Accepted for/Published in: JMIR Research Protocols
Date Submitted: Feb 9, 2020
Date Accepted: Dec 15, 2020
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He Korowai Manaaki (Pregnancy Wraparound Care): Study Protocol for a Cluster Randomised Clinical Trial
ABSTRACT
Background:
Maternal and infant health inequities between Māori (the Indigenous peoples of Aotearoa New Zealand) and New Zealand European (NZE) women are well documented and cannot be explained solely by socioeconomic status. This research centre-iwi (tribal) partnership aims to address these disparities and improve maternal and infant health outcomes by implementing an augmented maternity care pathway (He Korowai Manaaki) to improve access to services and evidence based care.
Objective:
The objective of this study is to test whether an augmented maternity care pathway improves Māori infant health outcomes.
Methods:
This is a Kaupapa Māori study with a cluster randomised clinical trial involving eight primary care practices allocated to the intervention or control arm. The intervention arm comprises an augmented maternity care pathway (He Korowai Manaaki) addressing both clinical and structural determinants of health (e.g. housing, transport etc.). It includes additional paid health care appointments, wraparound support and connections to allied services as appropriate. The control arm is usual care. Primary outcomes are reduction in hospitalisations and length of hospital stay and increase timely vaccinations for Māori infants in their first year of life.
Results:
Recruitment commenced in November 2018 and will be completed June 2020 to obtain the required sample size of 500 pregnancies (250 control, 250 intervention). Publication of results is anticipated late 2023.
Conclusions:
The results will inform primary health care policy as well as clinical pathways, including augmented pathways, and address structural determinants of health to strengthen the health and wellbeing of pregnant Māori women and their babies and improve the health outcomes for lifelong health and wellbeing. Clinical Trial: ACTRN12619001155189 Australian New Zealand Clinical Trials Registry http://www.ANZCTR.org.au/ACTRN12619001155189.aspx
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