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SMOOTH study: Social Maternity Care: a cOmbined medical and psychOsocial approach for a healTHy start of life

Projectomschrijving

SMOOTH studie: Sociale verloskunde voor een gezonde start

Doel

Stapeling van medische én niet-medische risico’s veroorzaken verschillen in perinatale uitkomsten. Armoede en achterstand hebben een substantieel effect op de gezondheid en welzijn van zwangere vrouwen en hun (ongeboren) kinderen. Dat vraagt naar meer samenwerking tussen de geboortezorg en het sociale domein voor vrouwen die naast medische ook psychosociale zorg nodig hebben: sociale verloskunde.

Aanpak en verwachte resultaten

In Groningen en Zuid-Limburg zijn veelbelovende aanpakken ontwikkeld om zorg voor vrouwen in kwetsbare situaties te verbeteren, maar effectieve disseminatie en duurzame implementatie is een volgende uitdaging. In deze studie gaan we samen met cliënten en partners in de geboortezorg en het sociale domein de aanpakken door ontwikkelen en bouwen we verder aan een goede samenwerking tussen alle zorgverleners uit het medische en het sociale domein. Vervolgens evalueren we deze samenwerking en onderzoeken we de impact van de aanpakken op uitkomsten bij moeder en kind in beide regio’s.

Producten

Titel: SAMEN VOOR GEZONDHEID 2
Auteur: Jessie Lemmens MSc, Darie Daemers PhD, Marijke Hendrix PhD, Marianne Nieuwenhuijze PhD
Titel: Overzicht van bevorderende en belemmerende factoren tbv implementatie SVg aanpakken Groningen en Zuid-Limburg
Auteur: Daemers D, Feijen-de Jong E, Hendrix M, Nieuwenhuijze M
Titel: Handleiding Kansrijke Start Zuid-Limburg - concept
Auteur: Academie Verloskunde Maastricht ea.
Titel: Werkplan Implementatieplan VSV's
Auteur: Hendrix M, Daemers D, Brouwers C, Peeters B, Coolen H.

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Samenvatting van de aanvraag

BACKGROUND Adverse perinatal outcomes show large variations within the Netherlands and are caused by an accumulation of medical and non-medical factors. Poverty and stress seem to have an important effect on health and wellbeing of Dutch pregnant women, their newborns and their children in adulthood. Although we have developed promising approaches to improve outcomes for these vulnerable women and newborns, effective dissemination and sustainable implementation of these approaches is the next challenge. However, this process of transition is complex and time consuming. More knowledge is needed to have the approaches sustainably embedded in the working practices of professionals from the medical and social domain. RELEVANCE There is a national call for a transition to social maternity care in which professionals and organizations from obstetric and social care work together to contribute to adequate care for women in vulnerable situations. Since 2020 researchers, professionals and client representatives in Groningen and South Limburg have been working together to gather and share knowledge in the project ‘Samen voor Gezondheid’ (SVG). In these regions, two different approaches have been developed, disseminated and evaluated to 1) improve the identification of psychosocial risk factors in pregnant women by midwives and 2) establish collaboration with Youth Health Care (YHC). In Groningen, the Alpha-NL is used to identify psychosocial risk factors in pregnant women. If risk factors occur, the midwife can contact the YHC by telephone. 17 care pathways support care. In Limburg, midwives use a questionnaire for psychosocial history to identify women in vulnerable situations. The Positive Health dialogue tool is used to support self-direction of women regarding possible health needs and to identify resilience. Each midwifery practice is linked to a YHC nurse for further support or care. However, within the scope of this project sustainable implementation is not feasible. Preliminary results are promising in terms of identification of vulnerable pregnant women and collaboration between midwives and YHC to guide women to social care if relevant. Once sustainable implementation is achieved (the difference in) the impact of both approaches for women and their (unborn) child and for professionals can be investigated. AIM The aim of the SMOOTH study is 1) to realize sustainable implementation of the two optimized SVG-approaches in co-creation with an interdisciplinary team of professionals and women and come to recommendations for national roll-out 2) to compare the impact of the optimized SVG-approaches on the well-being and self-direction of pregnant women and their (unborn) child and on perinatal maternal and child outcomes, in both regions. METHODS To examine these objectives, we propose a mixed methods study consisting of 4 parts with quantitative and qualitative study designs among women in vulnerable situations and maternity and social care professionals in the regions of Groningen and South Limburg. In part 1 (months 1-12) we develop sustainable implementation strategies based on the results from the SVG project, in co-creation with professionals (n=100) and women (n=20), using the A-EBCD technique. Subsequently, these strategies will be applied in Groningen en South Limburg In part 2 (months 15-36) we monitor the effectiveness of the implementation strategies on the execution of the approaches (process evaluation). Therefore, we conduct a multiple-case study with a sample of pregnant women (n=48) and a survey study among all professionals involved. In part 3 (months 13-44) we monitor the impact of the approaches on perinatal mother and child outcomes (effect evaluation). Therefore, we conduct a prospective cohort study among n=6000 women using medical records. In addition, we examine the perceived values of the approaches for professionals (n=24-30) and women (n=48) involved using the Most Significant Change technique. In part 4 (months 42-48), we will synthesize the results and place them in a broader context of social maternity care and will provide recommendations for the approaches and how to achieve their sustainable implementation in co-creation with women and professionals. We will apply various underlying models as theoretical framework for this study complemented by co-creation-approaches to take context and setting into account. KNOWLEDGE TRANSFER We will develop a factsheet to disseminate the results and recommendations of our project nationally and regionally and to support regional coalitions and VSVs in sustainably implementing regional social-medical collaboration. Further, the results of this study will be disseminated by scientific journals, conferences and social media. The results will be specifically brought to the attention of stakeholders and interested parties of Solid Start and social maternity care and to relevant educators to include in their curricula.

Kenmerken

Projectnummer:
05430052110001
Looptijd: 54%
Looptijd: 54 %
2022
2026
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
dr. M. Hendix
Verantwoordelijke organisatie:
Zuyd Hogeschool