Background: Maternal mortality (MM) rates doubled in New York State from 2005 to 2015, from 15/100,000 live births to 29/100,000 live births. In Monroe County in 2015, the rate was 24.5/100,000 live births. Estimates are that severe maternal morbidity (SMM) rates—life-threatening conditions arising from complications of pregnancy or childbirth—are 100 times greater than mortality rates. SMM rates for black women are two to four times higher than for white women.
Solution: The project team will build a consortium comprising multiple stakeholder sectors in Monroe County, New York. Consortium participants will be equipped to be effective contributors to PCOR. The consortium will investigate local trends and factors contributing to MM/SMM, explore interventions that might be tested, and create a five-year prioritized research agenda.
- Create and support a diverse consortium
- Identify local factors contributing to disparity in MM/SMM
- Achieve consensus on what works now, what is ideal, and what is needed to achieve the ideal
- Determine what research projects to pursue; set priorities for five years
- Ensure the consortium’s sustainability
- Create a core leadership team representing key stakeholder groups; determine the optimal composition of the consortium, including total number and proportions of various subsegments. The members will identify and recruit the desired consortium members, yielding a diverse membership across sectors and demographics.
- Establish communication protocols for consortium record keeping, information sharing, member input, and reporting
- Train consortium members in group communications and dynamics, appreciative inquiry, comparative effectiveness research (CER), and patient-centered outcomes research (PCOR)
- Determine the root causes of success that will be the foundation for discussing what needs to be studied
- Gather feedback and document the questions that should be the subject of research
- Learn from members about their networks’ responses; the consortium as a whole will achieve consensus on the research topics of most import.
- Develop and prioritize research topics that can be addressed through PCOR/CER
- A sustainable consortium of stakeholders
- Findings about impact, risk factors, access, care seeking, and care delivery
- A prioritized five-year research plan based in stakeholder knowledge, belief, and values
- Community capacity
Patient Engagement: The first layer of engagement is the leadership team, which was recruited during proposal development and comprises organizations impacted by MM/SMM. These leaders will identify and recruit patients and stakeholders who have relevant experience. The leadership team will determine what additional subsegments are needed in order to create a representative group who will then be integrated as equal partners with the initial leadership members. To access a much broader stakeholder perspective, members of the consortium will conduct listening sessions to learn about the perspectives of a wide range of stakeholders. Each member of the consortium will have an equal voice and will make meaningful contributions to the decision-making process. The schedule of small group and full consortium meetings will be determined by the group.
Collaborators: URMC Department of Public Health Sciences; UR Primary Care Network; Common Ground Health; YourCare Health Plan; Baby Love CHW home visiting program; URMC Department of Maternal and Fetal Medicine; the Center for Community Health and Prevention of the University of Rochester.