Background: Maternal morbidity and mortality in the United States are worsening, especially among Black and Native American populations. One cause is the rising prevalence of chronic conditions.
Proposed Solution to the Problem: Preconception care offers women the opportunity to optimize their health prior to conceiving and thereby improve their maternal health outcomes. There are serious gaps in research about how, when, and by whom to deliver preconception care, particularly among Black and Native American women.
Objectives: The project aims to increase understanding about how Black and Native American women with chronic conditions think about their reproductive health decision making and ways to optimize their health prior to conception; identify patient-centered, patient-designed strategies to identify testable and sustainable preconception and reproductive health practices; and set building blocks in place to support future collaborative action to drive the research roadmap forward.
Activities: The project team will engage 40 Black and Native American reproductive age women with one or more chronic conditions as patient stakeholders to help us understand their recommendations and priorities about how to best implement preconception care. The team will also convene a provider/researcher stakeholder group, seeking their input and ultimately bringing both groups together for collective conversation and idea sharing.
Projected Outcomes and Outputs: Together, the participants will produce a research roadmap guided by Research Justice and Behavioral Change Wheel frameworks and create an ongoing communication pipeline among stakeholders. Researcher and clinician stakeholders will listen to the recommendations and hopefully plan future research proposals that align with patient priority areas, which will include ongoing input and involvement from patient stakeholders. The team will also disseminate findings via a variety of modalities to inform the work of others as well.
Patient and Stakeholder Engagement Plan: The project team will engage a group of diverse Black and Native American women who have one or more chronic conditions. The team will coordinate opportunities for the women to build community, to share, and to document their stories and experiences. The team will coordinate opportunities for patient stakeholders to review themes and ideas shared by fellow stakeholders, including the researcher and clinician stakeholders, and then identify potential solutions and priorities for intervention. The team will create opportunities for all stakeholders to think side-by-side about implementation strategies and sustainability, creating a roadmap for future studies using a research justice approach. The lead research team will include four patient stakeholders and one community leader.
Project Collaborators: This is a partnership between the School of Medicine, the School of Social Work, Healthy Start Pembroke, the American Indian Center, and a variety of faculty and clinicians across North Carolina.
Sarah Verbiest, DPH, MPH, MSW
Rachel Urrutia, MD, MScCR
UNC Center for Maternal and Infant Health
Last updated: January 20, 2023