Digital Solutions to Reduce Maternal Morbidity and Mortality in Pregnant Refugee Women
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Nokia-Withings BPM Connect Blood Pressure Monitor, Smartwatch Devices.
- Who it may be relevant to
- Registry conditions: Gestational Hypertension. Basic parameters: from 18 years · Female.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Overview
The goal of this observational study is to use digital health tracking to improve how high blood pressure and other health issues are detected in pregnant refugee women. The main questions this study aims to answer are are: * Can a digital monitoring system that checks for high blood pressure in these women be tested and refined, using clinical training and validation? * Can this digital monitoring system accurately track any related pregnancy health issues and be used to refer participants to care providers? * Can this system be used to accurately identify risks associated with the contraction of pregnancy-related conditions, such as preeclampsia and high blood pressure? Participants will: * Complete baseline and follow-up in-person appointments; * Complete surveys at these appointment that track their health, stress levels, and comorbidities/risks associated with pregnancy; * Be given a smartwatch fitness tracker and electronic blood pressure cuffs for at-home measurements.
Detailed description
The objective of this application, funded by the National Academy of Medicine Catalyst Award, is to maximize the performance of a digital cardiovascular monitoring system to detect gestational hypertension in pregnant refugee women. The central hypothesis is that the application of these digital health technologies will be able to diagnose gestational hypertension in refugee mothers with 85% sensitivity as compared to the gold standard (clinical diagnosis). The rationale for this investigation is to improve the diagnosis of hypertension in refugee mothers, leading to targeted treatment.
This study's primary objective is to maximize the performance of digital health monitoring systems to detect gestational hypertension through system training and validation. The investigators aim to do this by utilizing technologies such as smartwatches and electronic blood pressure monitors to track health data throughout enrollment. Tracking this health data will also allow study investigators to track several other comorbid conditions in refugee mothers. This collection will take place over 24 months to train and validate this digital system. The performance of the prediction models will be assessed using two measures: Receiver Operating Characteristic (ROC) curve analysis, which evaluates the model's discrimination ability between disease states; and the Integrated Brier Score (cumulative mean squared error over time) will provide data on the model's predictive accuracy and reliability.
The secondary objectives of this study are to document comorbid illness and stress, assess the program's ability to make successful referrals, and connect the study population with healthcare providers for primary care visits. This will be completed by digital health tracking and the retention of contact with the participants throughout the duration of their enrollment.
Interventions
- Device Nokia-Withings BPM Connect Blood Pressure Monitor
At-home blood pressure (BP) measurements will be weekly via a blood pressure cuff (e.g., Nokia-Withings BPM (Beats per Minute) Connect), with measurements being manually entered into the study specific smartphone app. - Device Smartwatch Devices
Passive continuous collection of digital data (e.g., daily heart rate trends, activity levels, sleep measurements) for exploratory outcomes will occur via Apple Watches and Fitbit Versa 3s, which are synced to a smartphone application.
Primary outcome measures
- Digital Sensitivity for detecting gestational hypertension (HTN) [Time frame: 13 months [maximum duration of enrollment]]
Secondary outcome measures (12)
- Number of Participants that Complete All Surveys Between Appointments [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants That Complete All Surveys at the Baseline Appointment [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants Referred to Physicians/Care that do not have a designated provider [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants With No Comorbid Pain as Assessed by BPI-SF [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants With Mild Comorbid Pain as Assessed by BPI-SF [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants With Moderate Comorbid Pain as Assessed by BPI-SF [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants With Severe Comorbid Pain as Assessed by BPI-SF [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants with Low Comorbid Stress as Assessed by the PSS [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants with Moderate Comorbid Stress as Assessed by the PSS [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants with High Comorbid Stress as Assessed by the PSS [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants with Comorbid Stress as Assessed by the SOIS [Time frame: 13 months [maximum duration of enrollment]]
- Number of Participants Who Score Positive for PTSD Symptoms on the HTQ [Time frame: 13 months [maximum duration of enrollment]]
Eligibility criteria
Inclusion criteria
- Pregnant
- Refugee, asylum seeking, or asylee as designated by the U.S. Government
- Greater than or equal to 18 years of age
- Has a personal smartphone
Exclusion criteria
- Unable to provide informed consent
- Determined by the PI to be in an extremely vulnerable position and therefore not suited for research participation
- Planned move from the New York City (NYC) area within the next 24 months
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Observational model
- Cohort
Study locations
United States · 1 center
- Weill Cornell Medicine — New York
Identifiers
NCT: NCT06647511 · 24-01026913