ACURE4Moms

Join ACURE4Moms Study to improve health care for birthing people and babies! If your practice provides prenatal care in NC, it may be eligible to participate in the newly-funded ACURE4Moms Study, led by a team of clinicians, community-based doulas, and researchers across the state. 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.

Click for FAQs and how to submit an application.

View an ACURE4Moms Overview Slideshow.

What is involved in the study? The study aims to reduce Black-White disparities in perinatal outcomes, including low birth weight, through practice-based interventions.

There are 4 different “arms” of this study – ranging from:

1. Standard Care management
2. Practice-Based Data interventions
3. Community-Based Doula support for high-risk patient
4. A Combination of both the Data interventions and Doula support

What support will I receive? Depending on which study arm the practice is randomized to, the practice may receive: 1) Free community-based doula support for up to 6 high-risk deliveries per month, 2) Free IT support to set up a Maternal Warning System and race-stratified Disparities Dashboard, 3) Free quarterly racial equity trainings focused on maternal health. All practices will receive free QI Practice Facilitation from the NC AHEC program and reimbursement for extraction of their electronic health record data. The participating practices will be supported for 2 years, with the earliest start date of December 2022.

How do I learn more or get involved? If your practice is interested in applying, please complete a brief online application. The paper and Word applications can be emailed to ACURE4Moms@med.unc.edu. 

Email us with any questions – Dr. Jennifer Tang at jennifer_tang@med.unc.edu.

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 Sistas Caring 4 Sistas.

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.

Team Bio & About Page coming soon.

NEWS & PRESS

• Black Issues Forum | Black Women’s Maternal Choices and Health, 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.“

There are many doula and community-based organizations joining this study. This section will include a list of organizations, doulas, and resources for health care teams in NC.

For this study, a second type of 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 – Cindy McMillan, a certified doula and the executive director of Sistas Caring 4 Sistas Asheville, 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.

About Our Doulas page coming soon!

For clinic partners and ACURE4Moms teams, we have created monthly slideshow reports to highlight progress and share information related to our work. Check back regularly to review the latest information about our work.

• July 2022 Update – Download PDF slides.

Do you have something you’d like to share or feature among our ACURE4Moms network? Email SuzanneW@med.unc.edu with details and support promoting your work.

For questions or details, contact ACURE4Moms@med.unc.edu.

About the ACURE4Moms Study

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);

2) Standard care management + Practice-based data interventions (Data Arm);

3) Standard care management + Community-Based Doula (CBD) support (Doula Arm); and

4) Standard care management + Practice-based data interventions + CBD support (Data+Doula Arm).

The participating practices will be supported for 2 years, with the earliest start date of December 2022. The 10 Control Arm practices will be supported until July 2026, as they will be given the option to implement either or both of the interventions with support from the study from July 2025 to July 2026. 

The primary outcome will be to decrease low birthweight deliveries among Black women, and a secondary outcome will be to decrease experiences with discrimination during prenatal care among Black patients. To test how each of these interventions improves low birthweight alone and when combined together, the team will randomize 40 prenatal practices across North Carolina, into one of four groups: (a) no interventions; (b) data accountability intervention; (c) doula intervention; or (d) both the data accountability and doula interventions. The team predicts that about 30,000 patients will start prenatal care at one of the 40 practices during the study. For the patient survey, the team plans to enroll 100 Black patients from each of the 40 practices, for a total of 4,000 patients. The team will also interview up to 463 practice staff, doulas, patients, and practice facilitators to understand how well the study interventions fit their needs.

For details, 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.

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Do you have something you’d like to share or feature among our ACURE4Moms network? Email SuzanneW@med.unc.edu with details.

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