ABSTRACT A Career Development Award in Global Postpartum Health This application is for a Fogarty International Center K01 International Research Scientist Development Award (IRSDA) for Dr. Bridget Spelke, MD, an obstetrician-gynecologist and research fellow in Global Women's Health at the University of North Carolina (UNC). Dr. Spelke is in the formative stages of her research career and aims to establish herself as an independent investigator and future leader in the area of global postpartum health, a high-risk period that has been neglected for too long. She has lived full-time in Lusaka, Zambia since August 2019 where she has established a solid career foundation for clinical research in obstetric outcomes for women in resource-constrained settings. Dr. Spelke's proposed K01 research will leverage a recent expansion of the Zambian Preterm Birth Prevention Study (ZAPPS), a long-standing pregnancy cohort that is following women and their infants through 12 months postpartum. Dr. Spelke will study a novel strategy to identify women at risk for severe maternal morbidity and mortality in the first week after delivery: continuous remote physiologic monitoring with easy-to-use, multiparameter, wearable sensors. To inform the design of a future hybrid effectiveness-implementation trial, Dr. Spelke proposes a mentored research program that will estimate the frequency of severe maternal morbidity in the ZAPPS cohort (Aim 1); implement a pilot randomized feasibility trial of postpartum physiologic monitoring (Aim 2); and evaluate barriers and facilitators to adoption of a digital health intervention in a resource-constrained setting through implementation research frameworks (Aim 3). These three research aims will provide preliminary data toward the design of a future trial. They are interrelated and independent of each other; study results will advance research on digital and postpartum health in resource- constrained settings regardless of outcomes. Each of these studies aligns with individualized career development goals in clinical trials design and analysis, implementation research for digital health technologies, and collaborative global health research partnerships. Dr. Spelke has assembled a highly accomplished and eminently qualified mentorship team comprising: her primary Zambia mentor, Prof. Bellington Vwalika, an expert in clinical trials implementation in sub-Saharan Africa; her primary US mentor, Prof. Elizabeth Stringer, an expert in maternal-fetal medicine and maternal health epidemiology; and her core mentor, Prof. Ben Chi, an expert in implementation science in sub-Saharan Africa. All three mentors have decades of experience in collaborative global health partnerships and extensive experience mentoring early career researchers. The IRSDA will advance Dr. Spelke's skills in each of these fields, supporting both didactic and practice-based learning opportunities, as she establishes her independent area of investigation and progresses to...