RCMI Pilot Project
January 1, 2020 – December 31, 2020
PI: Tyra T. Gross, Ph.D.
Title: Black Maternal Health Assessment in Louisiana: A mixed-methods study of LaPRAMS data to identify the current health status of mothers
Abstract
Over the past decade, maternal mortality in the United States has increased as well as maternal morbidity (gestational diabetes, pre-eclampsia, postpartum depression). National reports from the Centers for Disease Control & Prevention (CDC) indicate that Southern states have poorer maternal health outcomes compared to other regions. In addition, there are racial/ethnic health disparities with Black (African-American) women experiencing a greater burden of risk factors for both poor maternal and infant health outcomes. Using a health equity lens, the objective of this application is to explore the maternal health status of Black women in Louisiana. We seek to answer these research questions: 1) What are the rates of chronic conditions in Black women during preconception, pregnancy and postpartum? 2) What are Black women’s experiences with healthcare across these time periods? 3) How do these conditions and healthcare differences differ between subgroups of Black women by sociodemographic factors? The objective of this application will be accomplished by addressing the following specific aims: Aim 1: To estimate the prevalence estimates of certain maternal chronic conditions and healthcare experiences in Black women in Louisiana using Pregnancy Risk Assessment Monitoring System (PRAMS) data; Aim 1a: To estimate the prevalence of chronic conditions (diabetes, hypertension, obesity, and depression), healthcare experiences (preconception care, prenatal care, and postpartum care), and health behaviors (tobacco use, alcohol use, and breastfeeding) in the total sample of Black women as well as by stratifying by age and education; Aim 1b: To estimate how socioeconomic and behavioral risk factors and healthcare experiences contribute to maternal chronic conditions from preconception to postpartum periods among Black women in Louisiana using regression models stratified by age and education; and Aim 2: To understand maternal health experiences of Black women in Louisiana using PRAMS qualitative data. This study is innovative because it is a secondary data analysis of Louisiana data on maternal health and utilizes both quantitative and qualitative PRAMS data to include participant’s voices on their lived experiences and looks at racial differences within Black maternal health by factors such as age, income, education and marital status. This study is significant because it will highlight the specific disparities of Black maternal health within Louisiana and serve as preliminary data for conducting a community-based needs assessment with the target population. It can also serve as a framework for other states to explore Black maternal health in their region and possibly for a multi-state or national level analysis using existing PRAMS data. This study approach will be a mixed methods secondary data analysis. Quantitative and qualitative data from the Louisiana PRAMS will be used, including data from Phase 8 from 2016-2018. Of the total participants over the three-year period, data will include only the Black participants (n=1361) in the proposed study. The long-term goal is to develop a community-based, culturally tailored program or initiative to improve maternal health outcomes in this population.