Addressing the Impacts of Health Care System, Health Policy, and Clinician Factors on Disparities in Maternal Mortality and Morbidity

Council Date: September 1, 2023

Objective

This initiative will solicit research to examine and address understudied factors pertaining to the health care system, health policy, and the clinical setting and their impact on disparities in maternal mortality and morbidity.

Download the full concept paper

Description of Initiative

This initiative aims to solicit R01 grant applications that would bridge the knowledge gap about understudied factors pertaining to health care systems and clinical settings during the full spectrum of perinatal care. Such factors include:

• Addressing clinicians’ implicit bias
• Diversifying the health care workforce
• Developing collaborative partnerships between hospital-based providers and community-based service providers
• Addressing care coordination and continuity of care
• Evaluating safety bundles

The proposed studies can include:

• Clinical trials
• Quasi-experimental studies
• Observational studies (primary/secondary data)
• Mixed-methods studies

The research projects proposed should examine the mechanisms/pathways through which these health care factors contribute to MMM disparities and/or interventions to address these disparities.

Potential Research Areas of Focus:

• Evaluation of strategies to improve the quality of perinatal health care for racial and ethnic minority women, including emerging innovative strategies, such as but not limited to evidence-based health care safety bundles, health improvement collaboratives, and innovative primary care models
• Investigation of the mechanisms through which health insurance coverage expansions impact racial and ethnic disparities in MMM, including private insurance coverage
• Investigation of care coordination challenges or breakdowns in the diagnostic or care pathways between primary care and specialists and during the transition from the pregnancy to post-partum periods, and impacts on access and quality of care
• Examination of clinician-level factors, such as implicit bias, patient–clinician communication, racial concordance between the clinician and patient, and strategies to improve cultural competence in relation to disparities in MMM
• Investigation of the contribution of differential access to and quality of obstetric and perinatal care (e.g., telehealth and workforce shortages) to rural and urban disparities in MMM, especially in terms of the interactions between race/ethnicity and rural/urban residential status

Page published April 10, 2024