physiological distress and promoting adaptability. This hypothesis is informed by preliminary data and prior research linking stress-related immune disruption and physiological strain to negative perinatal and infant health outcomes. Two specific aims will guide this work: 1) evaluate the impact of mindfulness-based childbirth and parenting (mbcp) on family adaptability and perinatal health outcomes; 2) assess the relationship between caregiver prenatal health indicators and early infant health outcomes, including gestational age, birth weight, and early measures of infant functioning. The study will use validated self-report instruments, an allostatic load index, clinical records, and NIH developmental assessment tools to measure physiological and developmental outcomes. The research team brings expertise in psychology, physiology, pediatrics, obstetrics, prenatal education, clinical trial design, statistics, epidemiology, and applied research. Anticipated outcomes include new insights into how prenatal stress management influences perinatal and early childhood health. Key contributions will include evidence supporting virtual delivery of structured education, biological mediation models, and context-sensitive strategies to support caregiver-infant health. Innovations include the integration of biological and behavioral metrics, virtual adaptation of mbcp for low- resource environments, and assessment of family involvement and infant development using standardized NIH tools. Positive findings from this trial will inform future prenatal care approaches and support scalable interventions aimed at improving health outcomes for caregivers and infants across varied healthcare environments.