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We are the Maternal Health Learning and Innovation Center, a network of maternal health equity experts and organizations working to make real change for women and birthing people in the U.S.
Our podcast is a series of episodes connecting around culture, lifting voices and stories, exploring innovations in maternal care and discussing ways we can center equity in the way we approach our health and wellness.
Learn more about us, explore our resource center and find support for all maternal health professionals at MaternalHealthLearning.org.
For more podcast information and content, visit MaternalHealthPodcast.org.
Kelli - 00:00:03:
Welcome to the Maternal Health Innovation Podcast Season 3. I'm Kelli Sheppard, Communications Director at the Maternal Health Learning and Innovation Center. This podcast is created by the Maternal Health Learning and Innovation Center. Episodes are released biweekly, so be sure you are subscribed. On this podcast, we listen to maternal health innovators about ways we can implement change to improve maternal health in the U.S. In this episode, we're talking about apps that are making maternal health care more accessible to all. Now we're talking about PM3, preventing maternal mortality using mobile technology. PM3 is a mobile app specifically crafted for and in collaboration with Black women that aims to assist new mothers in effectively managing their health post-childbirth, while also ensuring access to vital social support and community resources. So let's delve into the journey from its inception to its potential to reshape postpartum care for the better. Thank you both for joining us. Dr. Chandler and Sherilyn. And first question. Can you tell us more about yourselves and your roles in creating PM3 and its journey so far?
Rasheeta - 00:01:26:
Absolutely. So I am Rasheeta, Dr. Chandler, you know, I go by both. I am an associate professor in nursing at Emory University, and I am super passionate about the wellness and well-being of Black community, particularly Black women. And obviously, maternal health is an issue that plagues our community as far as health outcomes associated with birthing women. And we just kind of wanted to make sure that we were able to address that. PM3 is a dynamic digital resource for women, and it initially was geared toward rural women, because we know that they tend to have resource deserts in those areas. So we wanted to be able to have a central place for them to locate resources that would be beneficial to optimizing maternal health outcomes in those regions. But honestly, the tool could be used by any woman because the resources are quite relevant to any woman. So I'll turn it over to Sherilyn now.
Sherilyn - 00:02:46:
Hi, I'm Sherilyn Francis. I'm a digital health equity researcher and PhD student at the Georgia Institute of Technology or Georgia Tech. So my role was primarily centered around leading the qualitative research for the formative work that informed the design, the user interface and user experience of the PM3 app. So that included focus groups, key informant interviews and asynchronous, essentially qualitative activities where we we tried to understand. So from kind of a business perspective, we tried to understand the pain points of the women with regard to their perceptions and experiences in the health care system, specifically centered around their sexual and reproductive health experiences. And then we took those pain points and also the solutions that they've devised. And we use that information to conceptualize the PM3 app. So we designed it and then we used those designs to implement with the code or the back end for the PM3 design. And since it's an iterative design process, we also engaged in a pilot feasibility study. Where we had a small group of women using the app for a designated period of time. We took their feedback in addition to receiving feedback from the community advisory board or the project advisory board, which is composed of women, birthing persons, health professionals, medical professionals, community members. And we also took their feedback and are working continuously to improve the PM3 app.
Kelli - 00:04:03:
So what inspired you all to collaborate, to create the app and have it developed? Specifically designed for Black women.
Rasheeta - 00:04:14:
I think that we always kind of answer this question myself, and I definitely don't want to not mention my colleagues, Drs. Natalie Hernandez out of Morehouse School of Medicine in the Center for Maternal Health Equity and Dr. Andrea Parker, who is at Georgia Tech, and she is the leader of the Wellness Lab. We are mothers ourselves, and we each had our own personal experiences in this realm. Obviously, it didn't result in death, but that's not the only thing that ends up being necessarily a negative experience in the maternal health space for Black women. And so we felt like we each offered very unique perspectives. I'm a nurse and Dr. Hernandez is a public health expert. And Dr. Parker, obviously her and her lab are the tech entity of what we do. And so we felt like it was kind of destined for us to come together. And, you know, we're really passionate about it. Just, again, personal experiences and certainly me being a nurse and being in the women's health space, hearing stories from Black women themselves as well. So I've also practiced at the Center for Black Women's Wellness, which is a clinic here locally in Atlanta. And most of the clientele, I would say around, don't quote me on this, 90 percent are Black women. But it's open to other women. But, you know, with that being in the name, we get a lot of Black women who come through. So having conversations, asking about their experiences as well. And then the formative work that Sherilyn mentioned, you know, going out into the community and just hearing what women had to say.
Kelli - 00:06:02:
So, and you just mentioned pretty much community-based participatory research, right? So how has this approach influenced the development and evolution of PM3?
Rasheeta - 00:06:14:
I'll kind of start off, but I'll let Sherilyn kind of chime in because she was very instrumental in implementing the actual focus groups. I think it's just innate in us to want to talk to the community. Many times Black women have said that they're not heard and we wanted to make sure we were listening. And the way our tagline is, we see you, we hear you, we are you. And we mean that like we are really a part of the community itself as well. So it's not foreign to us to go to people. I can sit in my beauty salon and talk with women who look like me and ask about their experiences. And that's a focus group and really inspires a lot of our work as well. So we are active listeners when it comes to that because we don't have all the answers. We're a conduit for making sure we can be impactful. And how we can be impactful. And how we translate what they're saying to us into product or into research. Because we know traditionally people have gone into the community and implemented what they think works. When we know the answers are already in the community, we don't have to necessarily always come up with something. They have those answers. It's about having the resources to implement. And so Sherilyn, if you want to maybe share some of your experience with implementing the focus groups.
Sherilyn - 00:07:40:
Absolutely. Well, it's kind of hard to follow Dr. Chandler's explanation, but in the context of community-based participatory research, there's always this strange dichotomy, the power dynamic between the academic arm and the community arm. And we really wanted to, for PM3, be intentional about democratizing the technology development experience. And even technology development can have that differential access because one may perceive that they don't have the knowledge, therefore they cannot engage in the work of developing technologies. So we wanted to make the technology development experience accessible to our target user or our community members. And this is a community that we are a part of. So it's particularly important to us. When I started this project, I wasn't a mother, but I am now. And so even just going through the evolution of one, of course, as a PhD student, you can experience this as an academic exercise. But because I'm a member of the community of. The women who will be using the app, I was touched in a very different way from participating in the folks groups and hearing these stories and really understanding that my education and my income is not a protective factor against the possibility of death or sickness, simply as a result of fulfilling my biological imperative of having a child. Because when I step into an exam room, they don't see a highly credentialed, highly educated, well, you know, articulate. Economically stable woman, they see a Black woman. And then there are tons of prejudices and stereotypes that are associated with that. And then the implicit biases take place. And then that is what results in our poor health outcomes as relates to our maternal health. So in the context of CBPR, we wanted to just honor the women's experiences. And I would say, depending on how hardcore you are in the CBPR space, one may say, CBPR, we should have started with a community perspective and they define the research topic and the objectives. So from a technology space, it would probably fall more in the context of co-design. And we're hoping to transition to a more pure CBPR approach where we are presenting the research and the outcomes and the findings to our community. And we, as PM3s moving forward, we want to be very intentional about forefronting what the objectives and priorities of our community members in a way we're able to do that. So we're going to be very intentional about that. And we're going to be leading the research again in the space of democratizing the research experience and the technology development experience. Our CBPR approach thus far with engaging the community advisory board. And as I mentioned before, they are really the driving engine. So from a technology perspective, we may be like, wow, this thing is super cool. How about we do this thing? Because technology is always the next cool thing. But then the community advisory board would be like, is that really necessary outside of it just being a cool new thing? And then it's like, well, okay, maybe it's not really necessary. So from the technology development perspective, they help to keep us focused on prioritizing the needs of the user population, which is freaking American birthing persons.
Kelli - 00:10:53:
I get that. It's way more important to address needs versus setting trends. Am I making sense with that? Yeah, I totally get that. That's awesome. So the next question is a multi-partner, but it's in relation to resources, supplements. Fitbit tools, things like that, that PM3 provides. And so just kind of segwaying into that, my main question I think would be, PM3 doesn't provide medical advice. It focuses on a self-agency. Can you explain how the app empowers women to take control of their health and wellbeing using resources, supplements, tools to offer that.
Rasheeta - 00:11:46:
Oh, that's an excellent question. And I think one that really speaks to really the heart of what PM3 aims to do. So we take evidence-based studies. Content that kind of guides us about what self-agency might look like and what others have implemented that could help individuals feel empowered to take charge. So for instance, and I can certainly let Sherilyn give specifics about the tech, you know, what's actually included in a lot of those features. Although I'm familiar, you know, we wanted to make sure, for instance, it doesn't have much meaning without explanation. We wanted to make that explanation feasible, recognizable, something that is not foreign to them, kind of the green, yellow, red system that we're all really accustomed to in different contexts. And so for blood pressure, that's what we do. Like we, you know, range wise based on the evidence, you know, this is the green range, this is the yellow range, this is the red range. And it's for the red, obviously call 911 or your provider immediately in the yellow range. It's, you know, you need to be watching this very vigilantly, you know, if you see signs and symptoms. So it's things that honestly people could probably look up because we have so much access to things. But women told us like, we don't know what's credible. It's so much out there you have to dig through. So we, we wanted to, as in our professions and having the knowledge base, kind of compile all of that information and translate it into something that's usable for women that could save their lives. And so that's an example of how we give them agency. We also, within some of our resources and sections allow, give them tools on how to communicate with their provider, how to make them hear you when you feel like you're unheard. So, those are kind of ways of being able to make the tool useful to women and make it where hopefully we can meet the outcome of not having deaths related to that. And also decreasing kind of the morbidity issues like blood pressure, if they're monitoring and getting on the proper medications that they need to, because they've gone to the provider as opposed to sitting home and it just gets out of control. You know, those are the types of things, mental health is a big, big thing we had in there. Are they marking how they're feeling along the way? And as they go into their provider say, you know what, I've been tracking myself and it seems like I'm not really feeling up to getting out of bed a lot here. So how can we go to that? What's the next step for remedying these issues of potential depression, postpartum depression, things of that sort. So I think that's kind of where PM3 is useful. So I think that's kind of where PM3 is useful. So I think that's kind of where PM3 is useful. So
Sherilyn - 00:15:36:
Yeah, so to add to Dr. Chandler's point, I think it's really important to note that the reason that PM3, and this was a question I had very early in the process as well. The reason that PM3 emphasizes self-efficacy, self-monitoring agency and health self-monitoring is because one, there's a deficit of culturally competent health professionals in the reproductive space. Additionally, just because you have a clinician who looks like you, recognizing that that clinician operates in an inequitable system, there are still inequalities within those spaces. So because we couldn't ensure that just because we have a Black female doctor, for instance, that that would result in quality care or quality medical information or a nurse or whatever it may be, it was really important to develop technologies and develop features that promoted self-efficacy, self-care agency, and allowed for health self-monitoring. So as Dr. Chandler mentioned, we have blood pressure cuffs, we have digital scales from Google in addition to smartwatch or a fitness tracker. And what the women have reported is just the information, the information that they didn't know being now readily accessible and now being able to make decisions around their health because they're not in a situation where they're not able to make decisions around their health because, for example, they know how they're sleeping or they know what things in monitoring their heart rate when they're feeling anxious, they see that their heart rate increases and now they may be able to listen to music or calm down. So just simply providing the data visualization, which is associated and they are now able to link back to certain events in their life or how they're feeling or what they're thinking and all of those things has been really helpful for the women to engage in self-reflection. And because as Dr. Chandler mentioned, we found a way to visualize the data in a way that is not stigmatizing and in a way that is not overwhelming, the women are able to receive the information. Not all of it, because they still don't want to see the number on the blood pressure cuff. They may still not want to see the number on the scale, but they may be able to differentiate the red, yellow, green. And now, OK, maybe I'll go look at the number later. They're able to and they feel empowered to have conversations amongst themselves and with their health care professionals around their health data. So that's really the benefit of many of the devices that we have used thus far with PM3.
Rasheeta - 00:18:07:
And may I just quickly add to that? You know, I don't have to really add to the content of what Sherilyn said about the actual devices, et cetera. But I just wanted to kind of append with the fact that our women in the project have been extremely responsive to this tool. And I know that sometimes some people say that, you know, there's lack of engagement and things of that sort. We wanted to be really intentional about creating something that was really just, you know, useful. And when it comes to the aspect of self-care agency, I do want to say that we are looking toward maybe being providing medical information in the future. I just wanted to toss that in there. I think we would love to connect with health care systems where individuals can. Reach their provider, can reach counselors that's on the horizon. So that's kind of what I wanted to add to that.
Kelli - 00:19:15:
It sounds like the future of PM3 is looking very bright, honestly. I'm really excited about this. This is such an innovative application. If you could tell our listeners where they can find more information about PM3, its features, and how to get involved.
Rasheeta - 00:19:35:
Absolutely. So I will tell you, we do have a website. It's www.pm3forme.com. So that's pm3forme.com. And that has all the information about the study and our mission, et cetera. And then I will let Sherilyn mention about, because we are currently doing a pilot trial, which let me just do a really quick plug on that. We're doing a trial with women, getting feedback from them, and not a lot of apps have studies associated with them, like outcomes of what that app was able to accomplish by them having access to it. So I just want to plug that because I think that makes us stand out as well. So Sherilyn, do you want to let them know about the study and how to become involved?
Sherilyn - 00:20:32:
Well, if you are listening and you reside in the state of Georgia, you can go to pm3forme.com. And there is a button that indicates to join the study. And you can simply submit a form there. Additionally, let's see here. I'm just making sure that the form is up. Yes, the form is up. I'm actually on the website now. So you can click the button that says join the PM3 movement. And we would love to have you as a part of the study. Additionally, I'm sure hopefully we can share our email addresses. So maybe you're not certain if you want to join the study, but you just want to learn more about the study. There is a contact form on the website as well. And if we have the capacity to share our email addresses, you can email us and we will answer any questions that you have about the study. Additionally, if you're a clinical partner, same approach. You can click the button to join the study or fill out the form to learn more. Or you can email Dr. Chandler or I to learn more about the PM3 app if you'd like to make it available to your patient population.
Rasheeta - 00:21:32:
Thank you. Yeah, I just say we are certainly looking for partners, potential funders. If what we've said has touched you, like Sherilyn said, we are open to you content in us directly via email or through the website itself. We want to see this be a global phenomenon and a resource that we want it to continue to grow. I know there's AI happening and kind of emerging. I think we pride ourselves on being cutting edge as well. So, yeah, please reach out if you've been touched by this story that we've put out there for you to know about. And then PM34me.com.
Kelli - 00:22:12:
Thank you so, so much, Dr. Chandler and Sherilyn. We appreciate you.
Rasheeta - 00:22:17:
Thank you.
Kelli - 00:22:18:
And thank you all for listening. For more podcasts, videos, blogs, and maternal health content, visit the Maternal Health Learning and Innovation Center website at MaternalHealthLearning.org. We want to hear from you. Tell us what you want to hear more of, review our podcast, and share with like-minded innovators. We have some great episodes recording now. Be sure you are subscribed. Let's keep talking. Tag us in your posts using the hashtag maternal health innovation. I'm Kelli Sheppard, and we'll see you again next week on the Maternal Health Innovation Podcast.
Intro/Outro - 00:23:05:
This project is supported by the Health Resources and Services Administration, HRSA, of the U.S. Department of Health and Human Services, HHS, under grant number U7CMC33636, State Maternal Health Innovation Support and Implementation Program Cooperative Agreement. This information or content and conclusions are those of the author and should not be construed as the official position or policy, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.