Temple and Maternal Wellness Village Partnership Selected for $5.99 Million in PCORI Research Funding for Study on Black Maternal Heart Health
Researchers at the Lewis Katz School of Medicine at Temple University, in partnership with community-based providers from Maternal Wellness Village under the auspices of Oshun Family Center, have been approved for a 5-year, $5.99 million award from the Patient-Centered Outcomes Research Institute (PCORI) to compare two approaches for reducing heart disease risk factors in Black birthing people. The overarching goal of the study is to eliminate disturbing disparities in heart disease, including heart attack and stroke, among Black women and birthing people during and after pregnancy.
While it is well established that eating healthy and monitoring blood pressure can help prevent heart disease, a single individual-level approach that addresses these behaviors on their own has not been enough to stop the rising Black maternal mortality rate. Researchers have also established that depression, social isolation, and stress from racism lead to poor heart outcomes, but few studies have treated these psychosocial and structural factors in addition to individual behaviors to ensure optimal Black maternal heart health, particularly for mothers at higher risk, including those with high blood pressure and/or obesity.
To fill this treatment gap, the research team plans to compare two approaches that address multiple factors leading to heart disease. Both approaches will use text messaging to support healthy nutrition and physical activity, and will include home blood pressure self-monitoring. Both approaches will also provide training to medical care providers to reduce patients’ experiences of racism or mistreatment. However, only one of the approaches will add support for Black women by Black women, including community doula care, mental health services and lactation consultation, during their pregnancy, birth and postpartum. The research team wants to find out if these additional supports lead to lower blood pressure, treat social isolation and depression, and increase experiences of respectful maternity care.
"Amazing things happen when those with resources and the commitment to allyship listen to Black women,” said Saleemah McNeil, MS, MFT, Co-Principal Investigator and the Program Director of Maternal Wellness Village, a collective of Philadelphia-based Black birth workers. “It is our hope that this research will lead to more health systems recognizing the value of community-academic partnerships that center Black-led solutions for optimizing Black maternal heart health.”
The study will enroll 432 patients at Temple Faculty Physicians practices. The enrollees will be age 18 years and older, self-identify as Black or African American, have either obesity and/or high blood pressure, less than 24 weeks pregnant, and have a smart phone. The primary outcomes are change in maternal blood pressure and body weight at six weeks and one year after giving birth. The team will also evaluate how well the treatments are implemented and able to reach patients, be adopted into practice consistently, and lead to health care provider and patient satisfaction.
This study seeks to increase Black mothers’ understanding of the many influences on their heart health, and to help Black women with obesity and/or high blood pressure make informed decisions about the use of community doulas, lactation professionals, and psychotherapists as part of their care to reduce risks for heart disease during pregnancy or in the first year after their baby is born. Results of the study may also strengthen health systems’ commitment to anti-racism training as part of their efforts to provide quality health care for Black pregnant and postpartum people. This research may also provide evidence to insurance companies that coverage of this study’s package of supports is needed.
“Achieving equitable cardiovascular health care requires a commitment to listen to Black women and recognize that their input is vital for meaningful solutions to pregnancy-related morbidity and mortality,” said Sharon J. Herring, MD, MPH, Associate Professor of Medicine and Director of the Program for Maternal Health Equity at the Lewis Katz School of Medicine at Temple University, and Co-Principal Investigator on the study. “The complex context of Black birthing people demands comprehensive strategies that address root causes of racial disparities and systematically intervene at multiple levels of heart disease risk. We are thrilled that our research has been selected for funding.”
Additional partners on the study include faculty and staff from Temple’s Center for Urban Bioethics and the Departments of Obstetrics & Reproductive Sciences, Cardiology, and Clinical Sciences along with colleagues at Drexel, Jefferson, and Duke.
This funding award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.
PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions. For more information about PCORI’s funding, visit www.pcori.org.