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Moms2B Community-Based Interdisciplinary Intervention Delivers Results

Analysis  |  By Christopher Cheney  
   February 24, 2021

The primary feature of the Moms2B program is a two-hour educational and interventional session held on a weekly basis.

A community-based interdisciplinary intervention program in Ohio has improved pregnancy and infant outcomes in neighborhoods at high risk for infant mortality, a recent research article shows.

The Centers for Disease Control and Prevention (CDC) defines infant mortality as the death of an infant in the first year of life. According to the CDC, the top five causes of infant mortality in 2018 were birth defects, preterm birth and low birth weight, maternal pregnancy complications, sudden infant death syndrome, and injuries such as suffocation.

A co-author of the recent research article who is the founder of the Moms2B community-based interdisciplinary intervention program at The Ohio State University Wexner Medical Center in Columbus told HealthLeaders that infant mortality is a significant problem in the United States.

"It is a critical measure of the health of our neighborhoods, our cities, our states, and our country. We lag way behind the other developed countries in our infant mortality rate. Most concerning is that two-to-three times more Black babies die in the United States as White babies," said Patricia Gabbe, MD. In addition to founding Moms2B, Gabbe is a professor of pediatrics and obstetrics and gynecology at The Ohio State University College of Medicine.

The recent research article, which was published by Maternal and Child Health Journal, features data collected from more than 2,000 primarily non-Hispanic Black women and their infants. There were 675 pregnancies that had been exposed to the Moms2B program and a control group of more than 1,300 pregnancies.

The study includes three key data points:

  • Pregnancies exposed to Moms2B were less likely to result in a neonate with low birth weight than the control group, 9.45% versus 12.00%, respectively.
     
  • Moms2B participants had an infant mortality rate of 0.75%, and the control group had an infant mortality rate of 1.67%
     
  • Moms2B participants had a preterm birth rate of 10.9%, and the control group had a preterm birth rate of 12.7%

"The biggest contributor to infant mortality in our Black families is very preterm birth. So, the Moms2B program's emphasis on promoting a healthy pregnancy is designed to get moms to a full-term pregnancy," Gabbe said.

Primary elements of Moms2B

The Moms2B program was launched in 2010, with Gabbe and an infant mental health specialist as the only staff members. "We started with two pregnant women at a church in a high-risk, high-crime neighborhood. In 2019, we had almost 800 moms. Last year, even with the pandemic, we had 629 moms. It is a testimony to how much interest and need there is for this program. We now have a staff of 25," she said.

The current staff includes child development and parenting specialists, community navigators and health workers, dietitians, fatherhood leaders, lactation counselors, nurses, obstetricians, pediatricians, and social workers. Moms2B now has sites in eight Columbus neighborhoods.

The primary feature of the Moms2B program is a two-hour session held on a weekly basis at each Moms2B site. The sessions begin with a "sister-brother circle," Gabbe said. "The men hear the same lessons on breastfeeding, good nutrition, co-parenting, and anger and emotional management. Then, our sessions break up into three groups: a Dads2B group that works with a fatherhood leader, a parenting group for women, and a pregnancy group for women."

Childcare is provided during the two-hour sessions so participating adults can focus on the program.

Gabbe said the two-hour sessions have several educational and interventional elements, including the following:

  • Nutrition: All moms get a healthy meal during the two-hour session and can take a meal home. As is the case for all lessons, food preparation and nutrition lessons are accompanied by short and colorful handouts. Moms are connected to the federal Supplemental Nutrition Program for Women, Infants, and Children (WIC), as well as food banks. Once a month, Moms2B brings a Mid-Ohio Foodbank truck to its sites, so moms can go home with fresh foods and staples.
     
  • Breastfeeding: For infants, breastfeeding is protective. "Our moms initiate breastfeeding in the hospital about 80% of the time. When we started, it was about 50%," Gabbe said.
     
  • Safe sleeping: Moms2B models safe sleeping techniques for infants. For example, one interactive exercise consists of placing a crib filled with inappropriate items in the center of the sister-brother circle. The moms and dads are then asked which items should not be in the crib. "In the end, you end up with an empty crib with a baby flat on their back," she said.
     
  • Reproductive health: Moms2B provides education about several different methods of birth control. "Our team has developed a game called Repro Bingo, where you call out different methods of birth control and show what is effective and what is not effective," Gabbe said.
     
  • Smoking cessation: Moms2B conducts smoking assessments with moms and dads. The organization also has a partnership with a Columbus Public Health program called Baby and Me Tobacco Free. "We do not want our babies to go home where the mom or dad are smoking," she said.
     
  • Stress reduction: Moms2B teaches moms stress reduction techniques. "Sometimes, we blow bubbles to reduce stress, and we teach moms how to take deep breaths to relax," Gabbe said.

Return on investment

The Moms2B program has an annual budget of about $1.6 million, with the funding drawn from Medicaid, the Governor's Office of Faith-Based and Community Initiatives, and The Ohio State University Wexner Medical Center, Gabbe said.

"The cost per baby is about $2,000, said Gabbe. "That is a small investment to save a baby and to save a mom. We are focused on achieving equity in health—equity in the population of moms and babies. So, we are making a modest investment given what we are trying to achieve."

Moms2B generates a positive return on investment, she said. "When I do a cost-saving analysis, Moms2B saves money. This investment reduces healthcare costs that have been devoted to infants who are born premature and spend a lot of days in a NICU."

Related: 2 Ways 'Team Birth Project' Works to Decrease Maternal Mortality

Christopher Cheney is the CMO editor at HealthLeaders.


KEY TAKEAWAYS

The United States lags other developed countries in infant mortality rate.

The Moms2B program in Columbus, Ohio, is designed to generate positive pregnancy outcomes and to help infants survive.

The cost of funding the educational and interventional program is about $2,000 per baby.


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