Maternal Health (Multilevel Intervention for Racial Equity)
MIRACLE Project
In the U.S., African American women are three to four times more likely to die of pregnancy related complications than non-Hispanic white women and have twice the rates of severe maternal morbidity (“unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health”).
The Maternal Health MIRACLE Project is led by Drs. Jennifer Johnson and Cristian Meghea and is funded by a 5-year grant from the National Institute of Minority Health and Health Disparities. The project partners with community organizations and health systems in Genesee and Kent Counties in Michigan to address maternal health inequities at three levels.
System level. Health systems serving African American women are less likely to offer high-quality care. Quality initiatives that to do not directly target disparities often have little or no effect on disparities. We will work with health and enhanced prenatal care systems in both counties to implement newly developed community-based, disparities-focused maternal care quality guidelines.
Provider/practice level. At the provider/practice level, implicit and explicit biases and the structures and practices reflecting them contribute to inadequate quality of care for African American women, reduce the acceptability of treatment, and contribute to racial disparities in maternal morbidity and mortality. Our provider-level intervention will provide everyone from front desk staff to providers with maternal health-focused anti-racism training, including windshield tours and discussion/problem-solving about how to better meet the needs of perinatal African-American women.
Community level. The built environment and working multiple jobs while managing family obligations can make it difficult for African American women to access even enhanced prenatal and postnatal care programs designed for them (such as Michigan’s Maternal-Infant Health Program and Healthy Start). Our community-level intervention will expand access to and acceptability of enhanced prenatal and postnatal care services for African American women.
Interventions at each level are evidence-based and were developed or co-developed by our partners in these counties, who include African American women residents and community leaders, Community Based Organization Partners (CBOP), Genesee and Kent County Maternal Infant Health Programs and Healthy Start Programs, Genesee County Health Department, Spectrum Health, and physician/health system representatives in both counties (represented by the Genesee County Medical Society, Genesee County Board of Health, the Medical Officer for the City of Flint, and an OBGYN leader in Kent County).
Principal Investigators:
Jennifer E. Johnson, Ph.D., C.S. Mott Endowed Professor of Public Health, College of Human Medicine, Michigan State University, 200 East 1st Street, Room 366, Flint, MI 48502; 810-600-5669; jjohns@msu.edu
Cris Meghea, Ph.D., Associate Professor, Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, 965 Fee Rd, Room A627, East Fee Hall, East Lansing, MI 48824; 248-716-1043; meghea@msu.edu
Project coordinator:
Jennifer Raffo; overfiel@msu.edu