Reshaping Postpartum Follow-up

Study Overview
=================
Brief Summary
-----------------
The aim of this study is to evaluate the impact of personalized postpartum follow-up cards on completion of postpartum health related tasks. The intervention will consist of a card given to patients at time of discharge. One side of the card will list the patient's name and a list of recommended postpartum follow-up appointments based on their diagnoses at the time of discharge. Participants will be randomized to this intervention or the control group, which will consist of standard education routinely given at discharge. The primary endpoint will be the rate of completion of a postpartum blood pressure check or two hour glucose tolerance test, or both, depending on the patient's discharge diagnosis within the first year after discharge. The secondary endpoints will include establishing care with a primary care provider within the first year after delivery, or completion of postpartum pap smear or colposcopy, as indicated.

Official Title
-----------------
Reshaping Postpartum Follow-up in Women With High Risk Pregnancies

Conditions
-----------------
Hypertension in Pregnancy, Gestational Diabetes, Cervical Dysplasia

Intervention / Treatment
-----------------
* Behavioral: Postpartum follow up card
* Other: Control


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Subjects >=18 years of age Ability to read English or Spanish Delivered via vaginal delivery or c-section within the past 48 hours Able to consent for themselves Exclusion Criteria: Received antepartum care at a facility outside of the Medstar system or plans to continue care with a facility outside of the Medstar system

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Follow up cards<br>Subjects will receive a personalized postpartum health card with recommendations for follow up based on their comorbid conditions in pregnancy. They will receive education about these comorbid conditions when they receive their cards. | Behavioral: Postpartum follow up card<br>* The intervention will consist of a card given to patients at time of discharge. One side of the card will list the patient's name and a list of recommended postpartum follow-up appointments based on their diagnoses at the time of discharge. The back of the card will list relevant phone numbers to assist patients with scheduling.<br>|
| Placebo Comparator: Standard education<br>Subjects will receive standard postpartum education as it is routinely performed by nurses prior to discharge. | Other: Control<br>* No deviation from standard discharge education<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood pressure check | Rate of attendance at a blood pressure check one week postpartum | 6 months | 
| Two hour glucose tolerance test | Rate of completion of two hour glucose tolerance test at six weeks postpartum | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cervical cancer screening | Rate of completion of postpartum pap smear or colposcopy as indication | 6 months | 
| Primary care | Rate of attendance at visit with primary care provider for annual exam | 6 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Postpartum followup, hypertensive disorders of pregnancy, eclampsia, pre-eclampsia, pap smear, gestational diabetes