A study at the University of Arkansas for Medical Sciences (UAMS) and Community Health Centers of Arkansas, Inc. (CHCA) has been approved for a $17.5 million funding award by the Patient-Centered Outcomes Research Institute (PCORI) to study and reduce prenatal inequities.
Arkansas is ranked worst for both maternal health outcomes and food insecurity among the 50 states and has the third highest infant mortality rate. Arkansas also has the second highest prevalence of overweight or obesity among women in the U.S., with about 65% of women in Arkansas being overweight or obese when they become pregnant. These women are at greater risk of excessive gestational weight gain and its associated complications.
The goal of the proposed study, “Delivering HOPE (Helping Women Optimize Prenatal Equity),” is to compare the effectiveness of two intervention methods, Delivering HOPE and Enhanced Standard of Care (ESoC), on these maternal health outcomes.
ESoC includes implementing a standard clinical practice of nutritional and gestational weight gain counseling for pregnant women, helping them sign up for WIC and SNAP benefits and providing referrals to additional safety net food organizations in their community. Delivering HOPE includes the same practices as ESoC, but also includes grocery delivery of healthy foods to participants’ homes. Grocery delivery is well-established and increasingly covered by insurance companies.
Pregnant women living in rural and low-income areas have worse maternal outcomes, due in part to more challenging social determinants of health, such as higher food insecurity and transportation barriers that constrain access to healthy food.
For this reason, UAMS is partnering with CHCA for the study. CHCA is Arkansas’ primary care association and community-based organization that includes 11 Federally Qualified Health Centers, which are federally funded nonprofit health centers or clinics that serve medically underserved areas and populations, with more than 150 clinical locations across Arkansas, 121 of which provide maternity care.
“Addressing the health and well-being of Arkansans is vitally important to our community health centers,” said Lanita S. White, Pharm.D., chief executive officer of CHCA. “We are focused on ensuring families are healthy. A key factor in making that a reality is ensuring mothers are healthy during and after pregnancy.”
“In order to address the disparities in maternal morbidity and mortality, we must address social determinants of health such as food insecurity,” said Pearl McElfish, Ph.D., division director of the UAMS Office of Community Health & Research and co-principal investigator of the study. “Results from this study have great potential to improve maternal health outcomes in Arkansas and throughout the U.S.”