This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
COVID-19-Related Project Enhancement
In response to COVID-19, prenatal care has shifted from all in-person appointments to a combination of in-person and telehealth appointments, using phone, video, or other devices that help manage care.
With this enhancement, the research team wants to learn whether group prenatal care using telehealth works well for women with low incomes, particularly those who are Black or Latina. Working with the advisory group, the team will adapt their group prenatal care model for telehealth. The team will ask women who’ve had prenatal care during the pandemic about:
They will also talk with healthcare providers, payers, and people from community agencies. Results will be used to test whether the telehealth group prenatal care is feasible and acceptable.
Enhancement Award Amount: $499,930
What is the research about?
In the United States, about 10 percent of babies are born premature, which is before 37 weeks. Premature babies have physical and mental problems more often than babies born at full term, and they are at higher risk of dying as newborns. Women with low incomes, and women who are black, Latina, or Native American or Pacific Islander are more likely to have a premature baby than other women.
Having depression or anxiety or experiencing racism while pregnant may raise a woman’s chances of having a premature baby. This study is comparing two programs that provide care to pregnant women with low incomes to see how the programs affect premature births and women’s mental health and care experiences.
Who can this research help?
Clinics may be able to use the findings when considering ways to improve health care for pregnant women at risk for having a premature birth.
What is the research team doing?
The research team is working with 10 health clinics that serve racially and ethnically diverse patients in Fresno County, California. They are enrolling 2,600 women who are less than 24 weeks pregnant, speak English or Spanish, and are eligible for Medicaid.
Each clinic is offering the two prenatal care programs and assigning women to one of them based on their due date. In the first program, called Glow!, women with similar due dates receive pregnancy care in a group. In the second program, the Comprehensive Perinatal Services Program, or CPSP, women receive one-on-one pregnancy care. They also meet with CPSP staff up to three times to report on their health and living situation. In both programs, women have 7–11 prenatal care visits. Both programs offer services for depression, anxiety, smoking, drug and alcohol use, and health problems that could be dangerous during pregnancy.
Women in the study are completing surveys about their physical health, mental health, and care experiences when they enroll in the study, during their third trimester, and three months after they give birth. The research team is looking at women’s medical records to find out whether their baby was born premature. The team is also conducting in-depth interviews with some black and Latina participants to learn more about their care experiences.
A study advisory group is helping the research team plan and carry out the study. It includes women who received prenatal care in one of the programs, clinicians, and community organization representatives.
Research methods at a glance
|Design||Randomized controlled trial|
|Population||Women who are less than 24 weeks pregnant, speak English or Spanish, and are eligible for Medicaid|
Primary: premature birth rate
Secondary: anxiety, depression, satisfaction with care, perceptions of respectful care
|3-month follow-up after birth for primary outcome|
- In progress; Recruiting
These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them.
- Mental/Behavioral Health
- Reproductive and Perinatal Health
- Pregnancy and Birth Outcomes
PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders.
- Low Income
- Racial/Ethnic Populations
- Addressing Disparities
- COVID-19-Related Project Enhancement
PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care.
- Complementary and Alternative Medicine
- Other Clinical Interventions
- Care Coordination
- Patient Navigation
- Other Health Services Interventions
- Training and Education Interventions
- Addressing Disparities
The state where the project originates, or where the primary institution or organization is located.