EngagINg the COmmunity to Reduce Preterm Birth Via Adherence To an Individualized Prematurity Prevention Plan
Study Details
Study Description
Brief Summary
The purpose of this study is to determine if INCORPorATe IP3 is feasible prior to a larger trial focused on determining efficacy. Feasibility will be measured using the RE-AIM framework4: Reach or Participation (Primary Outcome): (a) percent of eligible participants who are successfully recruited and attend at least one group session; Effectiveness: retention rate in the intervention; Implementation: fidelity to the intervention protocol; Maintenance: intervention sustainability based on continued engagement from the participants.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Non-Hispanic black (NHB) women are 49% more likely to experience a preterm birth (PTB), delivery before 37 weeks. PTB is associated with increased risk of poor short and long-term neonatal outcomes. PTB can occur in multiple clinical scenarios including spontaneous PTB (e.g. preterm labor, preterm pre-labor rupture of membranes) and medically induced preterm labor (e.g. preeclampsia). Women with a history of PTB are at 1.5 - 2 fold increased risk for future PTB. There are medical therapies than can reduce the risk of recurrent PTB specific to the presumed etiology of the prior PTB. Thus, women with a history of a prior PTB who receive care with Duke Maternal Fetal Medicine (MFM) receive and Individualized Prematurity Prevention Plan (IP3) to reduce their risk of recurrent PTB. The IP3 plans are often labor intensive with requirements ranging from daily medications, weekly clinic visits, painful injections or invasive ultrasounds.
Given the increased rate so of PTB among NHB women and some suggestion of decreased adherence in this population1, we previously conducted qualitative studies with NHB women to uncover patient perceived barriers to IP3 adherence2,3. These studies revealed that NHB women with prior preterm birth felt that stress and lack of support were key barriers to preterm birth prevention adherence. Stress and limited support made women feel isolated from their peers and community. Based on these data we worked with a stakeholder group to develop a patient-centered, community-involved intervention that will increased adherence to an individualized prematurity prevention plan using community-level social supports. The resulting invention titled, EngagINg the COmmunity to Reduce Preterm Birth via Adherence To an Individualized Prematurity Prevention Plan (INCORPorATe IP3) includes community doula led group social support.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Other: Group Social Support Meetings and Facebook Group Facebook group where community doulas will be providing information on various pregnancy and support topics in addition to 8 possible group Zoom meetings that will include pregnancy-related/reflection topics. |
Behavioral: Facebook discussions and Virtual group meetings
Participants must join a study-specific private Facebook group and engage in discussion. Once the discussion is complete, participants have the opportunity to join virtual group sessions via Zoom
|
Outcome Measures
Primary Outcome Measures
- Reach or Participation Rate [1 year]
Percent of eligible participants who are successfully recruited and attend at least one group session
Secondary Outcome Measures
- Effectiveness [1 year]
Retention rate in the intervention measured by the number of sessions each participant attends
- Implementation [1 year]
Fidelity to the intervention protocol by observer at each group session recording the topics covered
- Maintenance [1 year]
Intervention sustainability based on continued engagement from the participants measured via healthcare utilization - The study will compare intervention participants and other patients in terms of the number of triage visits and the number of unscheduled provider add-on visits
Eligibility Criteria
Criteria
Inclusion Criteria:
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self describe race as Non-hispanic black
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history of prior singleton preterm delivery (before 37 weeks gestation
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current singleton gestation, with Individualized Prematurity Prevention (IP3) plan.
Exclusion Criteria:
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women with anomalous fetuses
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age below 18 years
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non-English speaking
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Duke University | Durham | North Carolina | United States | 27705 |
Sponsors and Collaborators
- Duke University
Investigators
- Principal Investigator: Sarahn Wheeler, MD, Duke University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- Pro00107668