Community-Based Maternal Support Services Program to Improve Perinatal Health and Equity in Rhode Island

What this Trial Is About

Researchers are studying perinatal health outcomes in Rhode Island, focusing on improving maternal and infant health by addressing social determinants of health SDOH such as food, housing, and transportation. The project aims to reduce adverse outcomes and racial disparities by integrating hospital services with community health workers, doulas, and community organizations. This effort is structured as a stepped wedge cluster randomized trial across six prenatal clinics over four years. The study involves implementing the Community-based Maternal Support Services COMSS program, which includes universal screening for risk factors at multiple prenatal and postpartum visits. Patients who screen positive receive coordinated care from care managers and community health workers, including doula care and referrals to address social needs. The intervention is introduced sequentially to all clinics, and data will be collected before and after the program to evaluate its impact. Participants will undergo screenings at their first prenatal visit, second and third trimesters, delivery, and 2-6 weeks postpartum. Those identified with risks will receive ongoing support and follow-up, with care continuing until at least three months postpartum before transitioning to primary care. Researchers will assess outcomes such as rates of severe maternal morbidity and mortality, cesarean births, prenatal care adequacy, postpartum depression screening, substance abstinence during pregnancy, infant death, and preterm birth.

Rhode Island Community-based Maternal Support Services