ClinicalTrials.gg
RecruitingNCT07778966AW2HUpdated Oct 28, 2026

Community Health Worker Support to Lower Blood Pressure After a Pregnancy With High Blood Pressure

An interventional study of Alabama Womb to Heart Solution (AW2H) Community Health Worker (CHW) Program and Usual postpartum care with self-measured blood pressure education and home blood pressure monitor in Pregnancy-Associated Hypertension, Gestational Hypertension and Preeclampsia, sponsored by University of Alabama at Birmingham. Recruiting at 1 site in United States. Open to female participants aged 16 Years to 56 Years. Per ClinicalTrials.gov, last updated 2026-10-28.

Sponsored by University of Alabama at Birmingham · Not applicable, Interventional, and Treatment

Updated Oct 28, 2026Now RecruitingSite recruiting status changed+1 moreGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
174
Allocation
Randomized
Ages
16 Years to 56 Years
Sex
Female
01

Study summary

High blood pressure during or after pregnancy (such as preeclampsia, gestational hypertension, eclampsia, or Hemolysis, Elevated Liver enzymes, and Low Platelet (HELLP) syndrome) raises a mother's risk of heart disease later in life. Many patients do not return for follow-up care after delivery, missing a key window to protect their heart health. The Alabama Womb to Heart Solution (AW2H) trial will test whether pairing postpartum patients with a trained community health worker (CHW) for 6 months lowers blood pressure compared with usual care.

A total of 174 postpartum patients who had pregnancy-associated hypertension or stage 2 high blood pressure will be randomly assigned (1:1) to usual care or usual care plus the AW2H CHW program. All participants receive education on measuring their own blood pressure and a pregnancy-validated home blood pressure monitor. Participants in the CHW group are also contacted regularly by a CHW for 6 months. CHWs coach home blood pressure monitoring, support taking blood pressure medications as prescribed, encourage heart-healthy habits based on the American Heart Association's Life's Essential 8 (LE8), help schedule a primary care visit, provide mother-baby education (such as safe sleep and immunizations), and offer emotional support.

The main outcome is systolic blood pressure 6 months after enrollment, measured at home with the study-provided monitor while a research coordinator observes in person or by video/phone. The study will also look at diastolic blood pressure and whether participants scheduled a primary care visit. Interviews and focus groups will explore participant, CHW, and provider experiences with the program.

Read the detailed description

This is a single-site, two-arm, parallel, randomized controlled efficacy trial conducted at the University of Alabama at Birmingham (UAB), building on the Alabama Womb to Heart Solution (AW2H) feasibility/acceptability pilot (NCT06353256, N=61). Postpartum patients with pregnancy-associated hypertension (gestational hypertension, preeclampsia, eclampsia, hypertension with superimposed preeclampsia, or hemolysis, elevated liver enzymes, and low platelet count [HELLP] syndrome) or stage 2 hypertension (systolic blood pressure [SBP] >=140 mmHg or diastolic blood pressure [DBP] >=90 mmHg) are randomized 1:1 to usual care or usual care plus a 6-month community health worker (CHW) intervention delivered in partnership with ConnectionHealth.

Usual care (both arms) includes brief self-measured blood pressure education, a pregnancy-validated iHealth blood pressure (BP) Cuff Kit (provided through partnership with the Preeclampsia Foundation), and written education on hypertensive disorders of pregnancy and long-term cardiovascular risk. The CHW intervention adds visits or contacts approximately 2 times per week for weeks 1-5, weekly for weeks 6-12, and monthly for weeks 13-26 (in person or virtual), covering home BP monitoring coaching with American College of Obstetricians and Gynecologists (ACOG)-concordant escalation guidance, medication adherence, postpartum and pediatric visit reminders, breastfeeding and contraception counseling, Life's Essential 8 behavior coaching, primary care linkage, mother-baby education, and trauma-informed emotional support.

The primary outcome is mean systolic blood pressure at 6 months post-enrollment (mean of 3 readings taken 1 minute apart with the validated iHealth monitor, following a protocol adapted from the Chronic Hypertension and Pregnancy (CHAP) Maternal Follow-up Study). The trial provides 80% power to detect a 7 mmHg difference in SBP (standard deviation [SD] 14.5, two-sided alpha=0.05) with 138 participants; enrollment of 174 allows for 20% attrition. Analysis follows intent-to-treat principles. Aim 2 comprises qualitative interviews (up to 20 intervention-arm participants) and two focus groups (CHWs/ConnectionHealth leadership; healthcare providers) analyzed thematically to inform future implementation.

02

Conditions studied

  • Pregnancy-Associated Hypertension
  • Gestational Hypertension
  • Preeclampsia
  • Eclampsia
  • HELLP Syndrome
  • Postpartum Hypertension
  • Stage 2 Hypertension

Keywords

  • Community health worker
  • Postpartum
  • Blood pressure
  • Self-measured blood pressure monitoring
  • Cardiovascular disease prevention
  • Life's Essential 8
  • Hypertensive disorders of pregnancy
  • Alabama
  • Primary care linkage
03

In context

Hypertension, Pregnancy-Induced

262 studies on the registry are indexed under Hypertension, Pregnancy-Induced; 71 are open to participants now.

This study's planned enrollment of 174 is above the median of 147 across 174 interventional studies indexed under Hypertension, Pregnancy-Induced.

Browse Hypertension, Pregnancy-Induced studies →

Lead sponsor

University of Alabama at Birmingham is the lead sponsor of 1,421 studies on the registry; 277 are open to participants now.

Of its 164 completed or terminated interventional studies of FDA-regulated products, 130 (79%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
16 Years to 56 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Postpartum patients with pregnancy-associated hypertension (gestational hypertension, preeclampsia, eclampsia, hypertension with superimposed preeclampsia, or hemolysis, elevated liver enzymes, and low count [HELLP] syndrome) or stage 2 hypertension per American College of Cardiology/American Heart Association (ACC/AHA) guidelines (systolic blood pressure [SBP] >=140 mmHg or diastolic blood pressure [DBP] >=90 mmHg) on two separate occasions at delivery-related hospital discharge or during the postpartum period
  • Delivered in the last six weeks at >=14 weeks gestational age, including pregnancy loss
  • 16-56 years old
  • Speaks and writes in English
  • Delivering at University of Alabama at Birmingham (UAB) Hospital

Exclusion criteria

Exclusion Criteria:

  • Declines randomization
  • Does not speak English
  • Currently incarcerated
  • Currently enrolled in other community health worker studies or services
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
174 participants (estimated)

Study arms

  • Active comparator
    Usual Care

    Cardiovascular disease (CVD)-prevention education before hospital discharge from the delivery-associated hospitalization, including brief self-measured blood pressure (BP) education, a pregnancy-validated iHealth BP Cuff Kit, and written education on hypertensive disorders of pregnancy, long-term cardiovascular risk, and postpartum danger signs.

    Other: Usual postpartum care with self-measured blood pressure education and home blood pressure monitor

  • Experimental
    Usual Care + Alabama Womb to Heart Solution (AW2H) Community Health Worker Program

    Usual care (as in Arm 1) plus enrollment in the Alabama Womb to Heart Solution (AW2H) community health worker (CHW) program for 6 months.

    Behavioral: Alabama Womb to Heart Solution (AW2H) Community Health Worker (CHW) Program · Other: Usual postpartum care with self-measured blood pressure education and home blood pressure monitor

Interventions

  • BehavioralAlabama Womb to Heart Solution (AW2H) Community Health Worker (CHW) Program

    Six-month community health worker (CHW) program delivered in partnership with ConnectionHealth. Visit/contact frequency: Approximately 2 times/week for weeks 1-5, weekly for weeks 6-12, and monthly for weeks 13-26; visits may be in person or virtual (phone/video). CHWs coach home blood pressure monitoring with American College of Obstetricians and Gynecologists (ACOG)-concordant escalation guidance, reinforce antihypertensive medication adherence, educate on postpartum danger signs and long-term cardiovascular risk, remind about postpartum and pediatric visits, counsel on breastfeeding and contraception, coach on American Heart Association (AHA) Life's Essential 8 behaviors, assist with scheduling and attending a primary care appointment, provide mother-baby guidance (safe sleep, immunizations, developmental milestones), and offer trauma-informed emotional support.

  • OtherUsual postpartum care with self-measured blood pressure education and home blood pressure monitor

    Standardized self-measured blood pressure (SMBP) education and a pregnancy-validated iHealth blood pressure (BP) Cuff Kit provided before hospital discharge, plus written educational materials on hypertensive disorders of pregnancy and other adverse pregnancy outcomes, long-term cardiovascular disease (CVD) risk, and postpartum danger signs.

06

What researchers measure

Primary outcomes

  1. Systolic Blood Pressure (SBP)

    Mean systolic blood pressure in mmHg, calculated as the mean of 3 readings taken 1 minute apart using a pregnancy-validated iHealth home blood pressure monitor, following a standardized measurement protocol during an in-person or coordinator-observed virtual visit.

    Time frame: 6 months post-enrollment

Secondary outcomes

  1. Diastolic Blood Pressure (DBP)

    Mean diastolic blood pressure in mmHg, calculated as the mean of 3 readings taken 1 minute apart using the same standardized protocol as the primary outcome.

    Time frame: 6 months post-enrollment

  2. Scheduling of a Primary Care Visit

    Proportion of participants with integration into primary care, defined as participant self-report of a scheduled primary care visit.

    Time frame: By 6 months post-enrollment

Other outcomes

  1. Mean Arterial Blood Pressure (MAP)

    Mean arterial blood pressure in mmHg, derived from blood pressure readings taken using the same standardized protocol as the primary outcome.

    Time frame: 6 months post-enrollment

07

Study locations

1 of 1 sites recruiting
  • University of Alabama at Birmingham (UAB Women and Infants Center)
    Birmingham, Alabama 35233, United States
    Recruiting
    • Jesse E Rattan, PhD, MPH, RN · Contactjrattan@uab.edu · (205)-934-1322
08

References and documents

Publications

  • Rattan J, Richardson MB, Toluhi AA, Budhwani H, Shukla VV, Travers CP, Steen J, Wingate M, Tita A, Turan JM, Carlo WA, Sinkey R. A Tool to Help Nurses Provide Health Education on Adverse Pregnancy Outcomes and Cardiovascular Health. Nurs Womens Health. 2024 Dec;28(6):404-409. doi: 10.1016/j.nwh.2024.05.005. Epub 2024 Oct 1. PubMed 39366662 ↗
  • Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, Grandner MA, Lavretsky H, Perak AM, Sharma G, Rosamond W; American Heart Association. Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association. Circulation. 2022 Aug 2;146(5):e18-e43. doi: 10.1161/CIR.0000000000001078. Epub 2022 Jun 29. PubMed 35766027 ↗
  • Muntner P, Shimbo D, Carey RM, Charleston JB, Gaillard T, Misra S, Myers MG, Ogedegbe G, Schwartz JE, Townsend RR, Urbina EM, Viera AJ, White WB, Wright JT Jr. Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association. Hypertension. 2019 May;73(5):e35-e66. doi: 10.1161/HYP.0000000000000087. PubMed 30827125 ↗
  • Lewey J, Beckie TM, Brown HL, Brown SD, Garovic VD, Khan SS, Miller EC, Sharma G, Mehta LS; American Heart Association Cardiovascular Disease and Stroke in Women and Underrepresented Populations Committee of the Council on Clinical Cardiology; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; and Council on Cardiovascular and Stroke Nursing. Opportunities in the Postpartum Period to Reduce Cardiovascular Disease Risk After Adverse Pregnancy Outcomes: A Scientific Statement From the American Heart Association. Circulation. 2024 Feb 13;149(7):e330-e346. doi: 10.1161/CIR.0000000000001212. Epub 2024 Feb 12. PubMed 38346104 ↗
  • Rattan JE, Ugwu LG, Torres-Benson K, et al. Alabama Womb2Heart pilot randomized trial for postpartum individuals with adverse pregnancy outcomes. SMFM 2026 Pregnancy Meeting. 2026.

Individual participant data

Plan to share: Yes — De-identified individual participant data underlying published results may be made available to qualified investigators on reasonable request to the Principal Investigator, subject to a data use agreement and any institutional approvals required at the time of the request. Sharing will be limited to uses consistent with the consent provided by participants.

Time frame: Beginning after publication of the primary study results. Requests will be considered on an ongoing basis thereafter.

Access criteria: Requests should be submitted in writing to the Principal Investigator and will be reviewed on a case-by-case basis. Access requires a data use agreement and any institutional approvals required at the time of the request.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Oct 2026 (actual). Primary completion is estimated for Jul 2029, 33 months after the start.

Of 90 non-industry interventional studies with no phase under Hypertension, Pregnancy-Induced, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 9 and three quarters within 34. This study's planned 33 months is above that.

Counting every sponsor, half of 91 studies reached it within 23 months; a quarter within 9 and three quarters within 34.

Start moved once since we started tracking on Sep 25, 2026: Aug 2026 → Oct 2026, on Oct 28, 2026.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Aug 18, 2026
First posted
Aug 21, 2026
StartActual
Oct 19, 2026was Aug 2026
Primary completionEst.
Jul 30, 2029
CompletionEst.
Jul 30, 2030
Last update
Oct 28, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Status
Not yet recruiting→Recruiting
changed Oct 28, 2026
Sites
University of Alabama at Birmingham (UAB Women and Infants Center) is now Recruiting
Oct 28, 2026
Start date
Aug 31, 2026→Oct 19, 2026 (actual)
Oct 28, 2026
Site contacts
Changed at 1 site. See the sites
Show the site
  • University of Alabama at Birmingham (UAB Women and Infants Center) · Birmingham, United StatesContact added j•••@uab.edu · •••1322
Oct 28, 2026
Show all 1 update
  1. Oct 28, 2026
    Not yet recruiting→Recruiting
    University of Alabama at Birmingham (UAB Women and Infants Center) is now Recruiting
    Start date Aug 31, 2026→Oct 19, 2026 (now actual)
    Site contacts Changed at 1 site. See the sites
    Show the site
    • University of Alabama at Birmingham (UAB Women and Infants Center) · Birmingham, United StatesContact added j•••@uab.edu · •••1322
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07778966
Collaborators
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), ConnectionHealth, Preeclampsia Foundation
Responsible party
Jesse Rattan (Assistant Professor, Department of Obstetrics & Gynecology, University of Alabama at Birmingham) — Principal investigator
First posted
Aug 21, 2026
Start date
Oct 19, 2026
Primary completion
Jul 30, 2029 (estimated)
Completion
Jul 30, 2030 (estimated)
Last update
Oct 28, 2026

Study contacts

Jesse Rattan, PhD, MPH, RN
Contact
jrattan@uab.edu
404-606-3319
Jesse Rattan, PhD, MPH, RN
principal investigator · University of Alabama at Birmingham

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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