# The role of pediatric interconception care in preventing adverse birth outcomes

> **NIH NIH K23** · CHILDREN'S HOSP OF PHILADELPHIA · 2021 · $166,644

## Abstract

Summary/Abstract
Preterm births occur in 10% of US births, cause 36% of infant mortality, and cost $26 billion each year. Repeat
preterm births represent approximately 20% of total prematurity. Preventive care that effectively addresses
modifiable risks (e.g. tobacco use, weight status, interpregnancy interval) among women with a prior preterm
birth could plausibly reduce overall preterm birth rates by 10% or more. However, our preliminary work found
that 39% of Medicaid-insured women with a prior preterm birth received no preventive care in the year after
pregnancy. Leveraging existing contact between pediatric health systems and new mothers, this research
proposes a pediatric-based nurse intervention as a novel strategy to reduce prematurity. We hypothesize
that nurse care coordination will increase receipt of preventive care. In addition, we propose embedding
motivational interviewing within the care coordination model to address modifiable health risks. We
hypothesize that this care coordination plus motivational interviewing intervention will increase receipt of
preventive care and reduce modifiable behavioral risks, thus improving subsequent birth outcomes. The
proposed intervention builds on existing care coordination models and on prior work demonstrating feasibility
of maternal risk screening in pediatrics. This intervention innovates over existing interconception (IC) care
models by: (1) locating our intervention in the pediatric health care system to capitalize on existing interactions,
(2) focusing on strategies to address needs and risks identified through screening, and (3) implementing
motivational interviewing within care coordination to better address modifiable risks. The candidate, Dr.
Gregory, has conducted prior maternal-child health research focused on the IC period. Her long-term goal is to
become an independent maternal-child health researcher developing clinical programs to improve birth
outcomes. This five-year mentored research proposal will support her goal through course work and
completion of mentored research. Candidate training will focus on three objectives: (1) motivational
interviewing, an evidence-based behavior change strategy, (2) implementation science, and (3) pragmatic
clinical trials. Research will address two specific aims. (Aim 1) will adapt care coordination and motivational
interviewing for women with a prior preterm birth. Using mixed methods, and starting with existing models of
pediatric care coordination, adaptation will focus on the needs of women with a history of preterm birth and on
integration of motivational interviewing. (Aim 1a: qualitative interviews; Aim 1b: iterative testing.) (Aim 2) will
conduct a pilot pragmatic randomized trial of usual care vs care coordination plus motivational interviewing for
women with a prior preterm birth. This trial will demonstrate intervention feasibility and estimate the effect size
of the intervention on health care utilization. Findings will inform an R...

## Key facts

- **NIH application ID:** 10249289
- **Project number:** 5K23HD102560-02
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Emily F Gregory
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $166,644
- **Award type:** 5
- **Project period:** 2020-09-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10249289

## Citation

> US National Institutes of Health, RePORTER application 10249289, The role of pediatric interconception care in preventing adverse birth outcomes (5K23HD102560-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10249289. Licensed CC0.

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