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Principal Investigator: JACOB E FRIEDMAN
Organization: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
Fiscal Year: 2024
Award: $200,680
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
Project Summary/Abstract
Indigenous mothers (those who self-identify as American Indian, Alaskan Native, or Native American)
experience the highest rates of maternal mortality and morbidity (MMM) in the U.S. Structural, social, and
biobehavioral factors driving these inequities such as food insecurity induced by food apartheid, chronic stress
perpetuated through intergenerational trauma, and loss of traditional birthing practices and roles require
innovative solutions. To accomplish this, the Center for Indigenous Resilience, Culture, and Maternal Health
Equity (CIRCLE) has been formed to better understand and address these factors through individual, family,
community, and health systems interventions. The long-term goal of the CIRCLE is to eliminate disparities in
Indigenous MMM through effective translational science spanning best practices in preconception, prenatal,
and maternal postpartum care through the first 2 years of life. The immediate goal of the CIRCLE is to bring
together researchers and community partners in Oklahoma/Southern Plains region to discover the sources of
Indigenous MMM disparities and translate scientific results into solutions that eliminate maternal health
inequities. The CIRCLE will: (1) leverage existing and expand current partnerships with tribal health partners
on patient-centered outcomes research and interventions; (2) cultivate and support an interdisciplinary team of
independent experts focused on discovering the bases for, and solutions to, Indigenous maternal health
disparities; (3) establish the foundation and initial processes necessary to enable translational research and
interventions focused on eliminating Indigenous maternal health disparities; and (4) exchange strategies, data,
findings, and recommendations from Aims 1-3 with key partners. Achieving the aims of the CIRCLE is
significant. Over 90 percent of Indigenous maternal deaths in the U.S. are preventable. Reducing MMM and
achieving maternal health equity are a national priority. An essential step in reducing MMM and assuring
maternal health equity in the future is the elimination of Indigenous maternal health inequities. The CIRCLE’s
focus on identifying solutions for Indigenous maternal health disparities therefore addresses a critical barrier to
achieving a national public health priority. The CIRCLE is innovative. Research centers focused on maternal
health disparities and inequities exist throughout the country; however, none of these centers focus specifically
on Indigenous maternal health. We also emphasize a strengths-based “culture as protective” approach at the
core of the CIRCLE.
Terms: <Address><Alaska Indian><Alaska Native><Alaskan American><Alaskan Indian><Alaskan Native><Alaskan Native American><American Indian><American Indians><Amniotic Fluid Embolism><Anthropology><Autoimmune Diseases><Automobile Driving><Behavioral><Bio-Informatics><Bioinformatics><Biological><Biometrics><Biometry><Biostatistics><Birth><Bleeding><Blood Vessels><COBRE><Cardiac><Caucasian Females><Caucasian Women><Center of Biomedical Research Excellence><Centers of Research Excellence><Cessation of life><Chronic stress><Collaborations><Collagen><Communities><Conceptions><Continuity of Care><Continuity of Patient Care><Continuum of Care><Coronary><Country><Data><Death><Death Rate><Development and Research><Discipline of Nursing><Discipline of obstetrics><Ensure><Epidemiology><Equity><Ethics><Family><Female Health><Food><Foundations><Funding><Future><Gestation><Goals><Gynecology><Health><Health Inequity><Health equity research><Health system><Hemorrhage><History><Homicide><Human Development><Immunology><Indigenous><Individual><Inequalities in Health><Inequities in Health><Inequity><Infection><Injury><Interruption><Intervention><Intervention Strategies><Investigators><Knowledge><Label><Leadership><Life><Maternal Health><Maternal Mortality><Maternal health equity><Maternal-fetal medicine><Medical><Mental Health><Mental Hygiene><Mission><Mothers><NIH><National Institutes of Health><Native Americans><Non-Hispanic><Nonhispanic><Not Hispanic or Latino><Nursing><Nursing Care Management><Nursing Field><Nursing Profession><Obesity><Obstetrics><Oklahoma><Outcome><Outcomes Research><Parturition><Pathway interactions><Patient outcome><Patient-Centered Outcomes><Patient-Focused Outcomes><Physiology><Population><Postpartum Period><Pregnancy><Pregnancy Outcome><Process><Psychological Health><Public Health><R & D><R&D><R-Series Research Projects><R01 Mechanism><R01 Program><Race><Races><Recommendation><Recording of previous events><Research><Research Grants><Research Personnel><Research Project Grants><Research Projects><Research Resources><Research Training><Research in health equity><Researchers><Resources><Role><Rural><Sampling><Self Care><Sociology><Source><Substance Use Disorder><Suicide><Testing><Translating><Translational Research><Translational Science><Trauma><Tribes><United States><United States National Institutes of Health><White Females><White Women><Woman><Women's Health><Work><adiposity><autoimmune condition><autoimmune disorder><autoimmunity disease><base><bases><biobehavior><biobehavioral><biologic><blood loss><cardiometabolic><cardiometabolism><career><community based participatory research><community led research><community participatory research><community partnered participatory research><community partners><community partnership><community-based partners><corpulence><cultural health><disparities in morbidity><disparity elimination><disparity in health><driving><eliminate disparities><eliminating disparities><epidemiologic><epidemiological><ethical><experience><fatal attempt><fatal suicide><food insecurity><health disparity><health equity-focused research><health inequalities><high risk><histories><implementation science><improved><indigenous community><injuries><innovate><innovation><innovative><insight><intent to die><intergenerational><interventional strategy><intimate partner violence><maternal death><maternal morbidity><maternal outcome><maternal wellbeing><member><morbidity disparities><mortality><mortality rate><mortality ratio><mother outcome><nutrition><participatory action research><pathway><patient oriented outcomes><personal care><post-partum><post-partum care><postpartum care><pregnancy associated death><pregnancy associated mortality><pregnancy related death><prenatal><public health priorities><racial><racial background><racial origin><research and development><research on health equity><research related to health equity><research to attain health equity><resilience><resilient><severe maternal morbidity><social><social role><substance use and disorder><suicides><synergism><translation research><translational investigation><translational opportunities><translational potential><tribal agency><tribal board><tribal community><tribal entity><tribal health><tribal leader><tribal leadership><tribal member><tribal organization><unborn><vascular>