Melanated Group Midwifery Care (MGMC)

University of Illinois at Chicago432 enrolled

Overview

This study is being conducted to determine if a multi-level intervention for delivering maternity care can improve patient trust and engagement among Black birthing people.

Low-risk pregnant participants will be randomized into Melanated Group Midwifery Care or usual individualized obstetric care. In Melanated Group Midwifery Care (MGMC), Black women will receive prenatal care from a Black midwife in groups with the same 8-10 other Black women throughout pregnancy. In pregnancy and into the first year postpartum, MGMC patients will stay connected to the health system through a proactive care coordinator, who is a Black licensed nurse. For the first year after giving birth, patients in MGMC will also be supported by a trained postpartum doula. All participants (intervention and usual care groups) will complete study measures that include validated surveys on patient trust, respect and engagement at 6 time points: * 3 time points in pregnancy \[baseline (\<20 weeks), 26-28 weeks, and 35- 37 weeks\] and * 3 in the postpartum at 2-, 6-, and 12-months * Additional qualitative interviews will be done to track the care received by medically and socially complex patients, including all who experience a severe maternal morbidity. The investigators will also document how MGMC gets embedded in practice through a qualitative process evaluation.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

DOUBLE

Enrollment

432

Conditions

Pregnancy Complications Maternal Care Patterns Patient Engagement

Interventions

Melanated Group Midwifery CareBEHAVIORAL

Racially concordant maternity care Group prenatal care Racially concordant nursing care coordination Postpartum doula support

Eligibility

Sex: FEMALEMin age: 15 YearsMax age: 49 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion criteria for patients: * pregnant women who self-identify as Black on a standard prenatal intake form * less than 20 weeks pregnant * 15 years old or older * present to the general obstetrics group at the University of Chicago Medical Center for their new prenatal visit * speak and understand English Inclusion criteria for providers: • All black midwives, care coordinators, and community postpartum doulas at the University of Chicago are eligible to participate. Exclusion criteria for patients: * having a condition for which they present to a higher level of obstetrics care (e.g., maternal fetal medicine) for their new prenatal visit * having a cognitive issue that impairs their ability to give informed consent.

Locations (1)

University of Illinois at Chicago

Chicago, Illinois, United States

RECRUITING

Outcomes

Primary Outcomes

Patient Engagement-Prenatal Adequacy

Appropriate number (yes/no) and timing of prenatal visits (yes/no) documented in electronic medical records

Time frame: Birth (T3)

Patient Engagement-Prenatal Adherence

Five tests completed during prenatal period (yes/no), documented in electronic medical record

Time frame: Birth (T3)

Patient Engagement-Postnatal adequacy

Appropriate number (yes/no) and timing of postnatal visits (yes/no) documented in electronic medical record

Time frame: 1 year postpartum (T6)

Secondary Outcomes

Patient activation

Patient Activation Measure (PAM), 13-item scale, range 0-100, Likert disagree strongly to agree strongly and not applicable. Assesses degree to which individuals take an active role in managing health and health care. Higher scores are more likely to understand that their active involvement is critical to their state of health and considered more ''in charge.'' The PAM has strong psychometric properties and is predictive of a wide range of health-related behaviors. Hibbard et al. report that a 4-point difference in PAM scores can be viewed as clinically significant.

Time frame: Change from baseline through 12 months postpartum (T6)

Patient Autonomy

Mothers Autonomy in Decision-Making Scale. 7 item scale, Likert completely disagree to completely agree. Assesses the degree to which patients were given decision-making for healthcare decisions, and if patients felt respected by providers. Higher scores indicate that providers supported patient autonomy and patient decision-making.

Time frame: Change from baseline through 12 months postpartum (T6)

Provider Trust

Central Contacts

Kylea L Liese, PhD

CONTACT

3129961867 kylea3@uic.edu

Data from ClinicalTrials.gov

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