# Identifying and Addressing Social Determinants of Health in Pregnant Women

> **NIH NIH R43** · POISERA, INC. · 2024 · $443,887

## Abstract

ABSTRACT
Maternal morbidity and mortality place a substantial financial burden on Medicaid. Medicaid finances about 41% of all births in the United States. Among women covered by Medicaid, those with severe maternal morbidities (SMM) have an average per-patient cost of care that is 2.75 times higher than those without SMM. In particular, non-Hispanic Black women (hereafter referred to as Black) have a 70% greater risk for SMM. Health-related needs, such as housing instability, food insecurity, unreliable transportation, employment instability, financial strain, and interpersonal violence, contribute to high SMM rates. Maternal mortality rates are three times higher among non-Hispanic Black (hereafter referred to as Black) than White women. Infant mortality rates are more than twice as high for Black than White infants. The National Institute of Minority Health and Health Disparities Strategic Plan identifies interventions to address the egregious disparities in severe maternal mortality and morbidity between Black and White women as an important unmet need. This project aims to increase prenatal care utilization and SMMovercome these disparities by screening and addressing the Social Determinants of Health (SDoH)health-related needs impeding the health and well-being of Black pregnant women. SDoH are social, economic, and environmental conditions that have been found to mediate between racial and ethnic health disparities and these tragic maternal health outcomes. YetPresently, no standard of care exists for how and when to screen for health-related social needs in pregnancy, let alone address them. Clinicians acknowledge the risks associated with SDoH health-related needs in pregnancy, yet few feel equipped to address them with their patients. Moreover, Black pregnant women do not trust clinicians to discuss social health-related needs due to fear of judgment, stigma, or even loss of parental rights. The product of this SBIR project is personalized and culturally competent chatbot conversations to screen and address SDoH health-related needs for Black pregnant women. We have developed a mobile health app to seamlessly monitor and screen for maternal mood disorders for women from early pregnancy through 36 months postpartum via chatbot, then refer to a behavioral health consultant when risk is detected. A preliminary study demonstrated our app had a 10X higher 30-day user retention compared to an average mental health app. This project will augment our existing app to also screen pregnant women for SDoH health-related needs each trimester and refer them to local social support services. The chatbot will follow up weekly until the need is addressed or refer to a human case worker if unaddressed after a month. Integrating health-related need SDoH screening and referral into a mHealth app that already screens and treats maternal mood disorders is an innovative approach to identifying and addressing multiple risk factors for maternal morbidity and mo...

## Key facts

- **NIH application ID:** 10815313
- **Project number:** 1R43MD019166-01
- **Recipient organization:** POISERA, INC.
- **Principal Investigator:** Marianna Kerppola
- **Activity code:** R43 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $443,887
- **Award type:** 1
- **Project period:** 2024-08-13 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10815313

## Citation

> US National Institutes of Health, RePORTER application 10815313, Identifying and Addressing Social Determinants of Health in Pregnant Women (1R43MD019166-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10815313. Licensed CC0.

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