Tuesday, April 1, 2025
4/1/2025
North and South Dakota Perinatal Quality Collaborative - The North & South Dakota Perinatal Quality Collaborative (NSDPQC) is applying for Component A of CDC-RFA-DP22-2207 “Statewide Perinatal Quality Collaboratives.” NSDPQC is a regional PQC representing North Dakota (ND) and South Dakota (SD), with a leadership team including representatives from both ND and SD Departments of Health, certified nurse midwives, registered nurses, obstetrician/gynecologists, maternal fetal medicine specialists, epidemiologists, and professors from North Dakota State University, University of North Dakota, and South Dakota State University. We also have representatives from Tribal Nations Research Group, North Dakota Department of Health Tribal Health Liaisons, and providers that serve the American Indian population. NSDPQC also collaborates with private, non-profit, and federal qualified health centers. Substance use during pregnancy is a major concern in the United States, and especially in ND and SD. For example, 11% of pregnant women in ND and 9% of pregnant women in SD smoked cigarettes late in pregnancy. For illicit drug use (e.g. marijuana, methadone, heroin, amphetamines, cocaine, tranquilizers, or inhalants), 9% of pregnant women in ND, and 7% of pregnant women in SD reported prenatal illicit drug use. There are also significant disparities in substance use by race/ethnicity and income, with American Indian women and women with lower incomes having high rates of prenatal substance use in both ND and SD. Due to high rates of prenatal substance use in our region, NSDPQC will focus on improving screening, identification and treatment of pregnant and postpartum people that use substances in pregnancy, heavily informed by the Alliance for Innovation in Maternal Health’s (AIM) “Care for Pregnant and Postpartum People with Substance Use Disorder” (SUD bundle). Implementation of this bundle targets Healthy People 2030 goals: MICH-D02 Reduce the proportion of women who use illicit opioids during pregnancy; MIHC-09 Increase abstinence from alcohol among pregnant women; MICH-11 Increase abstinence from illicit drugs among pregnant women. The NSDPQC will focus on outcomes that include the maternal-child dyad. In the initial period of performance (Years 1 & 2), we will focus on substance use, followed by a focus on reducing maternal hemorrhage (Year 3), reducing primary cesarean deliveries (Year 4), and the year 5 initiative will be informed by initiatives in the first 4 years, with input from a Patient Advisory Committee, state Maternal Mortality Review Committees, and NSDPQC members to best serve populations in ND and SD. The Year 1 outcomes for the substance use project include: 1) Increase percent of pregnant and postpartum people with opioid use disorder (OUD) who received or were referred to medication for opioid use disorder; and 2) Increase percent of pregnant and postpartum people with SUD who received or were referred to recovery treatment services. To build capacity and address disparities in perinatal outcomes in ND and SD, we have identified four areas of improvement: 1) NSDPQC staff capacity; 2) Data storage and management; 3) Engaging tribal populations; 4) Connecting with patients and community. We have identified staffing needs, such as a Data Analyst and Tribal liaison, will work with University of North Dakota and other collaborators on data storage and management, will partner with Tribal Nations Research Group and Department of Health Tribal Liaisons to better connect with tribal populations, and create a Patient Advisory Committee to advise the NSDPQC leadership team. The evaluation plan is informed by AIM’s SUD bundle, with state surveillance measures, process measures, outcome measures, structure measures, and period of performance measures. Data will be reported for the overall population, as well as by race/ethnicity and by income to determine if we are best meeting the needs of disproportionately impacted populations.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).