通过远程医疗改善产妇产后护理的可及性（IMPACT）：一项产后干预措施的多中心随机对照试验，以改善可及性和结果。

IF 2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Contemporary clinical trials Pub Date : 2025-03-14 DOI:10.1016/j.cct.2025.107882

Ran Zhang , Sheree L. Boulet , David B. Nelson , Peggy Goedken , Jacqueline Catchings , Donald McIntire , Marissa Platner , Robert B. Martin , Catherine Y. Spong , Elaine L. Duryea

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引用次数: 0

摘要

背景：产后护理对孕产妇健康至关重要，并对长期健康结果产生重大影响，但仍未得到充分解决，特别是在非西班牙裔黑人和西班牙裔人群中。通过远程医疗改善产妇产后护理可及性（IMPACT）研究的主要目的是比较两种产后护理模式在医疗服务不足个体的产后早期并发症检测、再入院预防、产后健康知识、生活质量和慢性疾病管理方面的有效性。方法：IMPACT研究是一项多中心、随机对照试验，在德克萨斯州达拉斯的帕克兰医院和佐治亚州亚特兰大的格雷迪纪念医院进行。它旨在比较3500名社会经济地位较低的非西班牙裔黑人和西班牙裔产后个体的两种产后护理模式（强化教育与增强虚拟护理）。第一阶段（1年）包括收集基线数据并根据患者反馈完善研究。第二阶段（第2-4年）继续招募参与者，并将他们随机分配到每个模型中。数据收集为期一年的随访期（入组后1 周、6 周、3 个月、6 个月和1 年），包括孕产妇健康结果、心理健康评估、实验室测试和患者报告的措施。结论：IMPACT研究提供了一种创新的产后护理方法，利用远程医疗提高服务不足人群的可及性和教育程度。该研究结果将对医疗保健提供者和政策制定者产生重大影响，为优化产后护理提供循证指导，并为有助于减少孕产妇健康差距的临床指南提供信息。

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Improving maternal postpartum access to care through telemedicine (IMPACT): A multi-center randomized controlled trial of postpartum interventions to improve access and outcomes

Background

Postpartum care is essential for maternal health and significantly impacts long-term health outcomes, yet it remains inadequately addressed, particularly among Non-Hispanic Black and Hispanic individuals. The primary objective of the Improving Maternal Postpartum Access to Care through Telemedicine (IMPACT) study is to compare the effectiveness of two postpartum care models on early postpartum complication detection, hospital readmission prevention, postpartum health knowledge, quality of life, and chronic medical condition management among medically underserved individuals.

Method

The IMPACT study is a multi-center, randomized controlled trial conducted at Parkland Hospital in Dallas, Texas, and Grady Memorial Hospital in Atlanta, Georgia. It aims to compare two postpartum care models (intensive education vs. enhanced virtual care) among 3500 Non-Hispanic Black and Hispanic postpartum individuals of lower socioeconomic status. Phase I (year 1) involves collecting baseline data and refining the study based on patient feedback. Phase II (year 2–4) continues recruiting participants and assigns them to each model randomly. Data collection spans a one-year follow-up period (1 week, 6 weeks, 3 months, 6 months, and 1 year after enrollment), including maternal health outcomes, mental health assessments, laboratory tests, and patient-reported measures.

Conclusion

The IMPACT study provides an innovative approach to postpartum care, utilizing telemedicine to enhance access and education for underserved populations. The study findings will have significant implications for healthcare providers and policymakers, offering evidence-based guidance for optimizing postpartum care delivery and informing clinical guidelines that can help reduce maternal health disparities.

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来源期刊

Contemporary clinical trials 医学-药学

CiteScore

3.70

自引率

4.50%

发文量

281

审稿时长

44 days

期刊介绍： Contemporary Clinical Trials is an international peer reviewed journal that publishes manuscripts pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from disciplines including medicine, biostatistics, epidemiology, computer science, management science, behavioural science, pharmaceutical science, and bioethics. Full-length papers and short communications not exceeding 1,500 words, as well as systemic reviews of clinical trials and methodologies will be published. Perspectives/commentaries on current issues and the impact of clinical trials on the practice of medicine and health policy are also welcome.