Mission
Thriving Hearts is a local health department-led program to create conditions for pregnant woman and moms in North Carolina to not only survive pregnancy, but to thrive. Our goal is to reduce rates of high blood pressure in pregnancy in ten North Carolina counties.
Background
Mothers in the United States experience unacceptable rates of severe maternal morbidity and maternal mortality. And hypertensive disorders in pregnancy are a major contributor to these morbidity and mortality rates.
Thriving Hearts is a grant funded program that will support 10 counties in central North Carolina through 2030 to address these poor outcomes. The program will focus on both patients and health care teams to create a more collaborative and empowered approach for mothers and birthing people journeying through pregnancy. Thriving Hearts intends to show this by partnering academic experts, community leaders, and people with lived experience.
About Our Funder
PCORI (Patient-Centered Outcomes Research Institute) is a funding agency based in Washington, DC, and is the leading funder of comparative clinical effectiveness research. Learn more.
The goal of the Thriving Hearts project is to understand how comprehensive support for pregnant and parenting families improves health outcomes. We are rolling out Thriving Hearts supports for over two and a half years, measuring how pregnancy outcomes change as the program reaches more families.
Learn More
The rollout is organized into six nine-month periods, with counties moving from their existing services (“Usual Care”) through a preparation phase (“Scale up”) before fully implementing Thriving Hearts. This staggered approach research project allows for gradual adoption, ongoing evaluation, and shared learning across counties. By January 2028, all ten counties will have implemented the program. We will continue to measure outcomes for births through June of 2029.
Effectiveness of a Community-Based Maternity Care Intervention in Reducing the Incidence of Hypertensive Disorder of Pregnancy
Project Summary
This study tests the clinical effectiveness of a community-based maternity care intervention in reducing the incidence of hypertensive disorder of pregnancy (HDP).
Who will this research inform?
HDP is a major cause of maternal morbidity and mortality. The study’s results may help community advocates, health system leaders and policy makers understand how effective the support at individual, clinician and community levels can be to improving pregnancy-related health outcomes, as well as to learn how to implement this type of intervention in other communities.
What is the research team doing?
Design
Stepped-wedge, cluster-randomized controlled trial
Population
Local health departments in 10 counties, involving 140,000 pregnant women
Interventions/Comparators
Thriving Hearts Program involves:Pregnant women: screening for pregnant women at high risk of HDP. High risk women will receive a home blood pressure monitor, low dose aspirin as well as text-based blood pressure reminders and health tips.
Healthcare teams: workshops on healing-centered, trauma-informed care for healthcare workers to prevent burnout.
Communities: community health workers connecting families to community resources, community events, and participation of medical-legal partnership.
Primary Outcome
Incidence of HDP during pregnancy, birth or within 28 days postpartum
Secondary Outcome
HDP morbidity, severe maternal morbidity or mortality, clinical care quality, patient-reported outcomes, healthcare team-reported outcomes, implementation outcomes
Patient and Community Engagement
People with lived experience of HDP, local health department staff, doulas, lactation counselors, community health workers, dieticians, social workers, health educators, nurses and doctors are working with researchers on this study.
Project Information
Principal Investigator: Alison Stuebe, B.S., M.D., MSc
Other Principal Investigator: Quintana Stewart, MPA
The University of North Carolina at Chapel Hill
Project Budget: $21,000,000
