(751) Improving participation in postpartum remote blood pressure monitoring collaborating with community doulas for Black women

Black persons have a higher incidence of hypertension disorders of pregnancy (HDP) and are 3-4 times more likely to experience mortality than non-Black persons. In an established postpartum (PP) remote patient monitoring program (RPMP) for HDP, daily BP submission was inequitable between non-Black and Black persons through 42-days PP. We aimed to increase participation equity for BP submission by incorporating community-based doulas with the RPMP.
Study Design

A prospective feasibility study was performed at a single site from 1/21-10/22. The existing RPMP partnered with a community doula program focused on supporting Black birthing persons. Patients enrolled in the standard RPMP were approached for study participation prior to discharge and if consented were paired with a full service PP doula. Quantitative data was analyzed, and summary data generated. Non-paired t-test was performed comparing the pre-post study periods for BP submission of Black participants with standard RPM compared to RPM with the addition of a doula.

Results

Of eligible Black PP persons, 49/153 (32%) enrolled. Over 42-days PP the mean total BPs submitted were significantly increased from 19.6 ± 12.0 prior to the study compared to 23.9 ± 10.9 when paired with a doula (p < 0.05). The percentage of patients who reported ≥ one BP by postpartum week was (week; %): 1; 96.1%, 2; 94.1%, 3; 86.3%, 4; 80.4%, 5; 68.6%, 6; 52.9%.) Of the types of doula services offered, social support was most associated with an increase in total BP submission. BP control improved PP, however 30% of patients continued to have stage 2 hypertension or worse at 6-weeks PP.

Conclusion

This study achieved an increase in participation of daily BP submission for Black PP persons through a community-based doula partnership within an established RPMP for HDP. Doula services involving social support were most impactful in increasing the total submissions. Community engagement and social support can improve health engagement of PP Black persons in the first 6-weeks PP.