Appendix B. List of Participants

Speakers

Carolyn Clancy, M.D.
Director
Center for Outcomes and Effectiveness Research
Agency for Healthcare Research and Quality

Robert Goldenberg, M.D.
Charles E. Flowers Professor
Department of Obstetrics and Gynecology
University of Alabama at Birmingham

Kimberly Gregory, M.D., M.P.H.
Director of Women's Health Policy
Department of Obstetrics and Gynecology
Cedars-Sinai Medical Center

Margaret Hamburg, M.D.
Assistant Secretary for Planning and Evaluation
U. S. Department of Health and Human Services

Vijaya Hogan, Dr.P.H.
Lead Epidemiologist, Pre-Term Delivery Section
Pregnancy and Infant Health Branch
Division of Reproductive Health
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention

Milton Kotelchuck, Ph.D., M.P.H.
Professor
Maternal and Child Health
Boston University School of Public Health

Carolina Reyes, M.D.
Assistant Professor
University of California, Los Angeles
Division of Maternal-Fetal Medicine
Department of Obstetrics and Gynecology
Cedars-Sinai Medical Center

Christine Schmidt, M.P.A.
Deputy to the Deputy Assistant Secretary for Health Policy
Office of the Assistant Secretary for Planning and Evaluation
U. S. Department of Health and Human Services

Joanna Siegel, Sc.D.
Director
Research Initiative on Clinical Economics
Center for Outcomes and Effectiveness Research
Agency for Healthcare Research and Quality

Lisa Simpson, M.B., B.Ch., F.A.A.P.
Deputy Director
Agency for Healthcare Research and Quality

Participants

Doris Barnette, M.S.W.
Principal Advisor to the Administrator
Health Resources and Services Administration

Beth Benedict, Dr.P.H., J.D.
Social Service Research Analyst
Division of Beneficiary Studies
Health Care Financing Administration

Cindy Berg, M.D., M.P.H.
Medical Epidemiologist
Division of Reproductive Health
National Center for Chronic Disease
Prevention and Health Promotion
Centers for Disease Control and Prevention

Karla Damus, R.N., Ph.D., M.S.P.H.
Senior Research Associate
Office of the Medical Director
National March of Dimes

William Freeman, M.D., M.P.H.
Director
Research Programs
Indian Health Service

Fredric Frigoletto, Jr., M.D.
Chief of Obstetrics
Department of Obstetrics and Gynecology
Massachusetts General Hospital

Marcy Gross
Senior Advisor on Women's Health
Agency for Healthcare Research and Quality

Embry Howell, Ph.D., M.S.P.H.
Vice President
Health Division
Mathematica Policy Research, Inc.

Jeffrey King, M.D.
Director of Maternal-Fetal Medicine
Department of Obstetrics and Gynecology
Wright State University School of Medicine

Michael Kogan, Ph.D.
Director
Office of Data and Information Management
Maternal and Child Health Bureau
Health Resources and Services Administration

Gontran Lamberty, Dr.P.H.
Chief, Research Branch
Division of Research, Training and Education
Maternal and Child Health Bureau
Health Resources and Services Administration

Jean Lawrence, Sc.D., M.P.H., M.S.S.A.
Senior Investigator
Research and Evaluation
Kaiser Permanente, Southern California

Charles Lockwood, M.D.
Stanley H. Kaplan Professor and Chair
Department of Obstetrics and Gynecology
New York University School of Medicine

Alan Peaceman, M.D.
Associate Professor
Department of Obstetrics and Gynecology
Northwestern University Medical School

Andrea Pernack, M.P.H.
Health Policy Analyst
Office of the Assistant Secretary for Planning and Evaluation
U.S. Department of Health and Human Services

Caroline Taplin
Senior Policy Analyst
Office of the Assistant Secretary for Planning and Evaluation
U.S. Department of Health and Human Services

Judith Weiss, Sc.D.
Co-Director
Maternal Mortality and Morbidity Project
Bureau of Family and Community Health
Massachusetts Department of Health

Lynne Wilcox, M.D., M.P.H.
Director
Division of Reproductive Health
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention

Sumner Yaffe, M.D.
Special Assistant to the Director
National Institute of Child Health and Human Development
National Institutes of Health

Observers

Jeffrey Coben, M.D.
Director
Center for Violence and Injury Control
Allegheny General Hospital

Steven Fox, M.D., M.P.H., M.S.
Medical Officer
Center for Outcomes and Effectiveness Research
Agency for Healthcare Research and Quality

Linda Franklin
Program Analyst (Women's Health)
Agency for Healthcare Research and Quality

Henrietta Hubbard, R.N., M.P.H.
Special Assistant to the Director
Center for Outcomes and Effectiveness Research
Agency for Healthcare Research and Quality

Kerry Paige Nesseler, R.N., M.S.
Deputy Associate Administrator for Programs
Maternal and Child Health Bureau
Health Resources and Services Administration

Diane Rowley, M.D., M.P.H.
Associate Director for Science
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention

Eileen Salinsky, M.B.A.
Director
Division of Public Health Policy
Office of the Assistant Secretary for Planning and Evaluation
U.S. Department of Health and Human Services

Peter van Dyck, M.D., M.P.H.
Associate Administrator
Health Resources and Services Administration

Facilitator

Lawrence Bartlett, Ph.D.
Director
Health Systems Research, Inc.

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Appendix C. Prenatal Care Research Sponsored by HHS, September 2000

The following matrix is a compendium of recent prenatal care research sponsored by agencies within the Department of Health and Human Services (HHS). It was Current as of September 2000. This list was compiled from various resources from HHS agencies (e. g., agency research plans, compilations of agency research as provided through Internet resources, informal surveys within agencies, additional information provided by agency staff ). Although we attempted to be as comprehensive as possible, we expect that there are additional research projects that are not included in this chart. The research projects are sorted by sponsoring agency.

Title	Investigator	Source	Performing Organization	Sponsoring Agency	Objective
Prenatal Care Barriers for Low and Moderate- Income Women	Paula Braveman	National Library of Medicine	University of California, San Francisco	Agency for Healthcare Research and Quality (AHRQ)	Study access to prenatal care in California women (with income below 250 percent of poverty in different insurance & ethnic groups) following expansions of poverty level and demographic change due to immigration. Determine the extent to which personal and systems barriers act alone or in concert with financial barriers to deter adequate use of prenatal care.
Low Birthweight in Minority Women and High- Risk Women	Robert L. Goldenberg	AHRQ	University of Alabama, Birmingham, Albert Einstein College of Medicine	AHRQ	Advance the scientific knowledge base about variation in and effectiveness of obstetrical practices and other interventions aimed at the prevention of low birthweight (LBW) and negative sequelae.
Medicaid Managed Care and the Oregon Health Plan	Alison Buist	National Library of Medicine	Johns Hopkins University	AHRQ	Identify and explore the extent to which prenatal care for low-income women has changed in Oregon as a result of changes following implementation of the Oregon Health Plan (OHP), which requires that Medicaid beneficiaries enroll in managed care.
Childbirth PORT (Patient Outcomes Research Team)	Emmett Keeler	AHRQ	RAND	AHRQ	Examine use and outcomes of cesarean delivery versus alternatives, including oxytocin, trial of labor, and normal and assisted vaginal delivery.
Developing Culturally and Linguistically Appropriate Prenatal Care Education	Virginia Gonzales	National Library of Medicine	University of Washington	AHRQ	Improve prenatal care for Spanish-speaking women in managed care populations by increasing their access to effective prenatal health education and develop general guidelines for culturally and linguistically appropriate health education materials.
Evaluating a Decision Tool for Prenatal Testing	Miriam Kuppermann	National Library of Medicine	University of California, San Francisco	AHRQ	Evaluate computerized prenatal testing decision- assisting tool for making choices about diagnostic testing for fetal chromosomal abnormalities.
Pregnancy Risk Assessment Monitoring System (PRAMS): numerous studies	Mary Rogers, Mary Lyn Gaffield, Suzanne Zane	Centers for Disease Control and Prevention (CDC), Division of Reproductive Health (DRH) Survey	State Health Departments, CDC/DRH	State Health Departments, CDC/DRH	Recent focus areas of study at CDC include: -content of prenatal care. -characteristics of women who do not receive ACOG- recommended messages. -barriers to oral healthcare services. -effects of welfare reform on prenatal care use. -effects of intimate partner violence on delayed entry into prenatal care. -socioeconomic disparity in use of prenatal care. -factors related to early entry into prenatal care.
Surveillance for Prenatal Care among Native American Populations	Health depts of various Native American Tribes; technical assistance from CDC/DRH	DRH Survey	Native American tribes	Indian Health Service	Conduct household based surveys: face to face interviews of American Indian women and men 18 years of age and older, including questions on prenatal care.
Maternal Infant Rapid Intervention at Delivery		CDC, DRH Survey		CDC/DRH	Develop, implement and evaluate strategies to provide integrated reproductive health services to women who present in labor with no prenatal care. Includes counseling on contraception and reproductive decisionmaking, early enrollment in prenatal care for future pregnancies, screening and treatment for STDs, provision of barrier methods of contraception; and for HIV-positive women, provision of HIV-related medical care.
Reproductive Health Status of Incarcerated Women in the State of Georgia	Lori deRavello, Dabo Brantley	DRH Survey	CDC/DRH	CDC/DRH; Georgia Department of Corrections; Georgia Division of Public Health	Conduct a retrospective study comparing birth outcomes among pregnant women incarcerated in Georgia for 1998-99.

 

Title	Investigator	Source	Performing Organization	Sponsoring Agency	Objective
SPEAC: Preterm Birth Among Inner City Women: Bacterial Vaginosis, Stressors, and Race	Virginia Rauh, Jennifer Culhane	DRH Survey	Health Federation of Philadelphia	CDC/DRH	Conduct a cross-sectional study of the prevalence of bacterial vaginosis (BV) and stress and determine other factors that are associated with these; use a prospective cohort design to study the association among BV, stressors, and preterm delivery.
Maternal Effects of Treatment for Bacterial Vaginosis	Jane Hitti	DRH Survey	University of Washington	CDC/DRH	Conduct a prospective, randomized trial of oral vs. intravaginal metronidazole for the treatment of bacterial vaginosis among pregnant women at low risk for preterm delivery. Study side effect profiles of each administration mode, compare the efficacy, and compare the effects on reduction of preterm delivery.
Harlem BirthRight	Leith Mullings, Alaka Wali	DRH Survey	New York Urban League	CDC/DRH	Document the contexts of pregnancy among African-American women in Central Harlem, New York City and disseminate this information to other public health and medical professionals.
Healthy African American Families (HAAF)	Loretta Jones	DRH Survey	Drew University	CDC/DRH	Define the context of pregnancy among African-American women and their families in Los Angeles. Qualitative research was conducted to understand the roles of health care, stress, family relationships, spirituality, nutrition, and work during pregnancy and to develop community and family asset models for prevention and intervention activities.
An Analysis of the Use of Urine Cotinine as a Measure of Tobacco Exposure in Pregnant Women	Lucinda England	DRH Survey	CDC/DRH	CDC/DRH	Evaluate the relationship between reported cigarette consumption and urine cotinine and the relationship between exposure and birthweight by analyzing Smoking Cessation in Pregnancy (SCIP) data.
Tobacco Exposure and Birthweight at Term	Lucinda England	DRH Survey	CDC/DRH	CDC/DRH	Analyze Smoking Cessation in Pregnancy (SCIP) data to evaluate effects of smoking reduction on birthweight in term infants.
Multi-Site Collaboration on Infection During Pregnancy	Sabina Cauci	DRH Survey	CDC/DRH	CDC/DRH	Conduct a multi-center collaborative study to assess the effect of IgA on levels of preterm delivery, particularly its effect in women with diagnosed bacterial vaginosis.
Social Networks Project	Michelle Kelley	DRH Survey	University of Illinois at Chicago Prevention Research Center	CDC/DRH	Through the use of community-university partnered research, document and understand the impact of social networks on access to prenatal care.
Uterine Rupture Associated with Trials of Labor for Vaginal Birth after Cesarean Section (VBAC)	Judy Weiss, Linda Bartlett	DRH Survey	Massachusetts Dept. of Health, CDC/DRH	Massachusetts Dept. of Health, CDC/DRH	Study uterine rupture rates for 1990-1997, describe the characteristics of the women who have ruptured uteri associated with a trial of labor for VBAC, explore the feasibility of predicting which women will have more severe ruptures and describe the outcomes of the women and their infants.
Investigation of Factors Associated with Maternal Mortality	Stacy Geller	DRH Survey	University of Illinois at Chicago	CDC/DRH	Evaluate prenatal and intrapartum quality of care and effect on survival among women with severe pregnancy morbidity.

 

Title	Investigator	Source	Performing Organization	Sponsoring Agency	Objective
Maternal Morbidity Caused by Infectious Agents	Linda Cushman	DRH Survey	Columbia University	CDC/DRH	Study the extent of maternal morbidity due to infectious agents among low income, predominantly Hispanic and African American, clinic patients at a large urban medical center; identify racial, ethnic, and sociodemographic differences in infection related maternal morbidity; share findings with practitioners and community groups to develop culturally sensitive prevention strategies.
Evaluation-Demonstration Improving Access to Care for Pregnant Substance Abusers	Embry Howell	National Library of Medicine	Mathematica Policy Research, Inc	Centers for Medicare & Medicaid Services (CMS), (formerly Health Care Financing Administration, HCFA)	Evaluate a demonstration to improve Medicaid access to care for pregnant substance abusers that is being implemented in five States: Maryland, Massachusetts, New York, South Carolina, and Washington State.
Maternal Birthweight and Reproductive Outcomes	Irvin Emanuel	National Library of Medicine	University of Washington	HRSA/ MCHB	Investigate the intergenerational relationships between the mother's birthweight and other maternal factors with several complications of pregnancy and birth outcomes.
Satisfaction with and Use of Prenatal Care	Arden Handler	National Library of Medicine	University of Illinois	HRSA/ MCHB	Determine whether the characteristics of prenatal care are related to a woman's satisfaction (independent of the woman's personal characteristics). Hypothesize that relationship between care characteristics and satisfaction do not differ for black Medicaid and non-Medicaid recipients.
Birth Record Enhancements of the New York State Medicaid Managed Care Encounter System	Patrick Roohan	National Library of Medicine	New York State Department of Health	HRSA/ MCHB	Monitor and assess the effects of the State's mandatory Medicaid Managed Care (MMC) program on MCH goals and objectives by incorporating birth record data and prenatal and birth outcome reports into the New York State Medicaid Encounter Data System (MEDS).
Healthy Families in a Healthy Community	Stephen Weeg	National Library of Medicine	Harms Memorial Hospital	HRSA/ MCHB	Study a frontier county with a large population of Hispanic migrant farm workers and a deficit of health services where mothers are 47% less likely than mothers statewide to receive adequate prenatal care. The objective is to increase the number of women using adequate prenatal care services to the Healthy People 2000 goal of 90%.
Honoring Our Children	Dale Wolf	National Library of Medicine	Great Lakes Inter- Tribal Council, Inc. (GLITC)	HRSA/ MCHB	Improve the health and well being of Native American children including assisting tribal partners with their efforts to reduce infant mortality and to increase the utilization of prenatal visits and well-child care.
Asthma Observational Study	Mitch Dombrowski	National Institute of Child Health and Human Development (NICHD) Maternal Fetal Medicine Units (MFMU) Network	Wayne State University	National Institute of Child Health and Human Development (NICHD) & National Heart, Lung, and Blood Institute (NHLBI)	Assess the relationship between moderate to severe asthma and adverse perinatal outcome, as compared with non-asthmatic controls.
Asthma Randomized Clinical Trial	Mitch Dombrowski	NICHD MFMU Network	Wayne State University	NICHD & NHLBI	Determine whether regular inhaled beclomethasone for patients with moderate asthma during pregnancy results in better asthma control than oral theophylline.
BEAM Randomized Clinical Trial	Dwight Rouse	NICHD MFMU Network	University of Alabama at Birmingham	NICHD & National Institute of Neurological Disorders and Stroke (NINDS)	Determine whether intravenous magnesium sulfate given to women remote from term, and for whom delivery is imminent can reduce the risk of cerebral palsy in their children.

 

Title	Investigator	Source	Performing Organization	Sponsoring Agency	Objective
Bacterial Vaginosis Randomized Clinical Trial	Chris Carey and Mark Klabanoff	NICHD MFMU Network		NICHD	Test whether administration of metroniadazole to asymptomatic women with bacterial vaginosis reduces the risk of preterm delivery.
Cesarean Registry Observational Study	Mark Landon	NICHD MFMU Network	Ohio State University	NICHD	Determine the characteristics of women undergoing a trial of labor and determine the efficacy and safety of a trial of labor; determine cesarean delivery rates by payer and provider status and describe complications and factors influencing outcome in women undergoing cesarean delivery.
Cervical Ultrasound Observational Study	John Owens	NICHD MFMU Network	University of Alabama at Birmingham	NICHD	Assess the relationship between shortened cervical length before 24 weeks gestation and subsequent spontaneous preterm delivery.
Factor V Leiden Observational Study	Donna Dizon-Townson	NICHD MFMU Network	University of Utah	NICHD and Office of Research on Women's Health (ORWH)	Determine the incidence of pregnancy-related thromboembolism in women carrying the FVL mutation and determine the effects of thrombophilia on the risk of thromboembolism.
Fetal Fibronectin Randomized Clinical Trial	William Andrews	NICHD MFMU Network	University of Alabama at Birmingham	NICHD	Test whether prophylactic antibiotic therapy administered to women with elevated mid-trimester fetal fibronectin decreases the risk of spontaneous preterm delivery.
Progesterone Randomized Clinical Trial	Paul Meis	NICHD MFMU Network	Wake Forest University	NICHD	Establish whether weekly progesterone injections for women who have experienced a previous spontaneous preterm delivery reduces the risk of preterm birth.
Repetitive Steroids Randomized Clinical Trial	Ronald Wapner	NICHD MFMU Network	Thomas Jefferson University	NICHD	Test whether a regimen of weekly courses of steroids is safe and effective compared with the single course.
Trichomonas vaginalis Randomized Clinical Trial	Chris Carey and Mark Klabanoff	NICHD MFMU Network		NICHD	Test whether administration of metronidazole to asymptomatic women with Trichomonas vaginalis reduces the risk of preterm delivery.
Mild Gestational Diabetes Randomized Clinical Trial	Mark Landon	NICHD MFMU Network	Ohio State University	NICHD	Determine whether identification and dietary treatment of women with mild gestational diabetes reduces the risk of delivering a large for gestational age infant compared with standard care.
Preeclampsia Prediction	Les Myatt and Menachem Miodovnik	NICHD MFMU Network	University of Cincinnati	NICHD	Determine whether biochemical or biophysical markers, individually or in combination, can predict the development of preeclampsia.

 

Title	Investigator	Source	Performing Organization	Sponsoring Agency	Objective
Genetic Asthma Study	Mitch Dombrowski	NICHD MFMU Network	Wayne State University	NICHD	Determine whether homozygosity of specific polymorphisms is associated with clinically significant functional changes in asthma severity.
Antioxidant Trial	Jim Roberts	NICHD MFMU Network	University of Pittsburgh	NICHD	Determine if antioxidant therapy prevents preeclampsia.
Fetal Pulse Oximetry	Steven Bloom	NICHD MFMU Network	University of Texas Southwestern	NICHD	Measure the impact of fetal oximetry as an adjunct to conventional electronic fetal heart rate monitoring on the overall cesarean delivery rate.
Smoking Cessation	Robert Goldenberg	NICHD MFMU Network	University of Alabama at Birmingham	NICHD	Determine whether smoking cessation therapy results in increased birthweight and/or an increased rate in smoking cessation during pregnancy.
Prenatal Care Use and Adverse Health Behaviors During Pregnancy	L. A. Maiman	National Library of Medicine	NICHD	NICHD	Study behavioral and social support interventions to improve early entry to prenatal care and adherence to the visit schedule and decrease adverse health behaviors during pregnancy.
Cost-Effectiveness of Perinatal Substance Abuse Programs	Jerry Cromwell	National Library of Medicine	Center for Health Economics Research	National Institute on Drug Abuse (NIDA)	Identify and quantify a wider range of costs and assess the extent to which alternative treatments are effective in reducing those costs.
Drug Treatment and Care During Pregnancy in HIV-Positive Women	Stephen Crystal	National Library of Medicine	State University of New Jersey, New Brunswick	NIDA	Study the impact of drug use, drug abuse, treatment, psychiatric comorbidity, characteristics of HIV-related health care, and other factors on access to prenatal care and adherence to recommendations to prevent vertical transmission of HIV.
Perinatal Assessment, Referral, and Service Use	Dorie Klein	National Library of Medicine	Western Consortium for Public Health	NIDA	Examine the formulation and implementation of California's 1990 law (SB 2669) mandating protocols for identifying and intervening in cases of prenatal substance use or exposure.
Use of Health Care by Drug-Using Pregnant Women	Donna Strobino	National Library of Medicine	Johns Hopkins University	NIDA	Describe the prenatal and other health care use of drug-abusing pregnant women and examine the factors that are related to the Health Belief Model.

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AHRQ Publication No. 02-0025
Current as of June 2002