Julie Taylor/MUSC
The Duke Endowment and the Medical University of South Carolina (MUSC) have launched an initiative to strengthen maternal and infant health outcomes across the Carolinas by expanding MUSC’s H.E.A.R. (Healing, Equity, Advocacy and Respect) 4 Mamas and Babies (H4MAB) program to additional health systems.
H4MAB is an evidence-informed screening and referral program developed at MUSC that uses text messaging and phone outreach to identify medical, behavioral health and social needs early in pregnancy and throughout the postpartum year.
The model proactively connects participants to timely, trusted services and has demonstrated significant improvements in the detection and treatment of mental health conditions, including maternal depression and anxiety as well as substance use disorders, chronic health conditions, intimate partner violence and unmet social determinants of health needs.
H4MAB has also helped to reduce disparities in access to care by identifying maternal and infant health needs early and connecting patients with personalized support from care teams via text and phone messaging.
The Duke Endowment has allocated more than $13 million to advance the initiative. The multiyear investment includes $8 million to support five health systems as they plan and implement H4MAB over the next four years. The participating health systems are Cape Fear Valley Health System, ECU Health, Atrium Health Wake Forest Baptist, Prisma Health and Spartanburg Regional Healthcare System.
The award also includes $5.3 million to establish a Technical Assistance and Training Center (TAC), led by MUSC in collaboration with the University of North Carolina at Chapel Hill. The TAC will provide training, technology, cross-site evaluation and data resources along with ongoing technical assistance to strengthen implementation. It will also partner with state agencies, Medicaid programs and private payers to explore long-term reimbursement pathways, helping to ensure the program’s sustainability.
“We are thrilled to launch this initiative in partnership with MUSC, UNC-Chapel Hill and five health systems,” said Jay Kennedy, senior program officer with The Duke Endowment’s Health Care program area. “Our aim is to work together to replicate and scale this program in hopes of improving health outcomes for more women and infants across the Carolinas.”
“H.E.A.R for Mamas and Babies was created to address the many gaps in maternal and infant health care by ensuring that individual concerns are heard and medical, behavioral health and social needs are proactively addressed by a trusted care team throughout pregnancy and the postpartum year,” said Constance Guille, M.D., TAC director, H4MAB principal investigator and professor in MUSC’s Department of Psychiatry and Behavioral Sciences. “With The Duke Endowment’s support, we now have the opportunity to bring this model to scale and improve outcomes for families across the Carolinas.”
Through the TAC, MUSC and UNC-Chapel Hill will guide health systems in adapting H4MAB to diverse care environments, including rural, urban, academic and community hospitals. The TAC will also lead a rigorous evaluation of clinical, economic and implementation outcomes across participating sites.
“We are honored to partner in this important endeavor,” said Sarah Verbiest, DrPH, director of the Jordan Institute for Families at the UNC School of Social Work. “By bringing together MUSC’s expertise, the H.E.A.R. 4 Mamas and Babies program, our experience implementing innovation in communities and The Duke Endowment’s sustained investment in maternal and child health, we believe this initiative has the potential to mitigate risk factors that lead to poor maternal and infant health outcomes, such as postpartum depression, while ensuring families across North Carolina and South Carolina receive the timely support they need to thrive.”