Reducing Perinatal Anemia through Patient Centered Community and Clinical Approaches

Stanford University, Stanford CA

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Abstract

Modified Project Summary/Abstract Section Iron deficiency anemia (IDA) affects up to one-third of gravidas during pregnancy. IDA is a condition of too little iron in the body, resulting in too few healthy red blood cells, which puts pregnant patients at risk for postpartum hemorrhage (PPH; excessive bleeding after childbirth) and related severe maternal morbidity (SMM). IDA is preventable, but current approaches to prevention and treatment are not working. The incidence of IDA during pregnancy is increasing, , and patient perspectives are lacking. The goal of this project is to increase hemoglobin (i.e., resolve anemia) at birth admission for all pregnant patients, thereby reducing anemia-related SMM from PPH. The objective of this project is to create a novel Anemia Prevention Toolkit (i.e., a set of patient- and community-centered guidelines and implementation strategies) and then implement and disseminate it at scale using collaborative quality improvement methods. The rationale underlying this work is that both clinicians, represented by the Clinical Collaborative Leadership Group, and community partners and people with lived experience of IDA, represented by the Anemia Community Leadership Group, desire the education and guidance of such a toolkit and are dedicated to working together to create, optimize, and implement it. We will achieve our goal by pursuing the following three Specific Aims: 1) develop an Anemia Prevention Toolkit that aligns evidence-based practice with patient-centered care, incorporating patients’ lived experience, community assets, and clinical/hospital workflows; 2) optimize the Toolkit to increase hemoglobin at birth admission by piloting it at 14 hospitals, and examine its acceptability and practicality; and 3) implement and disseminate the modified Toolkit across a network of more than 300 hospitals in CA, OR, and WA to reduce anemia and SMM from PPH. To pursue these aims, we will utilize a rigorous implementation science framework that combines patient-centered community perspectives with structured, evidence-based clinical care and education for anemia in pregnancy. The project’s outcomes will prioritize patient and community experiences and input. Clinical and health system stakeholders and frontline staff will work together in close alignment. This innovative approach holds the research team accountable to the patients and communities impacted by the significant problem of IDA during pregnancy—establishing community partners as project co-leads, adopting methods that require ongoing check-in with the community.