The University of Arkansas for Medical Sciences was awarded $17.5 million to conduct a multi-year study aimed at reducing inequities that contribute to complications from overweight pregnancies.
UAMS’ project is one of four studies receiving a portion of $80.5 million from the Patient-Centered Outcomes Research Institute (PCORI) for research using novel approaches to address social and clinical care factors that contribute to maternal health inequities, according to a press release.
The studies will focus on populations disproportionately experiencing adverse maternal health outcomes, including members of the Black, Hispanic and Latino communities, lower-income individuals and people living in rural areas.
UAMS Director of Community Health & Research Pearl McElfish and Community Health Centers of Arkansas CEO Lanita White will serve as principal investigators on the Arkansas project.
Equal partnerships between community organizations and research institutions was a condition of the PCORI funding. During a Tuesday press briefing, White called the work exciting because it features a diverse group of stakeholders, including the Arkansas Minority Health Commission and Arkansas Hunger Relief Alliance and Arkansas Blue Cross Blue Shield.
“These partnerships help ensure that we conduct research that can be translated into policy and also clinical interventions, and ultimately not only helps those enrolled in this study, but all pregnant women throughout the state of Arkansas and ultimately the United States,” White said.
U.S. Centers for Disease Control and Prevention data shows Arkansas has the nation’s highest maternal mortality rate and the third-highest infant mortality rate; 37 of the state’s 75 counties have no obstetric health care providers, according to the Arkansas Center for Health Improvement.
Arkansas also has the nation’s highest teenage pregnancy rate, according to a June report from the Annie E. Casey Foundation.
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Nearly 1,500 women will be enrolled in the Arkansas project, Delivering HOPE (Helping Women Optimize Prenatal Equity), with the majority of participants coming from rural Arkansas and minority communities. McElfish said researchers will examine differences between rural and urban areas as well as among racial and ethnic groups.
The research will be conducted at 14 federally qualified health centers and explore whether the provision of healthy foods during pregnancy reduces the proportion of women who experience excess gestational weight gain (EGWG) and the associated complications, McElfish said.
Arkansas has the second highest prevalence of obesity among U.S. women. Approximately 65% of women in Arkansas are overweight or obese when they become pregnant, according to UAMS.
A healthy diet can promote healthy weight gain during pregnancy, but many Arkansans do not have access to healthy foods. Arkansas has the highest rate of food security in the nation, according to the U.S. Department of Agriculture.
The Delivering HOPE program will implement interventions such as gestational weight gain and nutritional counseling, helping pregnant women sign up for WIC and SNAP at the clinic without going to another location, referrals to safety net food organizations in their community, and grocery delivery of healthy foods to participants’ homes.
McElfish said Tuesday that they’ve been in talks with Walmart to ensure women in rural communities can access grocery delivery and pickup.
“We are really committed to making sure that we reach those most rural areas and don’t let the complexity of implementation stop us from doing that hard work,” she said.
Delivering HOPE is one of two studies that will address maintaining a healthy maternal weight to prevent delivery or postpartum complications among primarily low-income patients in Arkansas and New York City, respectively.
A third study will be implemented in 10 North Carolina counties to track the results of a multi-pronged program that includes home-based blood pressure monitoring, provider education and support for community health workers to reduce hypertensive disorders of pregnancy.
Black maternal mortality in Arkansas rose 110% in two decades, study shows
The fourth study will focus on mood and anxiety disorders that affect one in five pregnant and postpartum individuals and compare how well a practice-level intervention and a peer support program improve symptoms of depression and anxiety among patients receiving care in the perinatal period at clinics in seven states.
Each study has a planning phase of up to one year and a research phase of up to five years.
“The usual approaches to health research and health care have not sufficiently addressed the alarming and worsening national crisis of maternal death and severe illness,” PCORI Executive Director Nakela Cook said in a statement. “Patient-centered comparative clinical effectiveness research that responds to the many challenges concurrently facing pregnant individuals and those who care for them has the capacity to answer questions about which combinations of approaches can best resolve some of these complex maternal health care challenges that have for too long defied solutions.”
Authorized by Congress in 2010, PCORI is an independent nonprofit that has invested more than $4.5 billion to fund patient-centered comparative clinical effectiveness research and support other projects.
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