Improving postpartum-to-primary care transitions for people with chronic conditions

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This randomized controlled trial embeds a behavioral-economics-informed, multi-component intervention into usual inpatient postpartum care to strengthen handoffs from obstetrics to primary care. Key components include default primary care visit scheduling, tailored nudge messages to patients, and ongoing care recommendations sent to clinicians. Outcomes will be measured repeatedly using administrative data and patient surveys to capture primary care engagement, quality, and patient experience. The goal is to produce actionable evidence to make obstetric-to-primary care coordination a standard part of postpartum care.

Why it matters

Who can join: the full rules

Inclusion Criteria

* Receiving obstetric care at an MGH-affiliated obstetrics practice (except for the MGH HOPE Clinic, which has a unique care model that provides prenatal and postnatal care for individuals with substance use disorder, including the provision of primary care through 2+ years postpartum)
* Pregnant with a live fetus or delivered a live-born neonate ≥24 weeks of gestation, based on the clinical estimate of gestational age
* If postpartum, has a neonate that is currently living at the time of enrollment
* Has one or more of the following conditions listed in the "Problem List," "Medical History," or clinical notes during prenatal, intrapartum, or postpartum encounters in the EHR (or in the case of BMI, the patient's anthropometric measurements):

  * Chronic or essential hypertension
  * Hypertensive disorders related to pregnancy (e.g., pre-eclampsia)
  * Type 1 or 2 diabetes (i.e., pre-existing diabetes)
  * Gestational diabetes
  * Class II Obesity (pre-pregnancy body mass index ≥35 kg/m2; or if pre-pregnancy body mass index is not known, a first trimester BMI of ≥35 kg/m2)
  * Depression or anxiety disorder
* Has a primary care clinician listed in the patient's medical record
* Has access to or agrees to be enrolled in the electronic health record patient portal and consents to be contacted via these modalities
* Able to read/speak English or Spanish language
* Is age ≥18 years old

Exclusion Criteria

• Any individual not meeting all inclusion criteria

Where it's running

• Massachusetts General Hospital
  Boston, Massachusetts, United States Recruiting

Study contacts

• Principal investigator: Mark A Clapp, MD, MPH — Massachusetts General Hospital
• Study coordinator: Mark A Clapp, MD, MPH
• Email: mark.clapp@mgh.harvard.edu
• Phone: 617-726-2000

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.