Supporting Pregnant Individuals in the Medicaid Population with a Community Based Intervention-A Feasible Study

Background: Those who are enrolled in Medicaid and from minoritized groups are more susceptible to adverse maternal outcomes and lack of support. A peer based community support program may be an effective way of helping these individuals through pregnancy through providing community, resources and tailored education. Objective: To determine feasibility of adapting a peer support program-Connect for Life (CFL) to the maternal health population in which local facilitators with shared lived experience run peer support groups with both nulliparous and multiparous mothers, provide support and community to each other. Methods: Through a feasibility study design, 1,482 expectant mothers were identified from claims data in greater Detroit, Michigan and grouped by geography and expected due date. Attendees were invited to the maternal CFL program which focused on education, practical exercises, access, navigation, social support and addressing social determinants needs. Routine operational metrics for engagement and running costs were collected and compared to engagement in the standard CFL program (N=16,911) that was provided to members enrolled in Medicaid in Detroit over the same time period. A subsample of expectant mothers completed a five point Likert survey that captured member sentiment of the maternal CFL program. Results: Of the 1,482 expectant mothers identified, 477 members were successfully contacted and 47 attended the maternal CFL program. This was higher than usual CFL attendance rates for the Medicaid population in the standard CFL program (3.17% vs. 1.58% (p=<0.01, 95% CI for difference (0.1%-2.5%)). Costs of running the program were significantly higher than the standard CFL program. 95% of surveyed members agreed or strongly agreed that the program improved knowledge and was valuable in the maternal CFL program. Discussion: The maternal CFL program appears to be a feasible peer support program for expectant mothers enrolled in Medicaid with member sentiment being high. The program has higher running costs than the standard CFL program, but its higher rate of attendance indicates sufficient demand amongst this Medicaid population. This feasibility study provides a foundation for further studies examining scalability, quality and cost effectiveness.