The Patient Centered Postpartum Contraception ToolKit PC

Project Abstract Short interpregnancy intervals IPIs pose risks for mothers and newborns alike including preterm birth low birth weight small for gestational age and placental abruption IPIs of less than months increase risk of neonatal death Short IPIs are a source of major health disparities and disproportionately affect African American adolescents Postpartum contraception significantly and perhaps uniquely lengthens IPIs Increasingly policy barriers have been removed to make highly effective methods such as the intrauterine device and implants available Yet tremendous caution is needed given a history of contraceptive coercion the concern is not to underuse or overuse these methods In the Institute of Medicine IOM published Crossing the Quality Chasm highlighting the potential for a patient centered care model to improve quality of care Within this model care is respectful and responsive to individual patient preferences needs and values Patients are actively engaged in making decisions about their health care and continuously informed and educated on all the care options Patient centered care has been demonstrated to improve health care utilization decrease costs and improve outcomes for a wide range of clinical outcomes including family planning Yet low income minority populations often demonstrate low levels of patient activation Tailored multisystem interventions addressing the patients and providers are needed to support immediate postpartum contraceptive initiation that reflects the needs and values of each patient The proposed STTR project will directly address the need for innovative solutions to reproductive health disparities in IPIs among adolescents The Patient Centered Postpartum Contraception Toolkit PC will be a novel toolkit for patients providers and administrators designed with pregnant and postpartum adolescents using the Information Motivation and Behavioral Skills Model and novel methodologies such as human centered design and lean startup techniques For this Phase I prototype the introductory module on activating patients to prevent short IPIs will be developed and tested with African American adolescents ACCESS the largest FQHC network in the Midwest will be the implementation partner Project Narrative This Phase project will develop a theory based mobile app to activate adolescent mothers to decrease their risk of short IPIs through immediate postpartum contraception uptake This app will be a central component of a larger multi media intervention around using patient centered postpartum contraception practices to improve IPIs It will target patients providers and administrators