NCT06682520 · Wake Forest University Health Sciences
Evaluation of a Health System Integrated Model for Postpartum Education and Support in Rural Populations
(NEST-Rural)
What this study is about
This study was designed to evaluate the implementation of the Nurse Education and Support Team (NEST) Program for postpartum women who reside in 5 rural counties in North Carolina. Overarching Hypothesis: Mothers and infants residing in rural communities, randomly assigned to the NEST-Rural care model over the 3-year course of the project will: 1.
View original scientific description
This study was designed to evaluate the implementation of the Nurse Education and Support Team (NEST) Program for postpartum women who reside in 5 rural counties in North Carolina. Overarching Hypothesis: Mothers and infants residing in rural communities, randomized to the NEST-Rural care model over the 3-year course of the project will: 1. Receive more coordinated care for addressing social, mental and physical health needs. 2. Experience fewer postpartum hospital readmissions and decreased utilization of emergency departments (ED) for healthcare. 3. Experience higher adherence to American College of Obstetricians and Gynecologists (ACOG) and American Academy of Pediatrics (AAP) guidelines for preventive care, including recently updated ongoing postpartum care, serial well-child visits and vaccinations compared to those assigned to usual care.
Interventions
OTHER
Postpartum NEST-Rural Program (Hospital based service model)
NEST-Rural services will include 3-5 nurse encounters and, if indicated, up to 3 social work encounters with mothers and their infants in the postpartum period, postpartum remote blood pressure monitoring, breastfeeding support, infant weight checks, linking mothers and infants to needed social, behavioral, and health-related resources, and integration of service delivery with healthcare providers.
Primary outcome measures
Median number of hospital readmissions - Maternal
Time frame: Baseline through 30 days postpartum
Number of hospital readmissions in the 4th trimester
Median number of hospital readmissions - Maternal
Time frame: Baseline through 90 days postpartum
Number of hospital readmissions in the 4th trimester
Median number of encounters for urgent or emergent care - Maternal
Time frame: Baseline through 30 days postpartum
Number of visits to Urgent Care or the Emergency Room in the 4th trimester
Median number of encounters for urgent or emergent care - Maternal
Time frame: Baseline through 90 days postpartum
To determine number of visits to Urgent Care or the Emergency Room in the 4th trimester
Proportion of women that attend recommended postpartum visits
Time frame: Baseline through 90 days postpartum
Percentage of women that attended recommended visits to their obstetrician after delivery.
Median number of hospital readmissions - Infant
Time frame: Baseline through 30 days postpartum
Number of hospital readmissions after birth following hospital discharge.
Median number of hospital readmissions - Infant
Time frame: Baseline through 90 days postpartum
Number of hospital readmissions after birth following hospital discharge.
Median number of encounters for urgent or emergent care - Infant
Time frame: Baseline through 30 days postpartum
Number of visits to Urgent Care or the Emergency Room following hospital discharge.
Median number of encounters for urgent or emergent care - Infant
Time frame: Baseline through 90 days postpartum
Number of visits to Urgent Care or the Emergency Room following hospital discharge.
Proportion of infants receiving a visit with an ambulatory care provider
Time frame: Baseline through 21 days postpartum
Percentage of infants that attended recommended visits to their pediatric care provider within 21 days following hospital discharge
Proportion of infants that received >/= 4 well-child care visits with an ambulatory care provider
Time frame: Baseline through 274 days postpartum
Percentage of infants that attended recommended visits to their pediatric care provider within the first 9 months following hospital discharge
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- Women that deliver an infant(s) at The Birth Center at Atrium Health Wake Forest Baptist and currently reside in Davidson, Davie, Stokes, Wilkes or Yadkin County in North Carolina
- Women that delivered an infant(s) at home, were transported to Atrium Health Wake Forest Baptist and received postpartum care at The Birth Center and currently reside in Davidson, Davie, Stokes, Wilkes or Yadkin County in North Carolina
- Ages 18 years or older
Exclusion criteria
- Women that delivered an infant(s) and did not receive postpartum care at The Birth Center at Atrium Health Wake Forest Baptist.
- Women that currently reside outside of Davidson, Davie, Stokes, Wilkes or Yadkin County in North Carolina
- Under 18 years of age
Where
- Winston-Salem, North Carolina
Collaborators
The Duke Endowment
Related conditions & keywords
Frequently asked questions
What is a clinical trial?
A clinical trial is a research study that tests new medical treatments, drugs, devices, or procedures to determine their safety and effectiveness. Trials are carefully designed and monitored to protect participants while advancing medical knowledge.
Is it safe to participate?
Clinical trials follow strict safety guidelines and ethical standards. Trials must be reviewed and approved, and participants are closely monitored by medical professionals throughout the study. You can withdraw at any time if you choose.
Will I be compensated?
Many clinical trials offer compensation for your time, travel expenses, and inconvenience. The specific compensation varies by study and will be discussed during the screening process. All study-related medical care is typically provided at no cost to participants.
Will I receive a placebo instead of treatment?
When effective treatment exists, participants typically receive either the standard treatment plus the study intervention, or the standard treatment plus placebo. You would not be denied effective care. Placebos are primarily used when no proven treatment is available, or in addition to standard care. Your trial consent form will clearly explain what treatments you may receive.
Can I leave a trial if I change my mind?
Absolutely. Participation in clinical trials is completely voluntary. You have the right to withdraw from the study at any time, for any reason, without penalty or loss of benefits to which you are otherwise entitled.
How long does a clinical trial last?
Trial duration varies widely depending on the study design and purpose. Some trials last just a few weeks, while others may continue for months or years. The study coordinator will provide specific timeline information during your screening call.
Data: ClinicalTrials.gov · synced Oct 28, 2025 · Source of record for eligibility and locations