Applying human-centered design to identify needs and generate recommendations to inform an integrated maternal health...

Maternal mortality continues to rise in concerning rates in the United States. Maternal mortality risks are increased by clinical factors like cardiovascular disease or infection and nonclinical factors like food insecurity, unequal access to healthcare, and systemic racism. Integrated care coordination programs aimed at addressing care needs are emerging as best practices to improve maternal health outcomes at and post birth. Our goal was to (i) evaluate the care needs during pregnancy and postpartum and (ii) formulate recommendations for integrating a clinic-level model and community-level model to develop an integrated maternal health services model.

Human Centered Design (HCD) activities were used to identify the care needs from pregnancy through postpartum involving 35 participants across three groups. Group 1 included community members; Group 2, clinicians and healthcare providers from an academic obstetric clinic; and Group 3, care coordination and social service providers. Each group completed three to four HCD sessions between April to July 2024. An inductive qualitative analysis of HCD outputs captured frequency, complementary, expansion, and divergence among groups, which subsequently informed the recommendations for designing the model.

Four categories captured the recommendations for designing the IMHS program: (1) Pregnancy needs (e.g., center the care of the pregnant women and their social support), (2) Pregnancy specialist needs (e.g., include doulas, midwives, and other specialties within care coordination), (3) Community system needs (e.g., create coordinated outreach systems to reach populations), and (4) Healthcare system needs (e.g., provide skill-based training for clinical staff).

Recommendations for addressing pregnancy, specialist, community, and healthcare needs should be integrated into the design of the IMHS demonstration program to improve the care of pregnant women in Southern Nevada.