Postpartum Access to Healthcare (PATH)

Overview

This one-year project (January-December 2019) seeks to improve access to care during the critical postpartum period. The specific aims are to:

  1. Document the experiences of underserved women when navigating the healthcare system after delivery and through the postpartum period, including the transition between the public insurance programs.

  2. Assess how state level programs are understood, utilized, and integrated by providers and by the local healthcare systems.

  3. Develop recommendations to improve women’s experiences with accessing postpartum care.

This project will describe the healthcare system from the perspectives of postpartum women, provide information on how state programs such as Healthy Texas Women are being implemented and experienced by the population they aim to serve, and identify factors influencing program effectiveness and utilization. This project will also assess how state programs can best be integrated with local programs to maximize resources and improve women’s access, experiences, and health. Recommendations will include shorter-term strategies, such as approaches to increase knowledge and effective sharing of resources; and longer-term strategies that may involve organizational, systems and policy changes. This project will result in plain-language materials targeting a variety of audiences, including providers, policy makers and state-level administrators, as well as academic publications.

 

Intervention by:

 
 

Methods

We will enroll a cohort of 20-30 women in late pregnancy who are eligible for Medicaid for Pregnant Women or CHIP Perinate and live in Travis, Williamson, Hays, Caldwell, or Bastrop. We will follow participants through 3-6 months postpartum, documenting their health care needs and experiences when seeking health-related information and care. Data will be collected through interviews, participant journaling, and focus groups, and will address overall well-being, perceptions of healthcare needs, perceived resources and options related to care, and experiences when seeking care, from setting the appointment through follow-up contacts with providers. We will also use provider lists for public insurance programs and key informant interviews with health clinic staff to document and describe the availability of care as well as staff understanding, experience with, and perspective on relevant state programs.

At the outset of the project, we will convene an advisory group including local health care providers, staff from community-based organizations, and state agency staff. This group will provide guidance and support throughout the data collection process. After data collection and analysis, the advisory group and other community stakeholders will help identify key issues and remaining information gaps, and generate short- and longterm recommendations for system improvement.

Funding and Support

PATH is a project of UT System Office of Health Affairs Population Health and the Texas Collaborative for Healthy Mothers and Babies (TCHMB), with support from the St. David’s Foundation.

Subcommittee
Community Health

Project Lead
Eileen Nehme, PhD, UT Health Northeast, Affiliate of The University of Texas System. 512-852-3235 (Office).

Chairs
June Hanke, MSN, MPH, Harris Health System
Janet Jones, MPH, CHES, Waco-McLennan County Public Health District