Better Birth Outcomes Through Technology, Education, and Reporting

NCT ID: NCT06261398

Last Updated: 2025-05-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

550 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-26

Study Completion Date

2028-03-31

Brief Summary

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This is a pragmatic randomized control trial to evaluate the BETTER intervention compared to standard obstetrical care (control) to determine whether it helps to reduce maternal anemia and other adverse pregnancy outcomes. The BETTER intervention includes one motivational interviewing session and bi-weekly text messages to encourage patients to connect with resources that address their social needs, including housing, food, and transportation. Quantitative data will be used to study participant outcomes, including surveys, and electronic health record data.

Detailed Description

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There are more than 3.5 million births per year in the United States. A substantial portion of these births (approximately 25-30%) occur in the context of significant adverse pregnancy outcomes (APOs) including preterm birth (PTB), hypertensive disorders of pregnancy (HDP), small-for-gestational-age birth (SGA), and intrauterine fetal demise (IUFD). Moreover, these complications significantly increase the risk of both maternal and perinatal morbidity and mortality and are associated with adverse health consequences throughout the life course of both individuals. Anemia in pregnancy has been consistently cited as an important factor in and upstream of APOs such as PTB and HDP, severe maternal morbidity, and maternal mortality, and for disparities in these outcomes as well.

This study will expand our understanding of addressing SDoH, including linkage to services that mitigate SDoH. This information can inform future interventions that address SDoH. Creating new tools to address the needs and strengths of obstetric patients, and encouraging their use, will improve the management of patient care during and after pregnancy.

The patient sample will include obstetric patients receiving care at the OSUWMC McCampbell OB/GYN clinic or the OSUWMC Outpatient Care East OB/GYN clinic. A total of 550 patients will participate in the study and be randomly assigned to either the intervention or control group. We will collect maternal and child health outcome data using patient electronic health records and surveys.

At the time of randomization at the patient's prenatal appointment, a researcher will use a survey to collect participant baseline data, including patient demographics and patient-reported outcomes. This information will be collected again during a study visit during the patient's prenatal appointment when the patient is 28-32 weeks gestation.

Final data collection from patient records will occur after delivery (for both intervention and control groups). Research staff will extract information from patients' and their baby's medical records, including maternal and perinatal outcomes.

The intervention includes one motivational interviewing session that encourages the patient to address their social needs. Following the intervention, patients will receive bi-weekly text messages with links to help them address social needs; these links are: (1) to a patient portal to enable them connect with their care team, (2) to Health Impact Ohio, a local organization that can help patients address social needs; and (3) to "findhelp.org," a site that can provide a list of resources based on zip code.

Conditions

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Pregnancy Maternal Anemia Pre-Term Birth Hypertensive Disorders

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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BETTER Intervention

Patients in the intervention group will receive one motivational interviewing session immediately after randomization and biweekly text messages until delivery to encourage them to connect to resources to address their social needs.

Group Type EXPERIMENTAL

BETTER: motivational interviewing and text messaging

Intervention Type BEHAVIORAL

Motivational interviewing to encourage individuals to address their social needs and engage with text messages that allow individuals to connect to their care team, a local organization that can help them address their social needs, and/or a resource that enables them to find help to address their needs based on their zip code.

Standard of care

No motivational interviewing or text messages will be provided.

Group Type ACTIVE_COMPARATOR

Standard of care

Intervention Type BEHAVIORAL

No motivational interviewing or text messages will be provided.

Interventions

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BETTER: motivational interviewing and text messaging

Motivational interviewing to encourage individuals to address their social needs and engage with text messages that allow individuals to connect to their care team, a local organization that can help them address their social needs, and/or a resource that enables them to find help to address their needs based on their zip code.

Intervention Type BEHAVIORAL

Standard of care

No motivational interviewing or text messages will be provided.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Less than 20 weeks and 6 days pregnant upon enrollment
* At least 18 years of age
* Receiving obstetric care at OSU McCampbell Hall or OSU Outpatient Care East
* Singleton pregnancy and fetus with a heartbeat
* English speaking
* Able to receive text messages

Exclusion Criteria

* Has a significant medical condition (eg sickle cell disease) that is a cause of anemia
* Has a plan for transfusion during pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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American Heart Association

OTHER

Sponsor Role collaborator

Ohio State University

OTHER

Sponsor Role lead

Responsible Party

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Ann McAlearney

Professor of Family Medicine and Executive Director, CATALYST

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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William Grobman, MD, MBA

Role: PRINCIPAL_INVESTIGATOR

Ohio State University

Ann McAlearney, ScD, MS

Role: PRINCIPAL_INVESTIGATOR

Ohio State University

Locations

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The Ohio State University Outpatient Care East

Columbus, Ohio, United States

Site Status RECRUITING

McCampbell Hall

Columbus, Ohio, United States

Site Status RECRUITING

The Ohio State University Wexner Medical Center OB/GYN Maternal and Fetal Medicine

Columbus, Ohio, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Ann McAlearney, ScD, MS

Role: CONTACT

614-293-3716

Nicole Thomas, PhD

Role: CONTACT

614-247-6228

Facility Contacts

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William Grobman, MD, MBA

Role: primary

(614) 293-4929

Anna Bartholomew, BSN, RN, MPH

Role: backup

614-685-3229

William Grobman, MD, MBA

Role: primary

614-293-4929

Anna Bartholomew, BSN, RN, MPH

Role: backup

614-685-3229

William Grobman, MD, MBA

Role: primary

(614) 293-4929

Anna Bartholomew, BSN, RN, MPH

Role: backup

614-685-3229

References

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McAlearney AS, MacEwan SR, Huerta TR, Thomas NR, Sova LN, Roth L, Bartholomew A, Rush LJ, Johnson KF, Grobman WA. Patient-informed outpatient intervention to improve pregnancy outcomes through connections to social services: protocol for the BETTER randomised controlled trial. BMJ Open. 2025 Jun 18;15(6):e096119. doi: 10.1136/bmjopen-2024-096119.

Reference Type DERIVED
PMID: 40533225 (View on PubMed)

Other Identifiers

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2023H0065

Identifier Type: -

Identifier Source: org_study_id

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