Assessing the Impact of a Digital Patient Navigation Tool for Iron Deficiency Anemia in Pregnancy: A Hybrid Effectiveness-Implementation Trial.
Objective: Iron deficiency anemia (IDA) is associated with adverse maternal and neonatal outcomes. Patient navigation tools have improved treatment and surveillance completion among postpartum populations. Our study aimed to evaluate the impact of prospectively implementing a digital patient navigat...
| Publicado en: | American Journal of Perinatology Vol. 43; no. 9; pp. 1148 - 1156 |
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| Autores principales: | , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Thieme Medical Publishing Inc.
Jul2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=194646024&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 194646024 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07351631 GQK jtl: American Journal of Perinatology issn: 07351631 maglogo: N pubinfo: dt: Jul2026 vid: 43 iid: 9 pid: 2811 pub: Thieme Medical Publishing Inc. place: New York, New York artinfo: ui: 194646024 194646024 194646024 10.1055/a-2719-4992 194646024 ppf: 1148 ppct: 8 formats: tig: atl: Assessing the Impact of a Digital Patient Navigation Tool for Iron Deficiency Anemia in Pregnancy: A Hybrid Effectiveness-Implementation Trial. aug: au: Kumar, Natasha R. Butt, Zoya Calcei, Jonathan B. Forkpa, Markolline Mumford, Sunni Levine, Lisa D. Hamm, Rebecca F. affil: Department of Obstetrics and Gynecology, University of Pennsylvania Health Systems, Philadelphia, Pennsylvania, United States sug: subj: Digital Health Utilization Patient Navigation Anemia, Iron Deficiency Therapy Prenatal Care Outcomes (Health Care) Patient-Reported Outcomes New England Human Pregnancy Female Tertiary Health Care Academic Medical Centers Pilot Studies Clinical Trials Hemoglobins Blood Multiple Logistic Regression Multiple Linear Regression Models, Statistical Descriptive Statistics Relative Risk Confidence Intervals Implementation Science Health Services Research Comparative Studies Fisher's Exact Test T-Tests Data Analysis Software Hypertension Epidemiology Chronic Disease Epidemiology Prevalence Insurance, Health Bivariate Statistics Self Report DSM Questionnaires Scales Female ab: Objective: Iron deficiency anemia (IDA) is associated with adverse maternal and neonatal outcomes. Patient navigation tools have improved treatment and surveillance completion among postpartum populations. Our study aimed to evaluate the impact of prospectively implementing a digital patient navigation tool for IDA in prenatal care (PN-IDA). Study Design: This pilot type 1 hybrid effectiveness-implementation trial utilized a difference-in-differences (DiD) design to compare pre- and postimplementation outcomes at an intervention site to a control site. The trial was performed at a tertiary academic center in the northeastern United States between April 2023 and April 2024. Patients with third-trimester Hgb < 9.5 g/dL were institutionally eligible for IV iron (IVFe) and included in this analysis. Dual primary outcomes were completion of ≥ 1 IVFe infusion and perceived health competence (validated eight-item survey). Implementation outcomes assessed penetration and fidelity. Multivariable logistical and linear regression models controlling for differences in site characteristics over time used interaction terms to estimate DiD. Results: Three hundred and seventy-eight patients were included. While IVFe completion increased at both sites (66–84% at the intervention site vs. 78–83% at the control site), there was no statistically significant difference (DiD RR: 1.13, 95% CI: 0.91–1.38). Perceived health competence remained similar at both sites (median score: 3.3–3.3 at the intervention site vs. median score: 3.3–3.1 at the control site, DiD RR: 0.15, 95% CI: −0.08 to 0.38). PN-IDA had a high level of penetration (i.e., integration of practice within a service setting), but poor fidelity (i.e., degree to which an intervention is delivered as intended). Sixty-six percent of eligible patients enrolled, but only 24% accessed PN-IDA more than once. Conclusion: PN-IDA implementation increased IVFe completion by 18% at the intervention site, but our study was underpowered to assess this difference. Future work will refine PN-IDA to optimize fidelity. Key Points: Completion of > 1 infusion increased by 18% at the intervention versus 5% at the control site (95% CI: 0.91–1.38). Two-thirds of eligible patients enrolled in the tool. Only 24% of enrolled patients accessed the tool > 1 time. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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