Creanga Andreea A, Kramer Briana, Wolfson Carrie, Mary Meighan, Stierman Elizabeth M, Clifford Sarah, Ezennia Ada, Rhule Jane, Martin Nina, Vance-Reed Maxine, Bruce Teneele, DiPietro Bonnie, Burgess Adriane, Warren Nicole, Lawson Shari N, Meyerholz Sarah, Bower Kelly
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Health Equity. 2024 Jun 27;8(1):406-418. doi: 10.1089/heq.2023.0127. eCollection 2024.
To describe two main pillars of the Maryland Maternal Health Innovation Program (MDMOM): (1) centering equity and (2) fostering broad stakeholder collaboration and trust.
We summarized MDMOM's key activities and used severe maternal morbidity (SMM) surveillance and program monitoring data to quantify MDMOM's work on the two pillars. We developed measures of hospital engagement with MDMOM (participation in quality improvement [QI] activities, participation in check-in meetings, staff involvement) and with other partners (participation in QI activities, representation in state-level groups). We examined Bonferroni-adjusted correlations between these hospital engagement measures and with key hospital characteristics: level of maternity care, annual delivery volume, and SMM rate.
Over 100 national and state organizations and individual stakeholders contributed to our building the MDMOM program and implementing key activities centering equity: hospital-based SMM surveillance in 20 of Maryland's 32 hospitals; almost 5,000 trainings offered to perinatal health care providers; two telemedicine/telehealth interventions; training of home visitors and community-based organization staff. Birthing hospitals represent MDMOM's main implementation partners. The strength of their participation in MDMOM QI activities is positively correlated to their participation in check-in meetings and with the degree of involvement by physicians in such activities. Higher engagement in MDMOM QI activities is also positively correlated to hospitals' participation in other state-level maternal health initiatives or groups.
Our experience with the MDMOM program demonstrates that an equity focus and broad stakeholder collaboration building strong relationships and providing implementation support can lead to high levels of engagement in innovative maternal health interventions.
描述马里兰州孕产妇健康创新项目(MDMOM)的两大主要支柱:(1)以公平为核心;(2)促进广泛的利益相关者合作与信任。
我们总结了MDMOM的关键活动,并使用严重孕产妇发病(SMM)监测和项目监测数据来量化MDMOM在这两大支柱方面的工作。我们制定了衡量医院参与MDMOM的指标(参与质量改进[QI]活动、参与签到会议、工作人员参与情况)以及与其他合作伙伴的指标(参与QI活动、在州级团体中的代表情况)。我们研究了这些医院参与指标与关键医院特征之间经邦费罗尼校正的相关性:孕产妇护理水平、年分娩量和SMM率。
100多个国家和州级组织以及个人利益相关者参与了我们构建MDMOM项目并开展以公平为核心的关键活动:在马里兰州32家医院中的20家进行基于医院的SMM监测;为围产期医疗保健提供者提供了近5000次培训;两项远程医疗/远程健康干预措施;对家访人员和社区组织工作人员进行培训。分娩医院是MDMOM的主要实施伙伴。它们参与MDMOM QI活动的力度与参与签到会议的情况以及医生参与此类活动的程度呈正相关。医院对MDMOM QI活动的更高参与度也与医院参与其他州级孕产妇健康倡议或团体的情况呈正相关。
我们在MDMOM项目中的经验表明,关注公平以及广泛的利益相关者合作,建立牢固的关系并提供实施支持,可以促使对创新性孕产妇健康干预措施的高度参与。