Project Grant R44MD019206

MONITORING AND OUTREACH FOR MATERNAL SAFETY (MOMS) POSTPARTUM: A CHW TRAINING PROGRAM TO REDUCE POSTPARTUM MATERNAL MORBIDITY AND MORTALITY - KDH RESEARCH & COMMUNICATION (KDHRC) SUBMITS THIS PROPOSAL TO EXPAND AND FULLY EVALUATE MONITORING AND OUTREACH FOR MATERNAL SAFETY (MOMS) POSTPARTUM. MOMS POSTPARTUM IS AN ONLINE PROFESSIONAL DEVELOPMENT COURSE TO PREPARE COMMUNITY HEALTH WORKERS (CHWS) TO CONDUCT OUTREACH TO POSTPARTUM WOMEN TO DECREASE RISK OF MATERNAL MORBIDITY AND MORTALITY. THE MOMS POSTPARTUM MODEL HAS TWO STAGES. IN STAGE ONE, THE TRAINING COURSE INCREASES CHWS' KNOWLEDGE, SKILLS, AND SELF-EFFICACY TO CONDUCT OUTREACH TO POSTPARTUM MOTHERS. IN STAGE TWO, MOMS POSTPARTUM-TRAINED CHWS SUPPORT POSTPARTUM MOTHERS, AND THROUGH THEIR INTERACTIONS, BUILD MOTHERS' KNOWLEDGE, SELF-EFFICACY, AND INTENTIONS TO MANAGE THEIR PHYSICAL, MENTAL, AND EMOTIONAL HEALTH. CHWS ARE FRONTLINE LAY HEALTH WORKERS WHO COMMONLY WORK THROUGH COMMUNITY-BASED ORGANIZATIONS, ARE DEEPLY FAMILIAR WITH THEIR COMMUNITIES' NEEDS AND RESOURCES, AND ARE WELL-POSITIONED TO REACH POSTPARTUM MOTHERS THROUGH THEIR OUTREACH ACTIVITIES. IN PHASE I, KDHRC CREATED A DYNAMIC DRAFT CHW TRAINING COURSE THAT SIGNIFICANTLY INCREASED CHWS' KNOWLEDGE ABOUT CONDUCTING POSTPARTUM OUTREACH. KDHRC ENTERS THE PHASE II PROPOSAL WITH THIS SOLID PROTOTYPE COURSE, STRONG FEASIBILITY RESULTS, PENDING PUBLICATIONS, AND AN OUTSTANDING TEAM OF COLLABORATORS, CONSULTANTS, CONTRACTORS, AND EXPERT ADVISORS. FOR PHASE II, KDHRC PROPOSES TO 1) COMPLETE THE CHW COURSE WITH EIGHT FULLY PRODUCED VIDEO LESSONS AND SIX AI AVATAR SIMULATIONS; 2) DEVELOP AND TEST A CHW COMMUNICATION MANAGEMENT APP (APP), WHICH WILL ALLOW PRIVATE, REAL-TIME CHW/MOTHER CONVERSATIONS THROUGH AN SMS INTERFACE AND INTEGRATE AI AGENTS (AUTOMATED PROCESSES TO ANALYZE INFORMATION AND MAKE RECOMMENDATIONS) TO HELP THE CHW RECOMMEND APPROPRIATE RESOURCES TO POSTPARTUM MOTHERS; AND 3) EVALUATE STAGE TWO OF THE MODEL IN A COMMUNITY-BASED RCT THAT EXPLORES HOW OUTREACH FROM MOMS POSTPARTUM-TRAINED CHWS IMPACTS MOTHERS. THE NEED FOR MOMS POSTPARTUM IS SUBSTANTIAL. WOMEN IN THE UNITED STATES ARE TWICE AS LIKELY TO DIE FROM MATERNAL COMPLICATIONS COMPARED TO OTHER HIGH-INCOME COUNTRIES AND YET UP TO 80% OF PREGNANCY-RELATED DEATHS ARE PREVENTABLE. DISPROPORTIONATELY IMPACTED COMMUNITIES HAVE POPULATIONS WITH SOCIOECONOMIC AND DEMOGRAPHIC CHARACTERISTICS ASSOCIATED WITH ADVERSE MATERNAL MORBIDITY AND MORTALITY. SUCH COMMUNITIES HAVE MATERNAL MORTALITY RATES THAT ARE TWO TO THREE TIMES HIGHER THAN THE GENERAL POPULATION. CHWS ARE IN A STRATEGIC POSITION TO SUPPORT POSTPARTUM MOTHERS, AND MOMS POSTPARTUM WILL BE A POWERFUL ADDITION TO THE PUBLIC HEALTH ARSENAL TO MITIGATE THIS CHALLENGE.