Accountability for Care Through Undoing Racism & Equity for Moms

Summary

This project-also known as "Accountability for Care through Undoing Racism \& Equity for Moms" or ACURE4Moms-aims to reduce Black-White maternal health disparities using multi-level interventions designed to decrease bias in prenatal care, improve care coordination, and increase social support. ACURE4Moms is a pragmatic 4-arm cluster randomized controlled trial conducted with 39 prenatal practices across North Carolina. Practices have been randomly assigned to receive either: Arm 1 (Standard Care): North Carolina Medicaid Care management for high-risk pregnancies; Arm 2 (Data Accountability and Transparency): North Carolina Medicaid Care Management + Practice-level Data Accountability interventions; Arm 3 (Community-Based Doula Support): North Carolina Medicaid Care Management + Community-Based Doula support intervention for high-risk patients during pregnancy and postpartum; or Arm 4 (Data Accountability and Transparency + Community-Based Doula Support): North Carolina Medicaid Care Management + Both Arms 2 and 3 interventions. During each practice's 2-year intervention period, the practice will initiate prenatal care for \~750-1,500 patients (up to 60,000 patients total), whose outcomes the investigators will follow and compare between arms until all these patients have reached 1-year post-delivery.

Conditions

• Pregnancy Related
• Maternal Health
• Maternal Mortality
• Low Birthweight
• Racism
• Implicit Bias

Interventions

OTHER

Data Accountability and Transparency

Collaboration with Practice Facilitators; Maternal Early Warning System; Disparities Dashboard; Racial Equity Training

OTHER

Community-Based Doula (CBD) Support

Community-Based Doula support for high-risk patients; Racial Equity Training

Sponsors & Collaborators

• Patient-Centered Outcomes Research Institute

  collaborator OTHER

• UNC Health Foundation

  collaborator UNKNOWN

• The Duke Endowment

  collaborator OTHER

• University of North Carolina, Chapel Hill

  lead OTHER

Principal Investigators

• Jennifer H Tang, MD, MSCR · University of North Carolina, Chapel Hill

• Rachel P Urrutia, MD, MSCR · University of North Carolina, Chapel Hill

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

FACTORIAL

Eligibility

Min Age

12 Years

Max Age

99 Years

Sex

FEMALE

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2023-06-05

Primary Completion

2027-07-31

Completion

2027-08-31

Countries

• United States

Study Locations