Integrated Clinic and Patient Technology-Enabled Program to Reduce the Risks of Cardiometabolic Disease Among Latinas with Prior Pregnancy Complications

Abstract Nearly 40% of Latinas experience an adverse pregnancy outcome (APO) that places them at significantlyhigher risk of developing cardiometabolic disease (CMD), including type 2 diabetes and/ or cardiovasculardisease. The primary care setting has been identified as a key locus for addressing this major public healthneed, as primary care providers assume responsibility for the majority of care 6 weeks after delivery. Althoughcurrently not widely available, digital technologies have been recommended as a solution for expanding accessto such preventive services in primary care. This lack of availability of digital technologies for women with priorAPOs is a particularly noteworthy gap among primary care clinics serving large Latina populations, given themany historical disparities experienced by Latinas in health, coverage, and access to care. To the best of ourknowledge, the proposed SBIR would be the first-ever effort to create and test an integrated clinic platform andpatient app to enable primary care practices to deliver behavior-change programming to support Latinas in the5 years after their APO. The integrated system will be developed using a user centered design approachincorporating feedback from both paraprofessional staff who will deliver the program and provide socialsupport, and Latina patients, with the goal of successfully marketing the program to primary care clinics servingLatinas. The project is innovative in its comprehensive approach that addresses the 5 major APOs associatedwith future CMD, a clinic platform that overcomes key barriers to delivering lifestyle interventions in primarycare, reliance on paraprofessionals to deliver the program, and combining an individualized approach forpatients with a population health approach for primary care clinics. Specific aims are: Aim 1: Develop a clinicplatform to integrate with our existing patient application to promote healthy behaviors among Latinas withrecent APOs predictive of CMD; Aim 2: Develop and test digital tools and digital training toolkit for the newclinic platform for use by paraprofessionals (e.g. CHWs, medical assistants, health educators) and test the newfeatures incorporated in the existing patient app; and, Aim 3: Evaluate feasibility, usability, and acceptability ofthe integrated clinic and patient application. The team includes a multicultural and multidisciplinary group ofclinicians and researchers who have collaborated on prior technology-based interventions for women in thepostpartum years. Hola Bebé, Hola Salud addresses a large unmet public health need with significantcommercial potential among primary care clinics serving Latina populations. Our B2B approach is consistentwith emerging trends on population health and value-based payment in primary care.