The Impact of Virtual Doula Services on Birth Outcomes in Rural Communities
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Virtual doula support, Ebook.
- Кому может быть актуально
- Состояния в реестре: Birth, Telehealth, Pregnancy, Maternal Health. Базовые параметры: 18 лет — 45 лет · Женщины.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- США
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Обзор
This study will assess the impact of virtual doula care on birth and postnatal outcomes among rural mothers. The goal of virtual doula services is to improve access to care in underserved communities and decrease urban-rural differences in key maternal health outcomes including mode of birth (cesarean vs vaginal) and birth satisfaction. By implementing a digital randomized controlled trial, the study team will efficiently recruit a national sample of rural pregnant women to provide evidence of the effectiveness of virtual doula care, the appropriateness of virtual visits for different care and support needs, and the role of virtual care in improving maternal health.
Подробное описание
Rates of maternal morbidity have been rising in the U.S., and there are stark rural-urban differences in cesarean births and adverse pregnancy outcomes. Increasing access to doula care is a promising strategy to improve maternal health. Doulas are non-clinical providers who offer physical, emotional, and informational support throughout the perinatal period. Yet, despite documented evidence of effectiveness, fewer than 10% of U.S. births involve doulas because of costs and workforce shortages. Virtual doula services may increase access to support in communities that lack doulas and decrease costs; however, there is minimal evidence of the effectiveness of this new care model. Lack of research in general, and randomized controlled trials in particular, represents a significant gap given that virtual doula services are currently offered by numerous organizations, and the states and payers adding doula benefits do not have evidence to inform their telehealth policies.
The study team will conduct an innovative digital, parallel design randomized controlled trial (RCT) to assess the impact of virtual doula services in rural communities. Primiparous, pregnant women who live in rural zip codes in the U.S. will be recruited. Recruitment will occur via online research panels. Participants will be randomized to scheduled visits with virtual doulas throughout the perinatal period or to usual care. Birth and postnatal outcomes will be captured via surveys and interviews. This study uses mixed methods and aims to assess the impact of virtual doula services on primary outcomes including type of birth (cesarean vs vaginal), birth satisfaction, and parental self-efficacy and secondary outcomes including maternal depression, breastfeeding initiation and duration, and receipt of prenatal and postnatal care. This study will also explore the acceptability of virtual care for different types of doula visits. Together, these aims will inform policy debates about regulation and reimbursement of doula services that incorporate virtual care.
Вмешательства
- Другое Virtual doula support
Participants randomized to the intervention arm will receive access to up to 4 scheduled doula visits through Pacify's mobile phone app. All visits will be virtual. Participants may also access the library of resources on the app and text with their doula on demand. - Другое Ebook
Participants will receive an ebook on parenting.
Первичные конечные точки
- Birth type [Срок оценки: Assessed at 3 weeks postpartum]
- Birth Satisfaction [Срок оценки: Assessed at 3 weeks postpartum]
- Parental Self-Efficacy [Срок оценки: Assessed at 12 weeks postpartum]
Вторичные конечные точки (5)
- Maternal Depression [Срок оценки: Assessed at 3 weeks postpartum]
- Breastfeeding duration [Срок оценки: Assessed at 12 weeks postpartum]
- Receipt of postnatal care [Срок оценки: Assessed at 12 weeks postpartum]
- Birth Truma [Срок оценки: Assessed at 3 weeks postpartum]
- Breastfeeding Initiation [Срок оценки: Assessed at 12 weeks postpartum]
Критерии участия
Критерии включения
- 18-45 years of age
- pregnant (second or early third trimester) with their first child
- reside in a rural zip codes in the U.S.
Критерии исключения
- non-singleton pregnancy
- police custody or incarceration
- infant to be separated from mother (e.g., placed for adoption, protective custody)
- working with a doula prior to enrollment.
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Тройное слепое
- Основная цель
- Профилактика
Центры проведения
США · 1 центр
- RAND — Arlington
Идентификаторы
NCT: NCT07293741 · 2R01NR018837-06 · 2R01NR018837-06