E5 - Positively impacting social determinants of health in maternal health through interprofessional collaboration and mhealth technology.

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Full Description: Long before the COVID-19 pandemic, there was a maternal health crisis happening in Iowa - and across the US; the pandemic is exacerbating what was already broken — birthing centers closing, less access to quality prenatal care in rural areas and Black moms losing their babies at twice the rate of white moms. Count the Kicks is an evidence-based public health campaign that teaches the method for and importance of tracking fetal movement in the third trimester of pregnancy. Count the Kicks helped lower Iowa’s stillbirth rate by nearly 32 percent in the first decade of its existence in our state. In the first five years of the campaign the stillbirth rate among African American women dropped nearly 39% (2008-2013). Unfortunately, Black women are still two times more likely to experience a stillbirth over white women and three times more likely to experience adverse maternal health outcomes such as death. Adverse Childhood Experiences (ACEs) are incidents that can create a toxic level of stress for a child. If we want to reduce ACEs and improve maternal health outcomes we need to start prenatally. By taking our evidence-based stillbirth prevention program and partnering with Iowa’s MIECHV program we were able to create a system to connect expectant women to local resources they need; whether that is parenting resources, food banks, mental health and more. Utilizing our evidence-based free kick counting tool we created a 4 question survey that is presented to Iowa app users after their 2nd kick session. These questions were developed with the assistance of experts in Adverse Childhood Experiences. The four questions are centered around asking if the app user feels they have parenting resources and assistance they need to be healthy and successful in their journey of parenthood. If the app user states NO to any question, they are encouraged to seek assistance and resources via the Iowa Family Support Network website (IFSN). IFSN is a state-run website that provides users access to key resources in their community; such as parenting groups, child care assistance, food banks and more. If we can connect expectant parents to services and resources before their baby arrives, we have a chance of lowering ACEs for that baby. The primary component of this project was ensuring home visitors across the state were aware of this feature and educated on the importance of how to teach about the importance of tracking fetal movement. Since the release of the survey on the app in November 2020 there have been 5,150 responses to the optional survey. Of those respondents a total of 18% answered no to at least one of the four questions, indicating they needed additional support, didn’t have healthy coping skills or didn’t know how to access support. This project and partnership allows us to better understand the needs of expectant parents in Iowa and helps us meet those needs to provide better birth outcomes and is now being replicated in additional states.

Abbreviated Description: Collaboration among a non-profit and MIECHV program in Iowa, home visitors are trained on the evidence-based stillbirth prevention campaign, Count the Kicks; educating home visitors on how to talk about stillbirth prevention with their clients and encouraging the use of best practice mHealth tools. The mHealth tool not only helps users see what’s normal in terms of their own baby’s movements but also can provide access to other resources the expectant mother is in search of. Training for home visitors includes health equity and inclusion as well as latest research in fetal movement monitoring and the benefits of it. Collaboration with a state-wide entity allows for more expectant parents to be reached with evidence-based resources. This pilot is now being replicated in other states.