Project Summary

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

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 Element Description
Design Randomized controlled trial
Population Women who are less than 24 weeks pregnant, speak English or Spanish, and are eligible for Medicaid
Interventions/
Comparators
  • Group pregnancy care with enhanced services (Glow!)
  • One-on-one pregnancy care with enhanced services (CPSP)
Outcomes

Primary: premature birth rate

Secondary: anxiety, depression, satisfaction with care, perceptions of respectful care  

Timeframe Timeframe Length of follow-up for collecting data on primary outcomes. View Glossary 3-month follow-up after birth for primary outcome

Project Information

Miriam Kuppermann, PhD, MPH
University of California, San Francisco
$6,044,626
Comparing Approaches to Enhanced Prenatal Care to Improve Maternal and Child Health in Central California

Key Dates

April 2019
September 2024
2019

Study Registration Information

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Health Conditions Health Conditions 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. View Glossary
Populations Populations 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. View Glossary
Intervention Strategy Intervention Strategies 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. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: February 5, 2024