496 - Acceptability, engagement, and clinical outcomes of pediatric-based navigation to address maternal needs after preterm birth

Publication Number: 4487.496

EMILY GREGORY, Children's Hospital of Philadelphia, PHILADELPHIA, PA, United States; Zia Huballah, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Hadassah s. Colbert, CHOP- Roberts, Philadelphia, PA, United States; Jasmeiry J. Bello, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Adya Maddox, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Rinad S.. Beidas, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Peter Cronholm, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Abbas F.. Jawad, UPenn/The Children's Hospital of Philadelphia, Philadelphia, PA, United States; Lisa Levine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Scott A. Lorch, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States; Ann L. O'Sullivan, Perelman School of Medicine at the University of Pennsylvania, Phila, PA, United States; Kenneth Resnicow, University of Minnesota school public health, St. Paul, MN, United States; Alexander G. Fiks, Childrens Hospital of Philadelphia, Philadelphia, PA, United States

Background: After a preterm birth (PTB), mother-infant dyads have increased health care needs yet experience gaps in health care access. Dyads are seen in pediatric care settings more often than in adult settings during the postpartum period.

Objective: Assess (1) acceptability and engagement and (2) clinical outcomes of a pediatric-based intervention to improve health care access and wellbeing after a PTB.

Design/Methods: We conducted a pilot randomized trial (NCT05756634) at an urban birthing hospital and 2 pediatric primary care practices. Participants were identified through labor and delivery inpatient census or newborn ambulatory visits and contacted either in-person or by phone. Inclusion criteria were: gestational age at birth < 37 weeks, maternal age 14 – 45 years, Medicaid insurance, English-language proficient, no history of sterilization procedure, and intending to seek infant primary care at the study practices. Participants were randomized 2:1 to intervention or usual care. Intervention participants were contacted by a doula-trained interventionist who offered support for 6-months, emphasizing health care navigation and using motivational interviewing to promote maternal self-care with a focus on maternal sleep and stress management. Participants reported sociodemographic data at baseline. Acceptability was assessed at 6 months using the Acceptability of Intervention Measure (AIM) for intervention participants and through participant engagement data. At baseline and 6-months participants completed the Perceived Stress Scale and the PROMIS Sleep Disturbances short form.

Results: We randomized 66 women from 7/2023 to 4/2025 (42 intervention, 24 standard of care). The intervention and study data collection continued through 10/2025. There were more participants that worked ≥ 20 hours weekly in the control group, otherwise there were no differences in socioeconomic characteristics between groups (Table 1). For intervention participants (Table 2), we made contact with 30 (73%), discussed sleep with 19 (46%), personal goals with 14 (34%), and care navigation with 13 (30%). 23 participants completed the AIM scale, scoring acceptability at 4.1 (out of 5). There were no differences between groups in change in stress or sleep scores between baseline and 6 months.

Conclusion(s): Intervention participants found the intervention acceptable, but low engagement meant that many did not receive all planned intervention components. One interventionist working at multiple sites for this small pilot may have limited our ability to take advantage of pediatric touchpoints.

Table 1: Characteristics of study population and key outcomes
pas_kpilot_20251031_table1.pdf

Table 2: Acceptability and engagement measures
pas_kpilot_20251031_table2.pdf