Research

Research

Our research deepens the knowledge base on issues related to maternal and child health, enabling us to continually improve our service delivery with more evidence-based interventions.

Maternal and child health research is dedicated to improving the health and wellbeing of pregnant women, mothers, and children through scientific study and evaluation of promising programs. Our research agenda is grounded in the belief that a mother’s health and well-being has a profound impact on her child. MCC is dedicated to improving the health and well-being of pregnant women, mothers, and children through the scientific study of promising programs.

This year we initiated two new research projects:

We adapted the promising results of our Postpartum Weight Management Study, which documented participant weight loss and increased self-efficacy, into Fit Beginnings for Mom, a health and wellness program offered at our MOMobile at Riverside program.

We also developed a pilot study, Enhancing the Communication Foundation for Language Development in Early Childhood, in collaboration with Temple University to develop and test a unique intervention promoting early language development in infants and toddlers.

Research Priorities

  • Enhancing the Communication Foundation for Language Development in Early Childhood
  • The Postpartum Weight Management Study
  • Motherhood and Jail Re-entry
  • Parenting and School Readiness
  • Recently completed Studies

Enhancing the Communication Foundation for Language Development in Early Childhood

Language ability in early childhood is the single best predictor of school readiness and later school success and is highly predictive of literacy outcomes. By their 4th birthday, however, many low‐income children are already markedly delayed in language ability. Dubbed the 30‐million-word gap, children in poverty hear significantly fewer words than their more affluent peers and this gap predicts lower intelligence scores, lower vocabulary, and less language processing efficiency. Although the amount of language children hear addressed to them is important, the quality of the communication foundation parents and toddlers construct together is largely responsible for language growth. Quality and quantity matter.

Our project, Enhancing the Communication Foundation for Language Development in Early Childhood, is a partnership with Dr. Kathy Hirsh-Pasek and her team at Temple University’s Infant and Child Laboratory. Beginning in summer 2015, the Maternity Care Coalition (MCC)-Temple team began to develop and test, in a randomized controlled pilot trial, an intervention to enhance the communication foundation with young children in MCC’s home-visiting and center-based programs. The pilot intervention will be incorporated into MCC’s established model and will be designed for translation and dissemination to other settings to potentially serve as a nationally replicable model.

The Postpartum Weight Management Study was a collaboration between MCC’s research team and Dr. Charmaine Smith Wright from the University of Pennsylvania to help moms lose weight after the birth of their baby. The team developed a wellness intervention with four parts:

  • Nightly motivational text messages
  • Pedometers to encourage physical activity
  • In-person classes and home visits
  • Encouragement of healthy eating and infant feeding by nutritionists and lactation consultants

The study results found a statistically significant impact on the cardiovascular health of its participants, including weight loss and decreased waist circumference, as well as psychosocial benefits such as increased self-efficacy and decreased depression risk.

To read more about our study, please see our recent publication: Wright, C.S., Mogul, M. and Shea, J., (2013). Psychosocial Factors Associated with Gestational Weight Gain in a Low Income Cohort. Journal of Healthcare for the Poor and Underserved, 24.1, and related conference presentations.

With support from the Aetna Foundation and Edna G. Kynett Foundation, we’ve taken the lessons we learned in our initial pilot study and adapted the project into a program, Fit Beginnings for Mom, to serve clients in our MOMobile at Riverside program.

The goal of Fit Beginnings for Mom is to empower incarcerated pregnant women to create a healthy lifestyle environment for themselves and their children, while incarcerated and after release from jail.

Components of the program include:

  • Individualized health and wellness goal plans
  • Enhanced training for MOMobile Advocates to deliver expert health and wellness support
  • Educational workshops including structured educational/curriculum materials
  • Empowering women to advocate for their health even while incarcerated

The program was implemented earlier this year and currently has 25 women enrolled. Preliminary results show women are setting realistic goals, taking more steps (as tracked by their pedometers), and keeping a daily food log. Our expert Advocates are conducting workshops regularly.

Motherhood and Jail Re-entry

Did you know the rate of incarceration is growing faster for women than men? 800% since 1973. Did you know that 75% of women behind bars in the Philadelphia prison system are mothers? Most mothers are their child’s primary caregiver when they are incarcerated, and 80% of women leave young children behind. Many women are survivors of trauma, suffer from mental health issues, and are incarcerated for minor, non-violent offenses.

The Mother’s Re-entry Study is an exploratory, in-depth examination designed to examine maternal perceptions of the reentry experience reuniting with their children after a short stay in jail and is a collaboration between MCC, the University of Pennsylvania, and LaSalle University.

The overall aims of the study are to:

  • Investigate the re-entry experience of mothers returning from a short stay in jail
  • Identify facilitators to successful re-entry for mothers of young children
  • Inform interventions and policies to increase successful re-entry and positive maternal and child outcomes

Fifteen semi-structured interviews were conducted with current and former program clients with young children who recently gave birth and had been released from jail for at least 30 days. Results found that women strongly identify as mothers while in jail and after return to the community. Children and other relationships generate motivation for successful re-entry.

Next steps include:

  • Research: Evaluation of promising practices to promote success in mother-child bond and re-entry
  • Practice: Provide parenting support to maintain maternal-child relationships and support strained family relationships
  • Policy: Work within and across systems to advocate for services and systems to support mothers transitioning from jail to home

To read more about our study, please see our recent conference presentation: Mogul, M., PhD, MBA, Harner, H., PhD, MPH, CRNP, WHNP-BC, Stelson, E., MSW, MPH, Grisso, J.A., MD, MSCE, Frasso, R., PhD, MSC, CPH. Motherhood and Re-entry: Implications for Research, Policy and Practice. American Society of Criminology, Washington, D.C., November 20th, 2015.

Parenting and School Readiness

Our Early Head Start (EHS) program supports parenting engagement and school readiness goals. The project is an in-depth qualitative study exploring parenting beliefs and practices and parental perspectives on engagement in the EHS program. Our partner, Dr. Maia Cucchiara, a Temple University Urban Education professor, has attended on-going home visits with a number of clients and has conducted in-depth interviews with clients and program Advocates.

Results will be examined in the context of the participants’ school readiness outcomes, providing a larger context to MCC’s school readiness outcomes, and will inform the development of the larger study, “Enhancing the Communication Foundation for Language Development in Early Childhood,” described above.

Recently Completed Studies

Partners for a Healthy Baby: Evaluating the Evidence

MCC’s home visiting programs utilize the Partners for a Healthy Baby curriculum created by Florida State University (FSU). MCC partnered with FSU and Georgetown University to conduct a cost-effective, community-based evaluation of the curriculum to investigate its evidence-base and to study how effective it is. The study examined several important outcomes measures. Clients experienced a significant reduction in depressive symptoms over the course of their participation, and clients adopted target health behaviors more often than did women in comparable community samples.

For more information about the study, see our publication: Hadley, B., Rudolph, K., Mogul, M. and Perry, D. (2014). Providing Home Visiting to High-Risk Pregnant and Postpartum Families: The Development and Evaluation of the MOMobile Program. Zero to Three Journal, 35:2.

Facilitating Effective Referrals for Perinatal Depression Study

Our Perinatal Depression study is a result of our solid partnership with Dr. Rhonda Boyd from The Children’s Hospital of Philadelphia. Our early pilot work identified barriers women face in navigating the behavioral health system, including:

  • Social support
  • Life events
  • Culture and language
  • Continuity of care
  • Mental health stigma

With support from the National Institute of Mental Health (NIMH), we implemented the Facilitating Effective Referrals for Perinatal Depression study to help clients and their Advocates navigate the often complicated behavioral health system.

While there were numerous barriers to accessing mental health treatment, the study found a surprising finding: advocacy is the key to success, as 83% of participants who attended a mental health visit were accompanied by our research assistant. Having a designated person help women navigate the system is critical to getting women the treatment they need for themselves and their baby.

For more information about the study, see our publication: Boyd, R.C., Mogul, M., Newman, D. and Coyne, J. C. (2011). Screening and Referral for Postpartum Depression among Low-Income Women: A Qualitative Perspective from Community Health Workers. Depression Research and Treatment, 2011, 1-7, and related conference presentations.

Evaluation and Outcomes

MCC strengthens families by empowering clients to maintain positive health behaviors, beginning in pregnancy. Currently, MCC evaluates the following client outcomes across programs and sites:

  • Reductions in maternal depression
  • Breastfeeding initiation
  • Safe sleep practices
  • Connection to medical care for mothers and babies
  • Connection to community resources

MOMobile: Evaluating the Evidence

From 2012-2014, Florida State University (FSU) and Georgetown University independently analyzed MCC’s outcomes and confirmed the positive impact of programs on the health and well-being of families. Favorable results included:

  • 68% reduction in maternal depression over the course of participation in programs
  • 83% breastfeeding initiation versus 49% in a community benchmark
  • 96% safe sleep practices versus 65% in a community benchmark

These results were published in Zero to Three, a leading maternal and child health journal, in November 2014. The programs’ positive outcomes have remained consistent across program models over time.

Publications & Reports

Here are some of the publications, presentations and reports developed by the MCC research team. For more information or to obtain copies, please email Marjie Mogul at mmogul@maternitycarecoalition.org.

Mogul, M., PhD, MBA, Harner, H., PhD, MPH, CRNP, WHNP-BC, Stelson, E., MSW, MPH, Grisso, J.A., MD, MSCE, Frasso, R., PhD, MSC, CPH. Motherhood and Reentry: Implications for Research, Policy and Practice. American Society of Criminology Annual Conference, Washington, D.C., November 20th, 2015.

Tucker Edmonds, B., Mogul, M., and Shea, J.A. (2015). Understanding Low-income African American Women’s Expectations, Preferences, and Priorities in Prenatal Care.  Family and Community Health (38)2 149-157.

Mogul, M. Stelson, E., Frasso, R. Grisso, J.A. & Harner, H. Mothers and Reentry: Relationship Findings. Poster presented at the Annual Society for Research in Child Development Conference, Philadelphia, Pennsylvania, March 21st, 2015.

Mogul, M. The MOMobile at Riverside Program. Poster presented at the Annual Society for Research in Child Development Conference, Philadelphia, Pennsylvania, March 21st, 2015.

Mogul, M. Producing relevant research: How to engage the community in designing effective public health programs. Virtual poster presented at the AcademyHealth’s 7th Annual Conference on the Science of Dissemination and Implementation, Bethesda, Maryland, December 8th-9th.

Mogul, M. How to build a bridge for community-campus engagement: The Maternal and Child Health Research Consortium. Poster presented at the Community-Campus Partnerships for Health 13th International Conference, Chicago, Illinois, May 1st, 2014.

Hadley, B., Rudolph, K., Mogul, M. and Perry, D. (2014). Providing Home Visiting to High-Risk Pregnant and Postpartum Families: The Development and Evaluation of the MOMobile Program. Zero to Three Journal, 35:2.

Bloch, J.R., Knauer, C., Kensey, M.O. & Mogul, M. (2014). Safe or unsafe motherhood: The invisibility of foreign-born Black mothers in Philadelphia. Asian American Pacific Islander Nurses Association’s 11th Annual Conference, San Diego, March 29, 2014.

Mogul, M. and Boyd, R.C. (2013). “Measuring Capacity Building to Conduct Perinatal Depression Research among Low-income Women”. The Community Psychologist (46)3, 22-23.

Price, S.K., Kready, S.F., Mogul, M., Cohen-Filipic, K. and Davey, T. (2013). “Partnership Process Guidelines: Social Work Perspectives on Creating and Sustaining Real-World University-Community Partnerships”. Journal of Community Engagement and Scholarship, (6)1, 5-14.

Wright, C.S., Mogul, M. and Shea, J., (2013). Psychosocial Factors Associated with Gestational Weight Gain in a Low Income Cohort. Journal of Healthcare for the Poor and Underserved, 24.1

Boyd, R.C., Mogul, M., Newman, D. and Coyne, J. C. (2011). Screening and Referral for Postpartum Depression among Low-Income Women: A Qualitative Perspective from Community Health Workers. Depression Research and Treatment, 2011, 1-7.

Mogul, M. A Community-Based Approach to Reducing Recidivism in a Population of High Risk Incarcerated Women. Paper presented at The American Society of Criminology Annual Conference, Washington, D.C., November 18th, 2011.

Mogul, M. & Barton, S. A Community-Based Approach to Reducing Recidivism in a Population of High Risk Incarcerated Women. Paper presented at The International Council on Women’s Health Issues 18th Annual Congress, Philadelphia, Pennsylvania, April 9th, 2010.

Mogul, M. & Boyd, R. Postpartum Depression: An Examination of the Referral Process for Low Income, Minority Women. Paper presented at the 14th Annual Conference of the Society for Social Work and Research, San Francisco, California, January 17th, 2010.

Smith Wright, C., Builder, D., Mogul, M., Allen, M., Rubin, D. and Shea, J. (2009).Characteristics of 98 low-income women in a Philadelphia Postpartum Weight Retention Study. Paper presented at the 137th Annual Meeting of the American Public Health Association, Philadelphia, Pennsylvania, November 9, 2009.

Smith Wright, C., Builder, D., Mogul, M., Allen, M., Rubin, D. and Shea, J. (2009). Impact of Race and Locus of Control on Gestational Weight Gain. Poster presented at the 137th Annual Meeting of the American Public Health Association, Philadelphia, Pennsylvania, November 10, 2009.

Mogul, M., Hilley, A. & Pollack. K. Facilitating Reentry: A Prison-based Case Managed Re-entry Program for Low Income Pregnant Women and New Mothers. Paper presented at the 13th Annual Conference of the Society for Social Work and Research, New Orleans, Louisiana, January 12th, 2009.

Mogul, M. Facilitating Re-entry: A Prison-based Case Managed Re-entry Program for Low Income Pregnant Women and New Mothers. NIMH/UTMB-G Mental Illness, Incarceration and Community Re-Entry Meeting, Austin, Texas, October 30th, 2008.

Price, S., Mogul, M., Filipic, K., Foreman Kready, S. & Davey, T. Creating and Sustaining Real World Partnerships: Voices from Community and Academe.Paper presented at the 54th Annual Program Meeting of the Council on Social Work Education, Philadelphia, Pennsylvania, November 1st, 2008.

Mogul, M. Criniti, S. & Yates, L. Lessons learned from a community-based HIV testing partnership: The HIV Minority Community Health Partnership, presented at the 136th Annual American Public Health Annual Meeting, San Diego, California, October 29th, 2008.

Criniti, S., Mogul, M., Aaron, E., Hilley, A. & Martin, B. Providing in-home HIV testing for pregnant women and their families: Challenges and benefits, presented at the 136th Annual American Public Health Annual Meeting, San Diego, California, October 27th, 2008.

Leed, R. & Mogul, M. Analysis of Hospital Policies on Midwifery. Paper presented at the 135th Annual American Public Health Association Meeting, Washington, D.C., November 5th, 2007.

MCC’s Research Consortium

MCC’s Research Consortium includes academic research partners with expertise in topics related to Maternal and Child Health and Early Care and Education. This multi-disciplinary, cross-institutional group includes representatives from many of the universities in the Southeastern Pennsylvania region. The group meets semi-annually and communicates throughout the year to share research results and consider collaborative research opportunities that align with overall MCC priorities. Current Consortium members include:

Diane J. Abatemarco, Ph.D., M.S.W.
Associate Professor of Pediatrics, Director of Pediatric Population Health, Nemours/Alfred I. duPont Hospital for Children

Kay Armstrong, M.S.
Consultant

Darlyne Bailey, Ph.D., L.I.S.W.
Dean and Professor, Special Assistant to the President for Community Partnerships, Bryn Mawr College, Graduate School of Social Work and Social Research

Nathalie Bartle, Ed.D.
Professor Emeritus, Drexel University School of Public Health

Joan Rosen Bloch, Ph.D., C.R.N.P., W.H.N.P.-BC
Assistant Professor, College of Nursing & Health Professions & the School of Public Health
Drexel University

Rhonda C. Boyd, Ph.D.
University of Pennsylvania
Children’s Hospital of Philadelphia
Department of Psychiatry
Center for Family Intervention Science

Rickie Brawer, Ph.D., M.P.H.
Assistant Professor, Department of Family & Community Medicine, Associate Director, Center for Urban Health Thomas Jefferson University and Hospital

Marilee Comfort, PhD., M.P.H.
Comfort Consults, LLC

Andrea Crivelli-Kovach, Ph.D., MA, CHES
Associate Professor and Director of Community Health Programs, Department of Medical Science and Community Health, Arcadia University

Maia Cucchiara
Assistant Professor, Urban Education, Temple University

Nate DeNicola, M.D.
Robert Wood Johnson Clinical Scholar (VA) at the University of Pennsylvania Perelman School of Medicine, Department of Obstetrics & Gynecology

Janet Eisenberg Shapiro
Professor and Director of the Center for Child and Family Wellbeing, Bryn Mawr College, Graduate School of Social Work and Social Research

Rosemarie Frasso, Ph.D, MSC, CPH
Director of Education, MPH Program, Center for Public Health Initiatives, University of Pennsylvania

Jeane Ann Grisso, M.D., M.S.C.E.
Professor Emeritus of Medicine and Nursing, University of Pennsylvania Perlman School of Medicine

James Guevara, M.D., M.P.H
Associate Professor of Pediatrics & Epidemiology
Senior Diversity Search Advisor
Perelman School of Medicine at the University of Pennsylvania
Director of Interdisciplinary Initiatives
The Children’s Hospital of Philadelphia PolicyLab

Noel Harbist, M.D.
Consultant

Holly Harner, Ph.D., M.P.H., C.R.N.P., W.H.N.P.-BC, FAAN
Director and Associate Professor, MPH Program, La Salle School of Nursing and Health Sciences

Cecily Knauer, Ph.D., M.A.
Consultant

Lynne Kotranski, Ph.D.
Research and Evaluation Consultant

Nora Lee, Ph.D.
Assistant Research Professor, Department of Epidemiology and Biostatistics, Drexel University School of Public Health

Linda Moldanado, Ph.D., R.N.
Ruth L. Kirschstein NRSA Post-Doctoral Fellow
University of Pennsylvania School of Nursing
Center for Global Women’s Health

Judith L. M. McCoyd, Ph.D., LCSW
Associate Professor, Rutgers University School of Social Work

Deborah Nelson, Ph.D.
Associate Professor
Director, Graduate Studies
Director, Maternal and Child Health Wellness Lab
Director, Division of Epidemiology and Biostatistics
Co-Director, MS in Clinical Research and Translational Medicine Program

Elizabeth B. Rappaport, M.D.
Associate Professor Emeritus, Department of Family and Community Medicine, Thomas Jefferson University

Martha C. Romney, R.N., M.S., J.D., M.P.H.
Assistant Professor, Jefferson School of Population Health

Jane Siegel, Ph.D.
Professor and Department Chair, Rutgers University, Department of Sociology, Anthropology and Criminal Justice

Carole Soskis, J.D., Ph.D.
Consultant

Leanne C. Wagner, M.S., M.B.A.
MCC Board Member

Charmaine Smith Wright, M.D., M.S.
Assistant Professor, General Internal Medicine, University of Pennsylvania

Chair:
Marjie Mogul, M.B.A., Ph.D.
Director of Research, Maternity Care Coalition