NCT06277661

Brief Summary

The investigator's long-term goal is to mitigate pregnancy-related mortality (PRM) risk by systematically delivering scalable integrated clinical and supportive care that is effective for all. The investigator's central hypothesis is that the Multi-modal Maternal Infant Perinatal Outpatient Delivery System (MOMI PODS) will mitigate postpartum (PP) risk for all by increasing patient engagement with evidence-based cilnical and supportive care, thus improving biopsychosocial profiles that drive clinical risk. To test this hypothesis, the investigators will conduct a hybrid type 1 randomized controlled trial (RCT) of MOMI PODS versus enhanced usual care (EUC, which we will term MOMI CARE) among a total sample of up to 384 mother-infant dyads (192/group) following pregnancy affected by a cardiometabolic and/or mental health condition. The investigators will enroll participants during late pregnancy and collect data at baseline and 6 months and 1 year PP. The investigators will collect implementation and service data across sites.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
384

participants targeted

Target at P75+ for not_applicable

Timeline
22mo left

Started Jun 2024

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress51%
Jun 2024Mar 2028

First Submitted

Initial submission to the registry

February 7, 2024

Completed
19 days until next milestone

First Posted

Study publicly available on registry

February 26, 2024

Completed
4 months until next milestone

Study Start

First participant enrolled

June 27, 2024

Completed
3.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2027

Expected
4 months until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2028

Last Updated

February 13, 2026

Status Verified

February 1, 2026

Enrollment Period

3.3 years

First QC Date

February 7, 2024

Last Update Submit

February 10, 2026

Conditions

Keywords

PostpartumMental HealthCardiometabolic HealthMaternal-Infant Health

Outcome Measures

Primary Outcomes (9)

  • Change in Life's Essential 8 (LE8) Composite Score

    Higher scores=better health (0-100). 0-100 points for each domain. Total divided by 8. Diet (Mediterranean Eating Pattern for Americans score): 100=15-16; 80=12-14; 50=8-11; 25=4-7; 0=0-3; Physical Activity (min. moderate+/week): 100=\>=150; 90=120-149; 80=90-119; 60=60-89; 40=30-59; 20=1-29; 0=0; Nicotine: 100=Never; 75=Former, quit \>=5y; 50=Former, quit 1-\<5y; 25=Former, quit \<1y or vaping; 0=Current; -20 living with indoor smoker; Sleep (avg. hrs./night): 100=7\<9; 90=9-\<10; 70=6-\<7; 40=5-\<6 or \>=10; 20=4-\<5; 0=\<4; body mass index (kg/m2): 100=\<25; 70=25-29.9; 30=30-34.9; 15=35-39.9; 0=\>=40; Non-HDL mg/dL: 100=\<130; 60=130-159; 40=160-189; 20=190-219; 0=\>=220; -20 if treated; Glucose (Diabetes/HbA1c): 100=No/\<5.7; 60=No/5.7-6.4; 40=Yes/\<7; 30=Yes/7-7.9; 20=Yes/8-8.9; 10=Yes/9-9.9; 0=Yes/\>=10; Blood pressure: 100=\<120/\<80; 75=120-129/\<80; 50=130-139 or 80-89; 25=140-159 or 90-99; 0=\>=160 or \>=100; -20 if treated

    Baseline (T1) to 6 months postpartum (T2)

  • Change in Life's Essential 8 (LE8) Composite Score

    Higher scores=better health (0-100). 0-100 points for each domain. Total divided by 8. Diet (Mediterranean Eating Pattern for Americans score): 100=15-16; 80=12-14; 50=8-11; 25=4-7; 0=0-3; Physical Activity (min. moderate+/week): 100=\>=150; 90=120-149; 80=90-119; 60=60-89; 40=30-59; 20=1-29; 0=0; Nicotine: 100=Never; 75=Former, quit \>=5y; 50=Former, quit 1-\<5y; 25=Former, quit \<1y or vaping; 0=Current; -20 living with indoor smoker; Sleep (avg. hrs./night): 100=7\<9; 90=9-\<10; 70=6-\<7; 40=5-\<6 or \>=10; 20=4-\<5; 0=\<4; body mass index (kg/m2): 100=\<25; 70=25-29.9; 30=30-34.9; 15=35-39.9; 0=\>=40; Non-HDL mg/dL: 100=\<130; 60=130-159; 40=160-189; 20=190-219; 0=\>=220; -20 if treated; Glucose (Diabetes/HbA1c): 100=No/\<5.7; 60=No/5.7-6.4; 40=Yes/\<7; 30=Yes/7-7.9; 20=Yes/8-8.9; 10=Yes/9-9.9; 0=Yes/\>=10; Blood pressure: 100=\<120/\<80; 75=120-129/\<80; 50=130-139 or 80-89; 25=140-159 or 90-99; 0=\>=160 or \>=100; -20 if treated

    6 months postpartum (T2) to 12 months postpartum (T3)

  • Change in Life's Essential 8 (LE8) Composite Score

    Higher scores=better health (0-100). 0-100 points for each domain. Total divided by 8. Diet (Mediterranean Eating Pattern for Americans score): 100=15-16; 80=12-14; 50=8-11; 25=4-7; 0=0-3; Physical Activity (min. moderate+/week): 100=\>=150; 90=120-149; 80=90-119; 60=60-89; 40=30-59; 20=1-29; 0=0; Nicotine: 100=Never; 75=Former, quit \>=5y; 50=Former, quit 1-\<5y; 25=Former, quit \<1y or vaping; 0=Current; -20 living with indoor smoker; Sleep (avg. hrs./night): 100=7\<9; 90=9-\<10; 70=6-\<7; 40=5-\<6 or \>=10; 20=4-\<5; 0=\<4; body mass index (kg/m2): 100=\<25; 70=25-29.9; 30=30-34.9; 15=35-39.9; 0=\>=40; Non-HDL mg/dL: 100=\<130; 60=130-159; 40=160-189; 20=190-219; 0=\>=220; -20 if treated; Glucose (Diabetes/HbA1c): 100=No/\<5.7; 60=No/5.7-6.4; 40=Yes/\<7; 30=Yes/7-7.9; 20=Yes/8-8.9; 10=Yes/9-9.9; 0=Yes/\>=10; Blood pressure: 100=\<120/\<80; 75=120-129/\<80; 50=130-139 or 80-89; 25=140-159 or 90-99; 0=\>=160 or \>=100; -20 if treated

    Baseline (T1) to 12 months postpartum (T3)

  • Change in Patient Health Questionnaire-9 (PHQ-9) Score

    We will assess mental health by self-report using the Patient Health Questionnaire-9 (PHQ-9), with higher scores indicative of more depressive symptoms (range 0-27).

    Baseline (T1) to 6 months postpartum (T2)

  • Change in Patient Health Questionnaire-9 (PHQ-9) Score

    We will assess mental health by self-report using the Patient Health Questionnaire-9 (PHQ-9), with higher scores indicative of more depressive symptoms (range 0-27).

    6 months postpartum (T2) to 12 months postpartum (T3)

  • Change in Patient Health Questionnaire-9 (PHQ-9) Score

    We will assess mental health by self-report using the Patient Health Questionnaire-9 (PHQ-9), with higher scores indicative of more depressive symptoms (range 0-27).

    Baseline (T1) to 12 months postpartum (T3)

  • Change in Generalized Anxiety Disorder-7 (GAD-7) Score

    We will assess mental health by self-report using the Generalized Anxiety Disorder-7 (GAD-7), with higher scores indicative of more anxiety symptoms (range 0-21).

    Baseline (T1) to 6 months postpartum (T2)

  • Change in Generalized Anxiety Disorder-7 (GAD-7) Score

    We will assess mental health by self-report using the Generalized Anxiety Disorder-7 (GAD-7), with higher scores indicative of more anxiety symptoms (range 0-21).

    6 months postpartum (T2) to 12 months postpartum (T3)

  • Change in Generalized Anxiety Disorder-7 (GAD-7) Score

    We will assess mental health by self-report using the Generalized Anxiety Disorder-7 (GAD-7), with higher scores indicative of more anxiety symptoms (range 0-21).

    Baseline (T1) to 12 months postpartum (T3)

Study Arms (2)

Intervention

EXPERIMENTAL

MOMI PODS is an innovative, dyadic model of PP primary care. Informed by the Chronic Care Model (CCM) and extensive stakeholder engagement, the MOMI PODS suite of services addresses four primary domains, with a focus on preventing PRM and eliminating SES, racial, and ethnic disparities in PRM. First, MOMI PODS is a dyadic model of care, with mothers and infants cared for in tandem throughout the PP year, and beyond. Second, MOMI PODS was strategically designed to facilitate a coordinated obstetric to PP primary care transition. Third, MOMI PODS is delivered in a way that promotes tailored, evidence-based care informed by the obstetric history. Fourth, MOMI PODS systematically integrates clinical and supportive care to concurrently address clinical and psychosocial needs, with MOMI PODS engagement extending beyond the typical referral process to facilitate direct access to needed resources and empower patients.

Behavioral: MOMI PODS

Enhanced Usual Care (EUC)

ACTIVE COMPARATOR

Usual care will be enhanced in by implementing an enhanced PP care handoff as an adaptation of typical institutional discharge procedures. Specifically, under current processes, birthing parents are asked to provide the name of their infant's pediatrician during the L\&D admission, must provide the name of their infant's pediatrician prior to discharge, and are assisted with identifying a pediatrician throughout this process as needed. Alternatively, under current processes, mothers are reminded to seek PP care but not required to identify the location of care or assisted with doing so. As a component of EUC, we'll provide participants with information about our 7 EUC sites and actively assist with identifying their preferred location of care and scheduling PP care. Our research team will also engage with EUC recipients throughout the study period to encourage engagement and study retention through small care packages and hand-written notes, as well as data collection.

Behavioral: Enhanced Usual Care (EUC)

Interventions

MOMI PODSBEHAVIORAL

MOMI PODS is an innovative, dyadic model of PP primary care. Informed by the Chronic Care Model (CCM) and extensive stakeholder engagement, the MOMI PODS suite of services addresses four primary domains, with a focus on preventing PRM and eliminating SES, racial, and ethnic disparities in PRM. First, MOMI PODS is a dyadic model of care, with mothers and infants cared for in tandem throughout the PP year, and beyond. Second, MOMI PODS was strategically designed to facilitate a coordinated obstetric to PP primary care transition. Third, MOMI PODS is delivered in a way that promotes tailored, evidence-based care informed by the obstetric history. Fourth, MOMI PODS systematically integrates clinical and supportive care to concurrently address clinical and psychosocial needs, with MOMI PODS engagement extending beyond the typical referral process to facilitate direct access to needed resources and empower patients.

Intervention

Usual care will be enhanced in by implementing an enhanced PP care handoff as an adaptation of typical institutional discharge procedures. Specifically, under current processes, birthing parents are asked to provide the name of their infant's pediatrician during the L\&D admission, must provide the name of their infant's pediatrician prior to discharge, and are assisted with identifying a pediatrician throughout this process as needed. Alternatively, under current processes, mothers are reminded to seek PP care but not required to identify the location of care or assisted with doing so. As a component of EUC, we'll provide participants with information about our 7 EUC sites and actively assist with identifying their preferred location of care and scheduling PP care. Our research team will also engage with EUC recipients throughout the study period to encourage engagement and study retention through small care packages and hand-written notes, as well as data collection.

Enhanced Usual Care (EUC)

Eligibility Criteria

Sexfemale
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

The Ohio State University

Columbus, Ohio, 43210, United States

RECRUITING

MeSH Terms

Conditions

Depression, PostpartumMetabolic SyndromePsychological Well-Being

Condition Hierarchy (Ancestors)

Puerperal DisordersPregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesDepressive DisorderMood DisordersMental DisordersInsulin ResistanceHyperinsulinismGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesPersonal SatisfactionBehavior

Central Study Contacts

Shannon L. Gillespie, PhD, RN

CONTACT

Sandra Solove, MA

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor

Study Record Dates

First Submitted

February 7, 2024

First Posted

February 26, 2024

Study Start

June 27, 2024

Primary Completion (Estimated)

November 1, 2027

Study Completion (Estimated)

March 1, 2028

Last Updated

February 13, 2026

Record last verified: 2026-02

Data Sharing

IPD Sharing
Will share

In accordance with the NIH Policy for Data Management and Sharing, we've carefully considered the data expected to be generated and the best approach to maximize the appropriate sharing of scientific data while also protecting the privacy of human subjects participating in research. We expect remnant biospecimens to be minimal after study execution and will therefore not submit biospecimens. Also of note, obstetric complications, postnatal complications, severe maternal morbidity (SMM), and pregnancy-related mortality (PRM) are rare occurrences. Details surrounding this information are publicly available in birth and death certificates and could be aligned with other information to identify a research participant. Thus, to protect participant privacy, we do not plan to share raw data but will produce collapsed variables for data sharing.

Shared Documents
STUDY PROTOCOL, ICF
Time Frame
Data will be made available at the time of associated publications, or the end of the performance period, whichever comes first. Data and Specimen Hub (DASH) considers submitted datasets to be permanently available.
Access Criteria
All requests for data through DASH is routed through the National Institute of Child Health and Human Development (NICHD) DASH Data and Biospecimen Access Committee. This committee reviews these requests and determines whether the proposed use is scientifically and ethically appropriate and does not conflict with data use limitations identified by the submitting institution. If deemed necessary, the committee will obtain additional approvals from the study-specific entity, such as the Multiple Principle Investigators (MPIs).

Locations