Concept: Advancing the Science of Complementary and Integrative Health Approaches To Improve Maternal Health Outcomes

Project Concept Review

Council Date: September 13, 2024     

Program Directors: Beda Jean-Francois, Ph.D. and Lanay M. Mudd, Ph.D.

Background

Among high-income countries, the United States has the highest maternal mortality rate. Improving maternal health is a national priority as reflected by the White House Blueprint for Addressing the Maternal Health Crisis. The Executive Order on Advancing Women’s Health Research and Innovation (EO 14120) signed by President Biden in March 2024 includes a comprehensive set of actions to ensure health issues of women across the lifespan are integrated across the Federal research portfolio and budget. The national focus on the maternal health crisis and women’s health has resulted in several research initiatives by the National Institute of Health (NIH). One NIH initiative is the Implementing a Maternal health and PRegnancy Outcome Vision for Everyone (IMPROVE), launched in 2019 to support research to address the high rates of pregnancy-related complications (i.e., severe maternal morbidity) and deaths (i.e., maternal mortality) in the United States. 

The IMPROVE effort, led by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) in collaboration with the Office of Research on Women’s Health (ORWH) and the National Institute of Nursing Research (NINR), is a multipronged initiative designed to build the evidence-base of maternal health–related solutions for all women to promote maternal health equity. The initiative encompasses several integrated components, including the Maternal Health Research Centers of Excellence (CoEs) funded in 2023. The goal of the Maternal Health Research CoEs is to utilize innovative approaches to design and conduct research projects in partnership with communities most affected (i.e., populations with health disparities; maternity care deserts) to reduce preventable causes of maternal deaths and improve health for women before, during, and after pregnancy. With support from a Data Innovation and Coordination Hub and the Implementation Science Hub, the research centers will share lessons learned, participate in trainings and research, and disseminate their results. In addition to conducting research projects and building community partnerships, the centers have a robust training and professional development element to grow the maternal health workforce. To date, there are 12 CoEs, 125 community partners, and over 20 research projects.

Although the CoEs are exploring a wide diversity of topics and conditions that impact maternal health, complementary and integrative health approaches are not included in the interventions proposed by the research centers. Thus, there is an opportunity to expand the science of the CoEs to include these approaches and build the evidence base of complementary and integrative approaches to promote healthy pregnancies and enhance maternal health outcomes. Systematic reviews and meta-analyses support the need for more rigorous studies to strengthen the evidence base of nonpharmacologic interventions to enhance maternal health outcomes.

Purpose of Proposed Initiative

The purpose of the proposed initiative is to support research to improve the evidence base of complementary and integrative health approaches, including nutritional, psychological, and/or physical approaches, to promote healthy pregnancies and enhance maternal health outcomes. The initiative aligns well with NCCIH’s strategic priorities on whole person health and health disparities.

Objectives

The objectives to be met by the initiative include but are not limited to the following: 

• Leverage the infrastructure of the funded IMPROVE maternal health research CoEs to expand current projects and/or propose new pilot projects to test the feasibility of utilizing complementary and integrative health approaches that include psychological, physical, and/or nutritional inputs to promote healthy pregnancies and enhance maternal health outcomes.
• Stimulate the NCCIH maternal health portfolio by developing a cadre of investigators to conduct research to enhance maternal health outcomes in the pre-pregnancy, pregnancy, or postpartum period.
• Promote partnerships between IMPROVE investigators and complementary and integrative health investigators.