In partnership with multiple community agencies across the Triangle, the UNC Center for Women’s Health Research has received funding—approximately $2.5 million per year for five years—from the National Institutes of Health Heart, Lung, and Blood Institute (NHLBI) to identify effective strategies for implementing pregnancy-related hypertension best practices in the outpatient setting.
In partnership with multiple community agencies across the Triangle, the UNC Center for Women’s Health Research has received funding—approximately $2.5 million per year for five years—from the National Institutes of Health Heart, Lung, and Blood Institute (NHLBI) to identify effective strategies for implementing pregnancy-related hypertension best practices in the outpatient setting.
Aiming to reduce maternal morbidity and mortality, the Advancing Community and Clinical Care for Childbirth-related Hypertension: Implementation, Engagement and Valuing Equity (ACHIEVE) study engages health care, public health, and other community-based agencies and individuals in adapting the existing Alliance for Innovation on Maternal Safety Severe Hypertension During Pregnancy and Postpartum Period Safety Bundle to the outpatient, community setting.
The United States ranks at the bottom among high-income countries in maternal mortality and morbidity. In North Carolina, Black birthing people are two times more likely to die or experience serious complications related to pregnancy, with hypertension and cardiovascular disease (CVD) being the leading drivers of these outcomes and disparities. Pregnancy-related hypertension and CVD increase the risk of high blood pressure and CVD over the lifetime. Early recognition and appropriate treatment can save a mother’s life and promote long-term health.
This grant builds on work of a multicomponent strategy in local clinics within the Piedmont Health Services network. In Phase II, ACHIEVE will test the strategy across 20 outpatient clinics in the Triangle area that provide prenatal and postpartum care. Community-based organizations will be funded to significantly expand guidance on adapting the “bundle” to various settings and developing information on the signs, symptoms, and treatment of hypertension in pregnancy and postpartum.
The leadership team includes Principal Investigator Kate Menard, MD, MPH, (UNC Obstetrics and Gynecology, Maternal-Fetal Medicine) and an interdisciplinary group of co-investigators with expertise in implementation science, maternal-fetal medicine, family medicine, nursing, health equity, maternal and child health, and community engagement/community-based participatory research. This group includes: Alexandra Lightfoot, EdD, of UNC Gillings School of Global Public Health; Jennifer Leeman DrPH, MPH, MDiV, of the UNC School of Nursing; Narges Farahi, MD, from UNC Family Medicine and Piedmont Health Services; Nicole Teal, MD, MPH, of UNC-Chapel Hill Maternal-Fetal Medicine; Kimberly Harper, MSN, RN, MHA, of UNC Collaborative for Maternal and Infant Health; Jen Medearis Costello, MS, MPH, a leader of a Chatham birth equity coalition, Equity for Moms and Babies Realized Across Chatham (EMBRACe), and an adjunct instructor at UNC Gillings School of Global Public Health; and Sarahn Wheeler, MD, from Duke University’s Division of Maternal Fetal Medicine.
“I consider it a great privilege to have the opportunity to work alongside this highly capable and committed team of academic and community partners in the development of such a meaningful project,” Menard said. “This is a remarkable opportunity to dig so deeply into what truly works in the outpatient setting, with a laser focus on community engagement, respectful care, equity. It is not enough to know what medicines work for treatment of pregnancy related hypertension. This study will help us to understand the best strategies to implement acceptable and sustainable lifesaving care plans. We cannot wait to get started.”