Dr. Laura Prater, Division of Health Services Management & Policy
Rank at time of award: Assistant Professor
and
Dr. Jennifer Hefner, Division of Health Services Management & Policy
Rank at time of award: Assistant Professor
Abstract
Maternal deaths are considered by Healthy People 2030 as a Leading Health Indicator, or a small subset of critical public health problems that require immediate action. Maternal mortality has gotten worse over time and is a source of significant inequities and health disparities among females of color. Pregnancy associated deaths, such as homicide and suicide are understudied. Homicide is the leading cause of death during pregnancy and postpartum, and suicide around the time of pregnancy is increasing. Firearms are the leading cause of violent death among pregnant and postpartum females, and firearm deaths among females have increased by one-third in the past decade. Despite the worsening of maternal mortality and the pervasive inequities, no interventions to assess and follow-up on firearm safety during pregnancy exist. The risk of intimate partner violence during pregnancy and postpartum is substantially escalated; females are also more likely to be exposed to a firearm through a cohabitating adult or intimate partner. Interventions to address firearms are thus complicated by the complex milieu and lack of standardized resources to intervene. Interventions such as the Women Initiating New Goals of Safety (WINGS) brief assessment and intervention program is an evidence-based approach to reducing IPV. WINGS is highly adaptable, allowing for the inclusion of a firearm module to assess and briefly intervene on firearm safety around the time of pregnancy. This study will use a community co-development approach to develop a module for integration into WINGS. In Aim 1 we will establish a Community Advisory Board and outline a partnership approach to developing a firearm module for integration into WINGS. In Aim 2 we will use focus groups to gather input from females around the time or pregnancy, both who live with firearms or have exposure to violence through their own experience or in their community. We will use established relationships with the central Ohio Moms2Be program and Federally Qualified Health Centers to partner in the development of our CAB and to recruit for focus groups. These Aims will achieve our goal of a conceptual framework to support the development of the firearm module, which will be required as preliminary data for a future R01 that will validate and test the adapted intervention in community health care settings.