ELEVATE
University of Utah
The ELEVATE Maternal Health Center of Excellence brings together a trans-disciplinary research team with expertise in obstetrics, addiction medicine, simulation training, experiential learning, bias and disparity reduction, community engagement and implementation science. ELEVATE aims to reduce maternal morbidity from substance use disorders among the disproportionately affected Native American mothers in Utah.
University of Utah
Contact
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Principal Investigator: Dr. Torri D. Metz
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Center Director: Dr. Erin Johnson
At a Glance
2
Research Projects
6
Community Partners
Research Topics- Indigenous health
- Rural populations
- Minority populations
Status
Research activities started
Overarching Aims
To provide integrated and efficient leadership of the three proposed projects, maximizing coordination with community partners and incorporating research training across all elements of the ELEVATE Center.
To mature our existing community partnerships and statewide networks in order to facilitate future implementation science and effectiveness trials to reduce maternal morbidity and mortality in Utah.
To reduce maternal morbidity in Utah and nationally through implementation of community-driven interventions and training of health care practitioners.
To provide research training opportunities that evaluate and support the development of a culturally-integrated perinatal SUD intervention for urban Native mothers by adapting the successful SUPeRAD model.
Research Project Details
Culturally Engaged Recovery- Moms Connected through Native Community (CEREMONY)
The CEREMONY project will implement a culturally-adapted, multi-disciplinary prenatal and postpartum care clinic that addresses gaps in substance use disorder (SUD) care for Native Mothers. The goal of the project is to dismantle institutional-, provider-, and patient-level barriers to SUD care, and amplify community and individual resilience. The project will be carried out at Sacred Circle Clinic, which has been a trusted healthcare partner in the urban Native and underinsured community in and around Salt Lake City, Utah since 2012, serving 7,800 patients annually. The project will utilize qualitative and quantitative data and methods.
Inter-Professional Simulation Program for Clinical Resilience and Empathy (INSPIRE)
The INSPIRE project will develop, implement and test an experiential learning package and simulation training for healthcare practitioners at partnering organizations intended to increase clinical empathy and respectful care, and reduce bias, stigma, and burnout. A robust train- the-trainer curriculum will allow the implementation of the program across the state and reach rural communities. The project will be conducted in 6 clinical sites in Utah with approximately 790 providers and over 5,700 births per year. The INSPIRE program will be tested in 3 in-patient settings at the University of Utah using a quasi-experimental design to determine its impact on healthcare team and patient outcomes, as well as its potential for scalability.
Key Maternal Health Indicators: Utah
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45,789
live births in 2022 1
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24.0%
of births were cesarean deliveries 1
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9.1%
of births were preterm 1
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17.3%
of deliveries were covered by Medicaid 1
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613
women with life-threatening complications per every 100,000 births 2
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15.3
women die from pregnancy complications per every 100,000 births 3
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2.5%
of women are without a birthing hospital within 30 minutes 4
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79.3%
of birthing women start prenatal care in the 1st trimester 1
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Top-3 causes
of pregnancy-associated deaths: drug overdose, suicide, and obstetric complications 5
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25%
of pregnancy-associated deaths were caused by drug overdoses 10
Partner Organizations
A Community Advisory Board has been convened with members of the groups listed below, as well as many additional community contributors.
- Sacred Circle Healthcare
- Utah Support Advocates for Recovery Awareness (USARA)
- Black Birth Workers of Utah Collective
- Rural Health Association of Utah
- Paiute Indian Tribe of Utah
- Utah Women and Newborns Quality Collaborative (UWNQC)
“This investment from the National Institutes of Health in promoting maternal health in partnership with the community will allow us to create the necessary infrastructure and garner appropriate resources to make strides in preventing the incredibly tragic event of maternal death, which always has far-reaching consequences. Addressing rising maternal deaths will take innovative approaches to overcome structural barriers, such as racism, classism, and stigma.”
References
- Data are from 2022 live births occurring within the US to US residents. Cesarean deliveries are the percentage of live births where the final route and method of delivery was cesarean. Preterm births are the percentage of live births where the gestational age at birth was less than 37 weeks. Medicaid coverage is the percentage of live births where the source of payment for the delivery hospitalization was Medicaid. Prenatal care in the 1st trimester is the percentage of live births where the first prenatal appointment occurred between the 1st and 3rd month of pregnancy.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Natality on CDC WONDER Online Database. - Life threatening complications are deliveries with a diagnosis or procedure code indicating severe maternal morbidity. Information reported for 2020.
Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, State Inpatient Databases 2010 to 2021. - Number of deaths is based on pregnancy-related deaths in 2020. Pregnancy-related deaths include deaths during or within a year of pregnancy from causes related to or aggravated by the pregnancy or its management.
Source: Utah Department of Health & Human Services, Utah’s Public Health Indicator Based Information System. Health Indicator Report of Maternal Mortality. - March of Dimes Maternity Care Deserts Report 2023.
- Causes of deaths based on pregnancy-associated deaths in 2015-2016. Pregnancy-associated deaths include deaths during or within one year of pregnancy, regardless of the cause.
Source: Utah Department of Health, Perinatal Mortality Review. Maternal Mortality in Utah 2015-2016.