NIH Opportunity: Understanding the Impact of Healthcare System and Clinician Factors on Disparities in Maternal Morbidity and Mortality

Funding Opportunity Number: PAR-24-059

February 5, 2024
March 5, 2024

Research Objectives
This initiative will focus on healthcare access and quality, emphasizing individual and structural social determinants of health (SDOH) that may impact maternal mortality and SMM in the United States. Adverse SDOH such as lack of access to quality and affordable care may increase maternal mortality and morbidity (MMM) risk, especially among African American/Black and American Indian/Alaska Native women. The scientific literature suggests that factors such as quality of care in hospitals with majority African American/Black patients, healthcare system factors and policies (payment mechanisms, health insurance policies, care coordination) and clinician factors (e.g., poor communication with patients, failure to diagnose potential complications, delays in diagnostic tests, lack of appropriate referrals) are related to SMM. Additional research is warranted to understand and address these and other important issues such as racial and ethnic disparities in health care quality within the same hospital, implicit bias, and discrimination.

The objective of this initiative is to solicit grant applications (R01s) seeking to bridge the knowledge gap about understudied healthcare system and clinician factors across the full spectrum of maternal care – prenatal, perinatal, and up to 1 year postpartum in the United States. Of particular interest are intervention studies (e.g., clinical trials, quasi-experiments, stepped-wedge designs) designed to evaluate and address these disparities. Preliminary observational studies (primary/secondary data) or mixed-methods studies are encouraged to support the proposed intervention targets and outcomes. Secondary goals of the research can include examination of mechanisms/pathways through which these healthcare factors contribute to MMM disparities.