The University of North Carolina at Chapel Hill has designed a study called ACURE4Moms to improve pregnancy outcomes and decrease health disparities. “ACURE” stands for “Accountability for Care through Undoing Racism and Equity.”
ACURE4Moms is a randomized controlled trial that aims to improve maternal health outcomes, satisfaction, and communication, particularly for Black moms.
About
ACURE4Moms is led by a team of clinicians, Community-Based Doulas, and researchers from across NC, including team members from UNC School of Medicine, Mountain Area Health Education Center (MAHEC), North Carolina Area Health Education Centers (AHEC), N.C. Department of Information Technology, Momma’s Village Fayetteville, and MAAME, Inc.
This study is led by a stakeholder advisory board, which includes patients of color who have had a pregnancy complication, community doulas, practice representatives, health insurance payers, patient advocacy group MomsRising, the North Carolina OB-GYN Society, the North Carolina Chapter of the American College of Nurse-Midwives, and the North Carolina Department of Public Health.
ACURE4Moms Team
ACURE4Moms is led by a team of clinicians, Community-Based Doulas, and researchers from across NC, including team members from UNC School of Medicine, Mountain Area Health Education Center (MAHEC), North Carolina Area Health Education Centers (AHEC), N.C. Department of Information Technology, Momma’s Village Fayetteville, and MAAME, Inc.
This study is led by a stakeholder advisory board, which includes patients of color who have had a pregnancy complication, community doulas, practice representatives, health insurance payers, patient advocacy group MomsRising, the North Carolina OB-GYN Society, the North Carolina Chapter of the American College of Nurse-Midwives, and the North Carolina Department of Public Health.
For questions or concerns, please contact Acure4moms at Acure4moms@med.unc.edu.
Our study’s Co-Principal Investigators are Drs. Jennifer Tang and Rachel Urrutia of UNC’s Department of Obstetrics and Gynecology, whose work is focused on addressing inequities in maternal healthcare. They will be supported by several other UNC Co-Investigators who bring with them extensive knowledge, experiences, and resources toward the project, including Dr. Sam Cykert, Dr. Kate Menard, Dr. Wanda Nicholson, and Dr. Marcella Boynton. Members of UNC’s Collaborative for Maternal and Infant Health (CMIH) will also be greatly involved through the course of the study, including Co-Investigator Sarah Verbiest. We will be relying on individuals from UNC’s Sheps Center for all our data management, analysis, and IT needs.
Momma’s Village Fayetteville (MVF) is a nonprofit community organization based in Fayetteville, NC providing Doula care, lactation support, holistic maternal mental health support, culturally -focused birthing & parenting education, and support & advocacy work for Black and brown families. They are one of our doula partners for this study and will be leading the community-based doula training and oversight in Eastern NC. Their founder, Angela Malloy, is also a Co-Investigator for this study.
MAAME, Inc. located in Durham North Carolina empowers Black, Brown, Indigenous, and other Birthing People of color and those historically excluded to navigate systems during pregnancy and postpartum, mobilize to offer resources, education, services, and support for holistic maternal health, wellness, sustainable communities, and economic advancement. Their founder, Maya Jackson, is also a Co-Investigator for this study.
MAHEC serves North Carolina’s 16 western counties and is involved with training and retaining healthcare professionals, especially in rural areas. The MAHEC team, which include Amanda Brickhouse-Murphy and Dolly Byrd, have been leaders in offering a race-equity-centered approach to OB care and for this study are involved in the creation of our Maternal Health Equity Education Trainings for practice staff, a racial equity curriculum specific to our project. They will also help implement our project interventions at practices in the Western NC area, such as Charlotte.
NC AHEC is proud to be a collaborative partner in this important study aimed at advancing maternal health care in North Carolina. We recognize the challenges practices face in addressing factors that impact patient care and outcomes, and have positioned our Practice Support Facilitators to help. The Practice Facilitators are trained to work with OB/GYN practices to help them make meaningful changes to improve birth outcomes. One way they do this is to help practices use data dashboards to promote timely intervention when there are changes in a mother’s key health indicator, such as blood pressure, which is known to impact a baby’s birth weight. The Practice Facilitators can assist practices to identify and follow up on missed appointments and tests that are recommended for pregnant moms. Timely intervention, along with recognizing and addressing care gaps, can significantly help reduce the chances of delivering a low birth weight baby which in turn reduces chances of a baby dying or having ongoing developmental and chronic health problems.
The NC Health Information Exchange Authority was made by the state of North Carolina to facilitate the creation of a modernized health information exchange (HIE) to better serve NC’s health care providers and their patients. A health information exchange (HIE) is a secure, electronic network that gives authorized health care providers the ability to access and share health-related information across a statewide information highway. For our project, the NC HIEA will help create our data interventions, the Perinatal Equity Dashboard and the Maternal Warning System, and will be involved in collecting data for analysis.
Team members from the: NC HIEA.
The ACURE4Moms study will be directed and guided by the Stakeholder Advisory Accountability Board Leading with Equity (STABLE). This group will ensure community participation in the development and progress of the ACURE4Moms study and act as an accountability partner for the Research Team. They will provide oversight on study design and dissemination and will advise on the development of material and study proceedings.
STABLE will be Co-Chaired by a Research Stakeholder, Christina Yongue, and a Doula Stakeholder, Brittany Curry. STABLE includes patients of color who have experienced low birthweight (LBW) or severe maternal mortality (SMM), Community-Based Doulas, and representatives from the NC Division of Public Health, NC Women’s Health Branch, (WHB), NC Medicaid, NC Maternal Health Innovations (MHI) Provider Support Network, the Greensboro Health Disparities Collaborative (GHDC), OB practices, commercial payers (BCBS/Anthem, United, Wellcare), patient advocacy groups like MomsRising, and professional organizations, like the American College of Nurse-Midwives and the NC Obstetrical & Gynecological Society.
Team members from the: NC HIEA.
Meet the Doulas
There are many doula and community-based organizations joining this study. Two primary Doula group partners are MAAME, Inc. and Momma’s Village Fayetteville.
For this study, there will be an intervention will match community-based doulas who are trained to provide culturally relevant care with high-risk patients after their first prenatal appointment. Two community-based co-investigators – Maya Jackson, MAAME, Inc., and Angela Tatum Malloy, a certified doula and the founder and CEO of Momma’s Village Fayetteville – will help facilitate the training of doulas that will be needed for the expansive study and will provide support to the doulas working with clinics in their communities. The doulas will provide support to patients during pregnancy and up to one year after birth by setting up peer support groups for clients with similar due dates, attending two prenatal visits with them, supporting them for up to 24 hours during labor, and performing a postpartum home visit.
Momma’s Village Fayetteville is a Community-Based Doula group based out of Fayetteville, North Carolina.
You can learn more about our Eastern North Carolina Doulas, get to know each person, the sites they practice, and their partnership at MVF at mommasvillage.com.
Angela Tatum
Jasmine Johnson
Taylor Johnson
Somariya Jackson
Genesis Banks
Quay Roache
Eboni Allen
Eva Charles
Iriana Kay
Nicole Collins
Precious McKendall
Taya Partin
MAAME, Inc. is a Community-Based Doula group based out of Durham, North Carolina.
You can learn more about our Western North Carolina Doulas, get to know each person, the sites they practice, and their partnership at MAAME, Inc. at MAAMEInc.org/.
Maya Jackson
Brooke Rucker
Cassey Mapp-Ahmed
Denawa Alberti
Khalilah Moore
Nakia Clark
Qua Sharpe
Sha’irah Khyah
Shatrell Mack
Shayla Rhem
Tiara Morris
In the News
For the latest updates about the ACURE4Moms study and related work in North Carolina, please subscribe to our listserv by emailing ACURE4Moms@med.unc.edu.
ACURE4Moms in the News
- NC moms speak out on medical neglect in high-risk pregnancies https://www.publicnewsservice.org/2024-10-09/reproductive-health/nc-moms-speak-out-on-medical-neglect-in-high-risk-pregnancies/a92764-1#google_vignette
- A big congratulations to Momma’s Village Fayetteville on being featured in a recent news article, which includes Angela Malloy, Jasmine Johnson, Taylor Johnson, Regine Lesane, and Diara Fitzgerald: Inside Angela Tatum Malloy’s nonprofit Momma’s Village – CityView NC
- Dr. Jennifer Tang, MD UNC Professor of OB-GYN and Co-Principal Investigator of the ACURE4Moms study was featured in “The Skimm” focusing on When do you need to seek a second OB-GYN opinion? Read more here Would you use AI to parent? | theSkimm
- Families in Durham and surrounding areas were gearing up for a momentous occasion as MAAME, Inc. announces its first-ever Black Maternal Health Walk, Run, and Stroll event March 7th, 2024. Walk4MAAME – MAAME, Inc. (maameinc.org)
- Angela Tatum Malloy was celebrated at NC Woman of the Year, with an ACURE4Mom mention in her USA Today interview. Read more here. Angela also held interviews with Bronco Radio and a local podcast. See Momma’s Village Fayetteville Facebook for the latest sources.
- Dr. Rachel Urrutia in the Press this Month: Birth control methods that use one hormone raise breast cancer risk as much as those with a combo, study finds – Rachel Urrutia in ABC News – read here. And a 2nd article: Is It Possible To Get Pregnant While You Are In Perimenopause?, Rachel Urrutia in Glam: Read More here.
- CDC reports a slight decline in fetal mortality among Black women, Angela Malloy, Momma’s Village Fayetteville in ABC 11
- ‘We are not thought of’: The true impact of Western North Carolina’s maternal desert on rural women, Dr. Rachel Urrutia in Carolina Public News
- Critical Term: Why are Black mothers and babies dying, WRAL News
- Dr. Rachel Urrutia on why many pregnant women are seeking care at urgent and emergency departments, NC Health News
- Black Issues Forum | Black Women’s Maternal Choices and Health, Dr. Jen Tang in PBS
- UNC Researchers Embark on Statewide Effort to Reduce Racial Disparities, Improve Maternal Health Outcomes for Black Moms, North Carolina Health News
- Addressing Taboo Topics: Racial Inequities in Maternal Care, ChapelBoro News
- More Than Half of U.S. Women Have Poor Heart Health, Everyday Health
- UNC Researchers Awarded $10 Million from PCORI to Study, UNC Health and School of Medicine
- Sistas Caring 4 Sistas team was featured in Goldman Sachs “One Million Black Woman: Black Impact Grants.“
Study Updates
For clinic partners and ACURE4Moms teams, we have created monthly slideshow reports and monthly newsletters to highlight progress and share information related to our work. Check back regularly to review the latest information about our work.
Recent Newsletters & Slideshow Report
- Dec 2025 and Jan 2026
- Oct and Nov 2025
- Aug and Sep 2025
- June and July 2025
- April and May 2025
- Feb and March 2025
- Winter Edition 2025
- November 2024
- October 2024
- September 2024
- August 2024
- July 2024
- March 2023 & Black Maternal Health Week Happenings – Download PDF slides.
- February 2023 Updates – Download PDF slides.
- January 2023 Update – Download PDF slides.
- November 2022 Update – Download PDF slides.
- October 2022 Update – Download PDF slides.
- September 2022 Update – Download PDF slides.
Do you have something you’d like to share or feature among our ACURE4Moms network? Email ACURE4Moms@med.unc.edu with details and support promoting your work.
For questions or details, contact ACURE4Moms@med.unc.edu.
About the Study – Background
About the ACURE4Moms Study
Accountability for Care through Undoing Racism and Equity for Moms, or ACURE4Moms, is working to decrease pregnancy complications for all women, centering Black women, by addressing institutional racism and bias in healthcare and improving community-based social support during pregnancy. The study, which will involve 40 prenatal practices across North Carolina and a team of co-investigators, will attempt to do so using two types of interventions.
ACURE4Mom Primary Aims:
- Aim 1: Compare the proportion of Black women who deliver a low birthweight baby between Arms (Primary Outcome).
- Aim 2: Compare number of ED visits and hospitalizations during pregnancy and up to 1 year after delivery between Arms.
- Aim 3: Explore trends in self-reported racism during pregnancy and up to 4 months after delivery between Arms through patient surveys.
We will evaluate clinical interventions through a cluster randomized controlled trial of 40 practices throughout North Carolina. Ten practices each will be randomized to one of four arms:
- 1) Standard Care Management (Control Arm) – 10 practices
- 2) Data Interventions-Only (Data Arm) – 10 practices
- 3) Community-Based Doula Support-Only (Doula Arm) – 10 practices
- 4) Data Interventions + Doula Support (Data+Doula Arm) – 10 practices
You can find additional details about the technical support and study here.
Contact ACURE4Moms@med.unc.edu.
Background
“We are using methods from previous studies that have shown to improve outcomes, and applying them to maternal care,” Tang said. “By creating data accountability and electronic warning systems, the ACCURE trial for breast and lung cancer patients, performed in partnership between UNC and the Greensboro Health Disparities Collaborative, achieved better outcomes for all patients, and markedly reduced the disparity in outcomes between Black and white patients.”
Learn more about the ACCURE study.
Patient Surveys & Interviews
Join the Maternal Healthcare Experience Survey
The ACURE4Moms project is looking for volunteers to share their feedback on their recent healthcare experiences. You may be eligible to participate in our survey if you’re receiving pregnancy care at one of our participating clinics. If you agree to join:
- You will complete up to four surveys during and after your pregnancy.
- You will receive a $20 gift card for each completed survey.
- You may be contacted for a one-time interview at the end of your pregnancy.
- You will receive an additional $50 gift card if you complete the interview.
- Additional $20 gift card for completing surveys 1 and 2.
- Participants who complete all surveys available them will be entered into a drawing based on chance in which each participant has equal odds of receiving one of at least 25 additional $500 gift cards.
You can do all the surveys online, or over the phone with a study staff member. Each survey will take 10-20 minutes if done online, or about 45 minutes if done over the phone. The interview will take place over Zoom and will take about 30 minutes.
We know that patients who identify as Black experience discrimination during pregnancy care in North Carolina and the United States. Sadly, this means that Black patients are more likely to have bad outcomes during pregnancy, childbirth, or in the year after having their babies. ACURE4Moms was created to understand the experiences from patients like you. We hope that this project leads to improved outcomes for patients who identify as Black and others.
To be eligible to take part in the surveys and interview, you must be:
- Black or African American
- 15 years old or older
- Between 14 and 23 weeks of pregnancy
- English, Spanish, or French speaker
Additional qualifiers may apply, including accessibility to a phone or web-based platform. You must be receiving pregnancy care at one of our participating clinics.
A community-based member of the ACURE4Moms team working with your clinic will reach out to you to schedule a time to talk about the surveys and interviews. This team member will ask you some questions to see if you are eligible and will tell you more about the project. If you are eligible and you want to join, the team member will then ask for your consent to join.
You can choose whether you want to participate or not. Your choice is confidential and will not be shared beyond the ACURE4Moms team. Your choice will not change your care from the clinic.
ACURE4Moms’s goal is to sign up about 4,400 people across North Carolina in the survey and to interview about 100 people. Everyone’s survey and interview responses will be grouped together, and the study team will review the responses to see if the two ACURE4Moms programs had an impact on discrimination, medical care, and emotional experiences during and after pregnancy.
Like most research projects, ACURE4Moms will share its findings through conferences and publications. Your personal information will not be used in any report or presentation. Instead, your responses will be grouped with other responses.
If you’re interested in receiving updates about what we learn from the project, including the surveys and interview, please complete this form.
ACURE4Moms is a research study trying to reduce:
- low birthweight babies
- emergency department visits and hospitalizations for birthing persons and their babies
- depression among birthing people
- discrimination in pregnancy-related care
ACURE4Moms is trying out 2 programs designed by people who have given birth. These programs include:
- Sharing patient data and warning alerts with clinic staff to keep them accountable for their patients’ outcomes and providing tools to help them reduce bias in care.
- Matching eligible patients with doulas from the same community as the patients.
ACURE4Moms randomly chose prenatal clinics to receive one, both, or neither of these programs. After each clinic has tried these programs for 2 years, we will see how the programs worked.
