Maternal health interventions in California hospitals: Understanding approaches & implementation to advance health

ABSTRACT This is a Mentored Research Scientist Career Development Award (K01) award for Dr. Sarah B. Garrett, PhD, a medical sociologist and Assistant Professor at the University of California, San Francisco (UCSF). Dr. Garrett is establishing herself as an investigator of healthcare facilities’ efforts to improve their patients’ maternity care outcomes. This K01 will provide Dr. Garrett with the support necessary to become an expert in this field and to lay the foundation for an independent research career focused on improving maternal health in the US. Dr. Garrett will be supported by an outstanding mentorship and advisory team with expertise in the proposed training areas: maternal healthcare, implementation science, and hospital-focused interventions. Co-Primary Mentors are: Dr. Daniel Dohan (UCSF), expert in health policy, institution-focused qualitative research, and medical culture; and Dr. Melissa Simon, MD, MPH (Northwestern), an obstetrician and NIMHD-funded clinician-investigator who has deep expertise in the application of implementation science to the design, evaluation, and scaling of impactful maternal health interventions. Co-Mentors will be Dr. Brittany Chambers, PhD, MPH (UC Davis), a preeminent scholar of maternal health-promoting interventions and community-based methods; and Dr. Melissa Rosenstein, MD, MAS (UCSF), a national leader in conducting and researching maternal health quality improvement. Scientific Advisors are: Dr. Christine Dehlendorf, MD, MAS (UCSF), an NIMHD R01-funded expert in reproductive health interventions and their implementation in large institutions; Dr. Hector Rodriguez, PhD (UC Berkeley), an expert in health system effects on patient care quality and outcomes; and Dr. Patience Afulani, PhD, MD, MPH (UCSF), an expert in measuring and improving patient experience of maternity care. Under the team’s close guidance, Dr. Garrett will gain proposed skills and knowledge via coursework, mentored tutorials, and practical experience. Hospitals recognize the need to improve the quality of maternity care, but there is inadequate evidence to guide them on how best to do so. Dr. Garrett proposes to use stakeholder guidance, implementation science, and theory-driven frameworks to investigate California hospitals' efforts to improve maternity care. Focusing on interventions intended to promote high-quality maternity care, she will: Aim 1) Characterize how a selection of California hospitals are working to improve maternity care for patients who tend to experience poorer outcomes; Aim 2) Identify drivers of practice change in facilities participating in a collaborative program to improve maternity care outcomes; and Aim 3) Generate actionable patient-centered guidance for hospitals seeking to implement interventions to improve maternity care. This implementation-focused K01 will provide evidence-based guidance for implementing maternity care improvement interventions. It will form the basis of an R01 to examine how maternity care interventions affect patient outcomes in hospital settings across the country.