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

PROJECT SUMMARY/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 advance maternal health equity. 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 reducing racial/ethnic inequities in maternal health. Dr. Garrett will be supported by an outstanding mentorship and advisory team with expertise in the

proposed training areas: maternal healthcare, implementation science, and health equity-promoting interventions. Co-Primary Mentors are: Dr. Dan 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 equity interventions. Co-Mentors will be Dr. Brittany Chambers, PhD, MPH (UC Davis), a preeminent scholar of antiracist birth equity 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 equity interventions and their implementation in large

institutions; Dr. Hector Rodriguez, PhD (UC Berkeley), an expert in health system effects on disparities in patient care quality and outcomes; and Dr. Patience Afulani, PhD, MD, MPH, 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 are well-positioned to advance birth equity, but there is inadequate evidence to guide them. Dr. Garrett proposes to use stakeholder guidance, implementation science, and antiracist frameworks to investigate California hospitals' health equity-promoting intervention efforts. Focusing on interventions intended to decrease

racial/ethnic inequities in maternal care quality and outcomes, she will: Aim 1) Characterize how a diverse set of California hospitals are working to reduce maternal health inequities; Aim 2) Identify drivers of equity-focused practice change in facilities participating in a collaborative program; and Aim 3) Generate actionable community-

led guidance for hospitals’ birth equity intervention work. This implementation-focused K01 will provide evidence- and community-based guidance for facilities’ selection and implementation of maternal health equity interventions. It will form the basis of an R01 to examine how health equity interventions affect patient outcomes

(clinical, experiential) in diverse hospital settings across the country.