Expanding the Family Check-up in Early Childhood to Promote Cardiovascular Health of Mothers and Young Children

April 2022 - April 2027

National Institutes of Health

With the University of Pittsburgh and UPMC Magee-Womens Research Institute, Healthy Start is seeking to improve the cardiovascular health (CVH) of mothers and their children by adding a targeted follow-up CVH promotion intervention to the Family Check-Up model (FCU), creating FCU-Heart. This multi-site, parallel randomized clinical trial will investigate the effect of enhanced CVH education and support within an established, credentialed program focusing on the postpartum years on the CVH of mothers and infants, with the aim of reducing racial disparities in cardiovascular risk factors.

Healthy Start’s role in this project involves co-developing the study design and protocols, employing and managing the community health workers who are providing the study intervention, and overseeing the development and delivery of a community health worker intervention to promote cardiovascular health utilizing the Family Check Up Model.

Wilkinsburg Community-Based Doula Pilot Study

March 2023 - February 2024

Allegheny Health Network; (This project is part of the Pittsburgh Study funded by the Children's Hospital of Pittsburgh Foundation, Grable Foundation, Shear Family Foundation, PNC, Heinz Endowments, and the Department of Pediatrics, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh).

With our partners, The Healthy Pregnancy Collaborative (part of The Pittsburgh Study) and the University of Pittsburgh, we are piloting an innovative community-based doula program in Wilkinsburg to decrease poor birth outcomes for Black birthing people. This co-designed community doula pilot study in Wilkinsburg, Pennsylvania will evaluate the degree to which an equity-centered community-based doula model contributes to perceived respectful care, patient autonomy, and improved birth outcomes.

Healthy Start’s role in this project includes co-developing study design and protocols, managing community outreach and engagement—including needs assessment activities—and employing and managing the doulas who are providing the study intervention.

Eliminating racial disparities in severe maternal morbidity by addressing hypertension in the year after delivery

July 2022 - June 2027

National Institutes of Health

Alongside our partners, Magee-Womens Research Institute and Foundation and the University of Pittsburgh, we are exploring evidence-based approaches to improve the blood pressure profile among Black women after diagnosis with hypertensive disorders of pregnancy (HDP) and to eliminate racial disparities in hypertension, maternal morbidity, and cardiovascular disease. This single site, parallel randomized control trial investigates the impact of one-on-one postpartum doula services and doula- and CBT clinician-moderated peer support groups, along with home blood pressure and weight monitoring, on reducing racial disparities in severe maternal morbidity.

Healthy Start’s role in this project includes the co-development of study design and protocols and the employment and management of the doulas who are providing the study intervention.

The Effects of Medicaid Policy Interventions on Racial Equity in Severe Maternal Morbidity

January 2023 - December 2027

National Institute of Nursing Research

We have partnered with the University of Pittsburgh, the Medicaid Research Center, the Pennsylvania Doula Commission, and the Maternity Care Coalition to conduct a study to assess the effects of three Medicaid policy interventions (the equity incentive payment program, the equity-focused obstetric care bundled payment model and the reimbursement program for doula services) on severe maternal morbidity outcomes among Black populations.

Healthy Start’s role in this project is to provide community voice on Medicaid policies and the way they impact community, as well as to provide context regarding ongoing work to advance health equity and improve health outcomes among Black populations.

Implementing and Evaluating Structural Interventions in Medicaid to Promote Racial Equity in Pregnancy and Child Health

September 2021 - August 2023

Robert Wood Johnson Foundation

The University of Pittsburgh, the Medicaid Research Center, the Pennsylvania Doula Commission, and the Maternity Care Coalition have partnered with Healthy Start to evaluate structural policies in Medicaid designed to address racial equity by improving maternal and child health outcomes among Black populations and expansion of doula coverage in Pennsylvania.

Healthy Start’s role in this project is to provide input as a community-based organization into the development of the study, to train and connect community members as direct contributors to the research rather than just study participants, to serve as advisory to the project, and to provide and support trained community health advocates to serve as citizen-scientists.

Fathers Matter: Exploring Paternal experiences of adverse pregnancy and the loss of Black mothers

December 2022 - December 2023

National Institute on Minority Health and Health Disparities, Richard King Mellon Foundation, The University of Pittsburgh

Healthy start has partnered with the University of Pittsburgh to explore paternal lived experiences, investigate the effect of previously unexplored paternal characteristics on persistent adverse pregnancy outcomes, and examine the role of fathers’ engagement in reproductive health and pregnancy to reduce adverse pregnancy outcomes. As part of this project, we will identify agencies that offer services for fathers to make resources more visible to interested fathers, and we will hold focus groups to capture the experiences of Black fathers whose partners are having or have had a difficult pregnancy.

Healthy Start’s role in this project is to serve as the primary community partner and leader, to assist with convening a network of father serving organizations in Pittsburgh and nationally, to provide feedback on proposed measurement for qualitative and quantitative research aims, to contribute to intervention design and development, and to continue partnership in the dissemination of research findings in scientific and community audiences.

Postpartum Mothers Mobile Study (PMOMS); Postpartum Weight Retention and Cardiometabolic Disparities: The Effects of Contextual, Psychosocial, and Behavioral Factors

September 2021 - June 2023

National Heart, Lung, and Blood Institute

Healthy Start has partnered with the University of Pittsburgh, the Western Pennsylvania Regional Data Center, UrbanKind, and Brown Mamas to use smart technology to understand factors associated with racial disparities in weight change and health during and after pregnancy. In addition to many other health-related factors, the Postpartum Mothers Mobile Study (PMOMS) surveyed participants on their experiences of stress and discrimination before, during, and after pregnancy. Over 300 participants enrolled in PMOMS, giving birth between January 2018 and July 2020.

Within this project, Healthy Start serves as advisory and supports the integration of community voice through storytelling and through planning and support of the PMOMS immersion experience. Additionally, Healthy start is responsible for assisting with the development of a dissemination plan for research including engaging partners and organizing and executing public forums.

Doula Care for At-Risk Women

January 2021 - June 2023

Richard King Mellon Foundation

As part of Phase II of the Infant Mortality Project, this research project focused on the creation of a protocol for providing doula support for women in need. Doula care was provided for over fifty women and data on the impact of doula care was collected and analyzed with the goal of building evidence that supports the inclusion of doula services as an accepted standard of care for all women at risk.

Healthy Start provided doula support for over fifty women during the antepartum, intrapartum, and postpartum periods, promoting adaptive change in behavior that impacts the outcomes of pregnancies and helping women and men build supportive relationships with family members and friends, while linking family members with other health and human services. Healthy Start also contributed to the process and outcomes evaluation for the doula services and the systems coordination.