Texas A&M interdisciplinary project receives HRSA funding

Rural and underserved communities face significant challenges accessing health care, especially in Texas—the state with the largest rural-residing population in the United States. Within the past 10 years, the number of physicians providing rural obstetrics (OB) services has declined significantly, leading to many expecting women in rural areas lacking adequate maternity care.

The Texas A&M Family Medicine Residency Program, in collaboration with the Texas A&M College of Nursing and others across the university, has been awarded a five-year, $3 million grant by the Health Resources and Services Administration (HRSA) to address the maternal and infant health care needs of rural and underserved areas in Texas, as part of a project titled “Enhanced Maternity Access thru Reimagined Training and Telemedicine” (EMARTT).

Led by Rae Adams, MD, program director of the Texas A&M Family Medicine Residency Program and clinical associate professor in the Department of Primary Care and Population Health at the Texas A&M University College of Medicine, this project will help broaden the training and scope of practice for resident physicians to provide high quality, evidence-based maternity care services.

“It feels like this grant was meant for us in regard to the goals of our program and what we’ve already been doing,” Adams said. “Our program has had a strength in maternity care historically and one of our current strengths is training our residents to provide both vaginal deliveries and c-sections in rural areas. This grant allows us to increase the number of trained residents who can deliver maternity care in rural areas, provides us with funds to purchase additional equipment and gives our faculty additional time to be able to develop innovative educational resources.”

Other initiatives within the EMARTT project include developing and implementing telehealth protocols and services, expanding curriculum for the family medicine residents—with the inclusion of training certified nurse midwives/advanced practice registered nurses to enhance interprofessional learning and instruction—and creating protocols to address social determinants of health and mental health conditions for mothers and infants.

These initiatives will allow the providers within the residency program to expand training and service across the Brazos Valley through partnerships with community resource centers, CHI Saint Joseph’s network of clinics, critical access hospitals, the Texas A&M College of Nursing and the Department of Psychiatry at the College of Medicine.

“Rural and underserved communities are increasingly facing long distances to receive prenatal care and ultimately deliveries,” said Nancy Dickey, MD, executive director of the Texas A&M Rural and Community Health Institute, who introduced the grant to Adams. “As a result, many times they forego prenatal care, and their complications are not diagnosed or managed. Teaching our residents how to help cover the OB deserts that are developing in rural America is one of the best solutions to the issues of morbidity and mortality for mothers and babies.”

Adams leads a multidisciplinary team of Texas A&M University faculty from colleges across campus. The team members include:

• Shana Batten, program coordinator II at the Texas A&M Family Medicine Residency, will serve as program coordinator.
• Amanda Bray, MD, clinical assistant professor at the Texas A&M Family Medicine Residency, will serve as co-investigator.
• Hector Chapa, MD, FACOG, clinical assistant professor of obstetrics and gynecology and clerkship director for OB-GYN at the College of Medicine, will serve as co-investigator.
• Whitney Garney, PhD, MPH, assistant professor in the Department of Health and Kinesiology at the College of Education and Human Development, will serve as evaluator.
• Anna Lichorad, MD, associate program director and clinical assistant professor at the Texas A&M Family Medicine Residency, will serve as co-investigator.
• Carly McCord, PhD, clinical assistant professor in the Department of Psychiatry and director of Telebehavioral Health at the College of Medicine, will serve as co-investigator.
• Gabriel Neal, MD, clinical associate professor in the Department of Primary Care and Population Health and director of the Texas A&M Health Family Care Clinic, will serve as co-investigator.
• Robin L. Page, PhD, APRN, CNM, assistant professor at the College of Nursing, will serve as co-investigator.
• Sonya Panjwani, MPH, senior research associate in the Department of Health and Kinesiology at the College of Education and Human Development, will serve as evaluation manager.
• Robert Pope, MD, clinical assistant professor at the Texas A&M Family Medicine Residency, will serve as co-investigator.
• Shelley White-Corey, DNP, APRN, WHNP, CNE, CHSE, clinical assistant professor at the College of Nursing, will serve as co-investigator.

The project’s initiatives align with the College of Medicine’s dedication to rural and population health and will bring health care where it is needed most to provide innovative care delivery and eliminate health disparities across the state.

“Very rarely do you have a grant that allows you to enhance education as well as enhance clinical care; most of the time it’s one or the other,” Adams said. “Ultimately, my goal with this five-year project is to have good outcomes and to be able to translate our initiatives to improve maternal and infant health across Texas and the country.”