$1.47 million grant awarded to TTUHSC for maternal health research

Based on a study recently published by the Journal of the American Medical Association, maternal morbidity and mortality rates in Texas through the last twenty years have greater than doubled from 1999 (10.3 deaths per 100,000 births) to 2019 (21.9 deaths per 100,000 births). This rate not only exceeds the national average (17.4 in 2018), however it also places Texas at or near the underside of most metrics used to find out the safest states by which to have a baby.

One among the first aspects related to the dearth of maternity care within the Lone Star state is the existence of maternity care deserts, that are counties where no maternity care exists. And within the Texas Panhandle, maternity care deserts are more common than in other regions of the state.

Preeclampsia, a condition marked by hypertension, protein within the urine and inflammation, is a serious reason behind maternal mortality. The incidence of preeclampsia, which develops most frequently after the twentieth week of pregnancy, has increased by 37% in Texas since 2017. The disease causes immediate health concerns (e.g., delivery complications, cesarean and preterm births), and it can also increase the chance of future heart problems in each the mother and child.

To assist reduce preeclampsia rates in several Texas Panhandle counties, the National Heart, Lung and Blood Institute (NHLBI) on the National Institutes of Health (NIH) recently awarded a two-year, $1.47 million grant to a brand new local research coalition led by Christine Garner, Ph.D., R.D., assistant vp for research and an assistant professor for the Department of Pediatrics, Department of Obstetrics and Gynecology and the InfantRisk Center on the Texas Tech University Health Sciences Center (TTUHSC) School of Medicine in Amarillo; Julie St. John, Dr.P.H., an associate professor for the TTUHSC Julia Jones Matthews School of Population and Public Health in Abilene; and Stephanie Stroever, Ph.D., MPH, director of the Division of Biostatistics on the TTUHSC Clinical Research Institute.

Unlike the more typical NIH grants reminiscent of the R01 for general research projects and the R21 for exploratory and developmental research, Garner said this latest TTUHSC award is an OTA, or Other Transactions Authority award. This OTA is run through the NIH’s Implementing a Maternal health Pregnancy Outcomes Vision for Everyone initiative Community Implementation Program (IMPROVE-CIP). Key community partners within the project include Casie Stoughton, MPH, R.N., from the City of Amarillo Department of Public Health; Liz Rascon, Ed.D., from the Amarillo Wesley Community Center and greater than 20 other community partners and organizations.

Brian Weis, M.D., Ph.D., interim regional dean for the TTUHSC School of Medicine in Amarillo, said Garner and her research team are addressing a problem of important importance to the health of the community.

The rise in maternal morbidity and mortality rates in our state is just unacceptable, and initiatives reminiscent of this from Dr. Garner and her colleagues are crucial to reversing this trend. The receipt of such a large grant from the NIH is a testament to the standard research planned by Dr. Garner and her TTUHSC and community collaborators.”

Brian Weis, M.D., Ph.D., interim regional dean, TTUHSC School of Medicine

Garner and her team will use its OTA award to finish the primary phase of a project titled, “Verifying and Implementing Evidence-Based Programs Addressing Needed Transformations for Maternal Health Outcomes, Measures and Support,” or VIBRANT MOMS. Garner said any such grant is more interactive than a typical NIH grant.

“We’re actually working with an external group called Westat to conduct the project, so the entire CIP projects for this particular grant are going through that group, however the NHLBI continues to be very much involved.”

Garner said Westat received a big award from NHLBI to administer the grant Garner received, along with similar grants awarded to 2 other teams. Meaning Westat will act as an intermediary between the NHLBI-NIH and the three teams that received the award, who will meet frequently to share knowledge and exchange ideas. That is a special method by which the NIH is providing funds, particularly for the forms of grants reminiscent of Garner’s which are community-oriented and community-based.

“That is an implementation science project,” Garner explained. “The goal of implementation science is taking evidence-based interventions, or things that we already know that work, and getting those interventions to the individuals who need them. We all know there are quite a lot of individuals who aren’t accessing care or getting the services or interventions they need, so the goal of implementation science is to develop strategies to attach the population with those interventions.”

Health issues reminiscent of obesity, hypertension and diabetes, and socioeconomic circumstances reminiscent of poverty and the dearth of medical insurance are prevalent within the Texas Panhandle and increase the chance and severity of preeclampsia. With that in mind, the VIBRANT MOMS project will seek to handle the numerous maternal health disparities that exist in six Panhandle counties: Deaf Smith, Gray, Parmer, Potter, Randall and Swisher. It should be managed by the newly formed Panhandle Maternal Health Disparities Research Coalition, which incorporates Garner’s team, Amarillo Public Health, the Wesley Community Center and others.

Through the two-year Phase I strategy planning stage covered by the grant, Garner said the Panhandle Maternal Health Disparities Research Coalition will use a mixed methods, community-based participatory research approach to develop implementation strategies for evidence-based interventions within the designated counties.

Preeclampsia might be prevented amongst those in danger by taking low-dose (81 milligram) baby aspirin after 12 weeks of pregnancy. For many who have hypertension while pregnant, additional medicines to regulate blood pressure are essential for reducing risk. To assist secure these resources and ensure they reach the suitable patients, Garner said the primary two years (Phase I) of the VIBRANT MOMS project will focus upon collecting data to raised assess health needs from the six counties covered by the grant.

“The important thing piece is that we’ve formed a community coalition of people who find themselves interested and motivated and need to make a difference for mothers,” Garner said. “It’s a wide range of people from nonprofit sectors, the health care field and community members who have an interest volunteers. All of those people and groups bring different sets of information and experiences that we will mix to discover strategies that can work best and be feasible and sustainable in those communities. That is the large picture for Phase I. Phase II, which we hope to have funded following the completion of this grant, is once we’ll take the Phase I strategies that we have developed and implement them by connecting mothers with the services and care they need.”

This research was, partly, funded by the National Institutes of Health (NIH) Agreement OT2HL158287. The views and conclusions contained on this document are those of the authors and mustn’t be interpreted as representing the official policies, either expressed or implied, of the NIH.