Background: Pregnant and postpartum individuals living in rural communities are more likely to experience poor maternal health outcomes than the general population. Efforts are underway to improve outcomes for high-risk populations, but there is no coordinated and stakeholder-generated research agenda to understand how to do this most effectively. More information is also needed about how to engage individuals in rural regions in the development and conduct of maternal health research.
Proposed Solution to the Problem: The project team will use several strategies to support the virtual engagement of diverse stakeholders in the development and monitoring of a research agenda that builds capacity to conduct patient-centered rural maternal health research.
Objectives: The main objective is to create a stakeholder network committed to improving rural maternal health outcomes through patient-centered research. The project team will do this through the development of a research agenda focused on stakeholder-informed priorities and research gaps and an advisory committee that will monitor the research agenda.
Activities: The project team will organize and convene a Rural Maternal Health-patient-centered outcomes research/comparative clinical effectiveness research Advisory Committee (RMH-PAC) made up of Pennsylvania-based and national stakeholders with expertise in various elements of rural maternal health to develop and monitor the research agenda. The project team will facilitate four Virtual Community Engagement Studios (V-CES) with rural pregnant/postpartum individuals to understand their maternal health-related needs and research priorities and determine strategies to support their engagement as members of a research team. The project team will also conduct interviews with key informants to understand diverse perspectives about rural maternal health research gaps and priorities.
Projected Outcomes and Outputs:
Short-term outcomes during the project period include a rural maternal health research agenda, findings report from V-CES and key informant interviews, RMH-PAC participant roster and meeting minutes, and an RMH-PAC charter/sustainability plan.
Medium-term outcomes (0-2 years post-project period) include the dissemination of the research agenda, continued meeting of the RMH-PAC to monitor and evolve the research agenda, and submission of at least one PCORI proposal to understand how interventions improve rural maternal health.
Long-term outcomes (3+ years post-project period) include sustaining the RMH-PAC and, ultimately, a meaningful improvement in rural maternal health outcomes.
Patient and Stakeholder Engagement Plan: Conversations with stakeholders informed the development of this project plan by identifying key rural pregnant/postpartum populations of focus and helping to identify stakeholder engagement activities. Stakeholder consultants will participate in project team meetings to help plan V-CES sessions, key informant interviews, and RMH-PAC meetings and to support the creation of all project deliverables.
Project Collaborators: The project team will contract with three consultants including the developer of the V-CES toolkit from Brandeis University; a mother in recovery who provides substance use services in rural Pennsylvania; and a rural obstetrics provider who co-founded the Lancaster Diversifying Doulas Initiative, which trains doulas of color to support expecting Black and Latinx individuals. Additional collaborators include the Pennsylvania Office of Rural Health, National Rural Health Association, Behavioral Health Alliance of Rural Pennsylvania, Association for Community Affiliated Plans, Rural Health Redesign Center, and several others.