Building Equitable Linkages with Interprofessional Education Valuing Everyone (BELIEVE): research protocol for a multisite step-wedge cluster randomized trial

BACKGROUND: Severe maternal morbidity (SMM) and maternal mortality (MM) rates are higher in the U.S. than in other high-income countries, with Black birthing individuals disproportionately impacted. Research highlights the need for collaborative, team-based approaches to tackle these disparities. Interprofessional education and practice (IPEP) competencies provide a promising framework to foster interdisciplinary relationships and improve maternal health outcomes. However, there is still insufficient integration of these competencies in educational curricula and clinical practice. This study aims to evaluate the effectiveness of an interprofessional education (IPE) maternity care training to reduce disparities in maternity care. METHODS AND DESIGN: The study is a multisite step-wedge cluster randomized trial to evaluate the extent to which IPE training reduces racial disparities in maternity care, indexed by postpartum pain experience, assessment, and treatment. IPE training will be implemented at four maternity hospitals in central North Carolina that provide intrapartum care to about 15,000 people each year. The IPE training will be delivered to healthcare team members who provide postpartum maternity care at each facility. The training design includes a 30-minute pre-work module, a 90-minute interprofessional collaboration session utilizing virtual reality (VR) headsets, and a 30-minute post-work module. The pre- and post-work modules will be delivered through an online learning platform. Outcomes will be measured over six study periods, each lasting four months. In the first study period, hospital maternity staff will continue to receive standard continuing education. During study periods 2 to 5, hospitals will sequentially invite their staff to participate in the BELIEVE IPE training. During study period 6, all hospitals will have completed the staff training intervention. Outcomes will be assessed before, during, and after implementation of the IPE training at all four hospitals over 24 months. Our primary outcome is prevalence of severe postpartum pain among Black and white birthing people. The protocol version at time of writing is 6.1. DISCUSSION: This project will evaluate the effectiveness of a virtual reality interprofessional training to reduce disparities in clinical care. Results will inform future IPE training for maternity care teams to improve quality of care and reduce disparities. TRIAL REGISTRATION: National Clinical Trial (NCT) Identified Number: NCT06483022 (date registered: July 1, 2024).