GoMo Health and the Center for BrainHealth focused on what matters most: meeting women where they are, making brain science easy to understand, and empowering them to take ownership of their mental and emotional well-being.
Maternal Brain Health
in an Era of a Global Pandemic
TABLE OF CONTENTS
Introduction ........................................................................................................................................ 3
Program Overview ............................................................................................................................ 4
Program Partners .............................................................................................................................. 5
The Need .............................................................................................................................................. 6
Program Design ................................................................................................................................. 7
Program Objectives ......................................................................................................................... 12
Engagement and Activation ....................................................................................................... 13
The Science of Precision Engagement ...................................................................................... 14
Program Results ............................................................................................................................... 15
Conclusion ......................................................................................................................................... 16
References .......................................................................................................................................... 17
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Maternal Brain Health in an Era of a Global Pandemic
This paper describes a unique approach to learning how to improve the way you use your brain every day — based on rigorous science. GoMo Health ® and the Center for BrainHealth ® have partnered to empower mothers to take ownership of their brain health. No matter who we are or where we’re from, science has demonstrated that we all have a lifelong ability to nurture and strengthen our brain power, just as we do other parts of our body. Our brains define our personalities, how we engage with others, and how we perceive the world around us — even our political leanings and our spiritual connections. Our brains hold our memories and help us solve challenges large and small. At the most fundamental level, it’s through our brains that we experience life. Each of us has the power to make our brains work better for us. This program teaches people how.
For a quick 1-minute overview of the nature of the content, check out this video that kicks off the program for participants! BrainHealth Empowerment with Jennifer Zientz Deputy Director of Programs, Center for BrainHealth Click on the thumbnail or visit: gomohealth.com/activating-maternal-brain-health
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Maternal Brain Health in an Era of a Global Pandemic
PROGRAM OVERVIEW
In mid-2020, as data began emerging on the impact of the COVID-19 pandemic and its effect on the social, emotional, and mental toll it took on women, the Center for BrainHealth and GoMo Health collaborated to provide pregnant and postpartum women with brain health tools, strategies, and techniques that are empowering, easy to understand, and that activate within the context of daily living. The goal is to maintain and improve moms’ brain health as they navigate this major life transition, with all the joys and challenges it brings. While this program is designed for pregnant and postpartum women, brain health is a priority for all genders and ages, in all phases of life — who wouldn’t want to know how to build resilience, lengthen years of cognitive robustness, and regain brain energy to maximize the potential of our most vital organ? This initial program, focused on maternal brain health, will inform other brain health programs currently under development, including those for cardiac, diabetes, oncology, and behavioral health management.
Talk to any pregnant woman and she will likely tell you it feels like there are a million things to think about during pregnancy, from remembering to take daily prenatal vitamins, to finding the right daycare provider, even down to what kind of diapers to use. Considering all that a mother is thinking about at any given moment — whether regarding herself, her child(ren), spouse, or family, it’s easy to understand how those thoughts might lead to feeling overwhelmed, stressed, or anxious. Add the new concerns brought on by the pandemic, and the road to wellness might seem daunting to travel. The science of brain health provides an organized pathway and actionable tools for moms-to-be and new parents to better manage it all. People spend a lot of time and energy focusing on “what” to think about, but do not give enough attention towards “how” to think. This seemingly slight, yet extremely impactful, shift in perspective changes the thinking paradigm from one of psychological and even physiological overload to one of empowerment and resiliency — which is something every new and/or experienced parent could benefit from adding to their “toolkit.”
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Maternal Brain Health in an Era of a Global Pandemic
PROGRAM PARTNERS
CENTER FOR BRAINHEALTH Founded in 1999 as a cognitive neuroscience research and translational science institution, the Center for BrainHealth at The University of Texas at Dallas has made tremendous progress in advancing the science of brain health: how the brain best learns, reasons, and innovates; ways to protect it from decline; and how to repair and regenerate brain systems — all by adopting science-backed healthy brain habits. Acclaimed cognitive neuroscience experts at the Center for BrainHealth have been at the forefront of brain health research for decades, with hundreds of publications in prestigious science journals. They are boldly impatient to bring proven discoveries to the public at the earliest time possible. The Center’s proprietary training program, Strategic Memory Advanced Reasoning Tactics (SMART™), which has been studied in randomized control trials across the lifespan in clinical and healthy populations, provided the foundation for the cognitive tools presented through this program. SMART is a strategy-based training program that teaches individuals to use their brains to be more strategic, innovative thinkers. Utilization of the tools has shown to improve not only cognitive performance but also aspects of psychological wellbeing and daily function. GOMO HEALTH Founded in 2014, GoMo Health is an industry leader in designing, implementing, and marketing award-winning, personalized patient, member, employee, and consumer “health-at-home” engagement solutions that support the continuum of care. Solutions are highly scalable and cost-effective, enabling better self-management, healthy decision making, and improved outcomes. Basing its programs on BehavioralRx ® , its proprietary, evidence-based behavioral and cognitive science of precision engagement, GoMo Health has proven to increase human resiliency, resulting in better patient health outcomes, reduced medical costs, increased joy in practice, and reduced physician and nurse fatigue. BehavioralRx is based on the guiding principle that no two people are identical; therefore, their care plans cannot be either. When considering optimal management of clinical conditions, there are not only the commonly discussed social determinants of health to consider, but personal determinants as well — including confidence in following a care plan, circle of support, and most importantly, outlook. When people are viewed from a combined emotional, behavioral, physical, and metabolic perspective, treating the whole person can be achieved with precision care.
THE PARTNERSHIP The maternal brain health program created by GoMo Health and the Center for BrainHealth is a culmination of the strengths of both the Center for BrainHealth’s clinical brain health research and protocols, and BehavioralRx. Together, this partnership is scaling up decades of brain health research and translation into science-backed protocols — and reaching important new audiences with actionable directives to incorporate into everyday living.
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Maternal Brain Health in an Era of a Global Pandemic
THE NEED
Maternal anxiety, depression, stress, distress, and feelings of being overwhelmed are not new occurrences. Pre-pandemic, it was estimated that approximately 29% of pregnant mothers experience moderate to high levels of anxiety. (Statistics on Rates of Postpartum Depression, n.d.) Clinical researchers are evaluating the pandemic’s influence on stress, including health concerns, economic impacts, and social isolation.
171% increase in women with postpartum depression* In comparison with pre-pandemic mothers, a recent study from the NIH (Ahmad & Vismara, 2021) shows: 148% increase of women reporting moderate to high anxiety 14% increase in depressive symptoms
*The Edinburgh Postpartum Depression screen measures how symptoms of depression impact daily life.
“The prevalence rates of mental disorders among pregnant and postpartum women during the COVID-19 pandemic were high. Timely and tailored interventions should be applied to mitigate mental problems among this population of women, especially multigravida women and women in the first and third trimesters of pregnancy.”
FRONTIERS IN PSYCHOLOGY (Yan, Ding, & Guo, 2020)
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Maternal Brain Health in an Era of a Global Pandemic
PROGRAM DESIGN
This 12-month interactive brain health program for prenatal and postpartum moms was created through the partnership between GoMo Health and the Center for BrainHealth. The program integrates with the GoMo Health suite of perinatal concierge care programs that cover general and individualized education about pregnancy, fetal development, birth, and the postpartum period for both mother and baby.
The Maternal Brain Health program provides bi-directional and engaging education to mothers about healthy brain practices through text messages, detailed dives into additional information, interactive surveys and assessments, monthly videos from experts, and easy exercises and skill development activities to improve brain health. These weekly activities allow mothers to not only learn about the different functions and processes within the brain, but to also take ownership of their brain health. Core to the program, they also learn how to apply the information to everyday obstacles most mothers face, regardless of socioeconomic status. By applying this knowledge to real-life challenges, mothers are empowered to make small, everyday changes that have a big impact on their own quality of life and that of their family. The program is delivered to each participant via any web-enabled device (ex: mobile phone, laptop, desktop, tablet). The content leads with bite-sized, easy-to-digest tidbits of information; many of the brief messages also include links to additional web-based content such as videos and practice worksheets. These links can be accessed through a phone or computer/tablet and were developed and tested by a team of brain health experts, including cognitive neuroscientists, instructional designers, and clinicians.
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Maternal Brain Health in an Era of a Global Pandemic
Six main topics are covered throughout the program. Each topic is introduced during the prenatal period and reinforced during the postpartum time with slightly different suggestions on how to apply the concepts to daily life (referred to in the program as weekly “challenges”). Following are the six main topics, with a highlight and overview of how each is broken down into smaller segments that are easy to understand and apply:
1.
Defining Brain Health and Healthy Brain Habits + Brain Health Empowerment What role do you play in your brain’s fitness? + Brain Health Myth Busting
Monday 1:00PM
A compilation of common brain health myths and the rationales behind the truth. + Positive Brain Health Habits Practical everyday activities that promote brain health.
Understanding Why Less is More for the Brain + With Brain Health, Less is More Distractions decrease our ability to focus. + Test Your Multitasking Ability Think multitasking makes you more efficient? Guess again! + Multitasking; It’s Toxic to the Brain It leads to a decline in fluid intelligence, greater brain atrophy, and chronic stress… just to name a few. + Overcoming Information Overload Learn how to identify when enough is enough with information intake. Wednesday 3:00PM
2.
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Maternal Brain Health in an Era of a Global Pandemic
3.
How Stress and Anxiety Impact the Brain + Brain Breaks Incorporate practical 3-5 minute brain break tips into your day. + It’s OK to Prioritize Yourself! Learn how to remember… you!
Friday 10:00AM
+ How Do Stress and Anxiety Affect the Brain? The not-so-surprising answer: negatively. + Why It’s Important to Prioritize Yourself Accomplishing tasks that are meaningful to us releases dopamine — our brain’s natural reward system. + Possibility Thinking Identifying possibilities decreases stress response and grants access to the brain’s innovative networks.
4.
Understanding How Flexibility of Thinking Can Help Your Brain + Flexibility of Thinking Practice mental flexibility. + Reframing The brain can be rewired to shift from thinking negatively to identifying the positives. + More Than One Right Answer Contrary to popular belief, most problems have more than one solution, and finding them is very healthy for the brain! + Rumination Practical ways to help rewire your brain to shift out of rumination cycles in low-stress situations. + Escaping Status Quo Status quo leads to brain stagnation. Monday 1:00PM
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Maternal Brain Health in an Era of a Global Pandemic
5.
The Importance of Social Relationships on Your Brain + Social Relations Social connections are vital to overall well-being and the brain. + Tips to Strengthen Connections Deepen meaningful relationships through practical tips. + Do Something New
Wednesday 3:00PM
Creating richer interactions with others strengthens our brain’s frontal networks. + Giving and Receiving Advice Perspective-taking strengthens the brain.
6.
The Impact Gratitude Has on the Brain + Gratitude Identifying things to be grateful for (no matter how small) strengthens the brain. + Gratitude Meditation (prenatal only) Practice taking time for gratitude. + Who Are You Grateful For? (postpartum only) The practice of identifying who you’re grateful for strengthens social connections, improves well-being, and promotes brain health. + New Ways to Show Gratitude (postpartum only) Identifying new ways to show gratitude strengthens the brain, and improves social cognition.
Friday 10:00AM
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Maternal Brain Health in an Era of a Global Pandemic
At the end of each month, the mother is asked to complete a brief, voluntary survey to gauge her receptivity, comprehension, and applicability of the information presented.
Once the mother has completed the monthly challenges, including the end of the month survey, a certificate of completion is electronically presented to her in recognition of her efforts to prioritize her brain health.
Wednesday 3:00PM
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Maternal Brain Health in an Era of a Global Pandemic
PROGRAM OBJECTIVES
The main objective of the program is to empower mothers by giving them access to information that makes it easy to understand how the brain functions and how to effectively nurture it, so it operates at optimal levels. In turn, this can provide mothers the tools they need to work through life’s challenging moments and leads to a decrease in feelings of being overwhelmed, anxious, stressed, isolated, and depressed.
In addition to the main objective of the program, there are five supplementary goals:
Mothers believe the knowledge learned will improve their quality of life and sense of well-being.
1.
Mothers feel the information and practices will help them in their motherhood journey.
2.
Mothers confirm the information is easy to understand.
3.
Mothers report not only feeling capable of applying the information/concepts to their daily lives, but actively doing so.
4.
Mothers enrolled in the program will learn something they didn’t already know.
5.
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Maternal Brain Health in an Era of a Global Pandemic
ENGAGEMENT AND ACTIVATION
GoMo Health and the Center for BrainHealth simplified delivery of cognitively complex topics into bite-sized pieces of information that are easily understood by the layperson. Since most U.S. based mothers supported with GoMo Health programming are receiving coverage through a Medicaid Health Plan provider, grade leveling, health literacy, and social determinants of health were at the forefront of conversations regarding content development and presentation.
To meet the program objective of empowering mothers by giving them access to information that makes it easy to learn about the importance of and take ownership of their brain health, the program team relied heavily on BehavioralRx, the science of precision engagement.
BehavioralRx is the GoMo Health evidence-based behavioral and cognitive science of precision engagement that has proven to increase human resiliency, resulting in better patient health outcomes. BehavioralRx uses psychological techniques, leveraging emotional attributes and cognition to motivate in-the-moment actions at home, work, and play that enable a person to adjust their lifestyle to improve their daily functions.
Behavioral Psychology
Focused on human motivation and activation; highly correlated to emotional attributes such as trust, credibility, outlook, and reciprocity.
Cognitive Neuroscience
Focused on cognitive human factor engineering; highly correlated to brain functions such as short- and long-term memory, encoding and movement, learning and memory storage and persistence, and mindful memory retrieval and recall.
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Maternal Brain Health in an Era of a Global Pandemic
THE SCIENCE OF PRECISION ENGAGEMENT
Within the Maternal Brain Health program, GoMo Health utilized BehavioralRx technology to determine the activation strategy, approach, and content delivered. The techniques used include:
BehavioralRx Technologies
Program Application
Simplifying complex brain health topics, breaking them down into step-by-step actionable instructions that are delivered one at a time.
Reduction Technology Activation through simplifying
Tailoring Technology Activation through “in-the-moment” customization
Messages are tailored to the mother’s current month of pregnancy/postpartum time-period.
Nurturing Technology Guided motivation
Through frequent, supportive messaging, participants are gently guided to information that supports brain health lifestyle changes.
Brain health topics are delivered to coincide with a mother’s prenatal/postpartum journey to give her the best opportunity to be able to digest the information and apply it. Each mother decides how many brain health challenges she receives each month. The intent is to provide the information with a frequency that feels right and achievable. High-level brain health topics are broken down into actionable suggestions for ways mothers can apply the information and learning to their daily life. Check-in messages are used to assess if the mother has been able to practice a concept and if it is helping her.
Environment of Need Technology Intervening at the right moment
Influence Technology Activation through shared decision making
Wander and Wonder Technology Activation by increasing memory persistence and recall via mental and physical activities that stimulate contextually relevant neuroreceptors
For additional insights into the GoMo Health BehavioralRx science, check out this video from CEO and Founder, Bob Gold and Shelley R. Schoenfeld, Chief Marketing and Client Services Officer: https://youtu.be/bB2eN-YeoZk
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Maternal Brain Health in an Era of a Global Pandemic
PROGRAM RESULTS
GoMo Health and the Center for BrainHealth are not new to improving the lives of those served. Outcomes data is currently being collected from this program; however, decades of clinical research and real-world applications conducted by each organization have achieved remarkable outcomes and improvements to quality of life in various participant populations, which overlap with the intent of the maternal brain health program, including:
COGNITIVE PERFORMANCE
PATIENT OUTCOMES 69%
PROGRAM MEASUREMENTS 98%
BRAIN HEALTH
31% Increase in Working Memory 27% Increase in Flexibility of Thinking 23% Improvement in Complex Reasoning
30% Increased Connectivity of CEN 17% Increased White Matter Connection 12% Increased Connectivity of DMN 8% Average Increased Cerebral Blood Flow
Participant Satisfaction 90% Retention Rate 77% Participant Activation
Reduction in ED Visits and Hospital Readmission Rates
60% Reduction in Cost of Care 58% Reduction in Depressive Symptoms
42% Reduction in Stress Symptoms
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Maternal Brain Health in an Era of a Global Pandemic
CONCLUSION
The prenatal and postpartum periods can be a time of great joy for many women, but it is also often a time of feeling overwhelmed, anxious, and stressed. The impacts of the COVID-19 pandemic are only compounding these common emotional hurdles and mothers need tangible, easy-to-understand information and actionable tools to better navigate their lives. While there will never be a one-size-fits-all approach to any condition or challenge we face as humans, there are tools available, backed by decades of clinical research. When explained and broken down into digestible suggestions on how to apply to daily life, these tools build upon each other to lay a solid foundation that allows each individual to find empowerment and resiliency no matter the challenge they face. This is the essence of the program created to support every mother’s brain health through the collaboration between GoMo Health and the Center for BrainHealth. To us, every mother matters. Empower a mother and you change the lives of all future generations.
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Maternal Brain Health in an Era of a Global Pandemic
REFERENCES
Want to learn more about how to deliver this brain health program to your members and/or patients? Text BRAIN to 43386 to set time to connect with our team.
Ahmad, M., & Vismara, L. (2021, July 18). The Psychological Impact of COVID-19 Pandemic on Women’s Mental Health during Pregnancy: A Rapid Evidence Review. Retrieved from NCBI: https://www.ncbi.nlm.nih. gov/pmc/articles/PMC8297318/ Statistics on Rates of Postpartum Depression. (n.d.). Retrieved from Postpartum Depression: https://www.postpartumdepression.org/ resources/statistics/ Yan, H., Ding, Y., & Guo, W. (2020, November 25). Mental Health of Pregnant and Postpartum Women During the Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis. Retrieved from frontiers in Psychology: https://www.frontiersin.org/articles/10.3389/ fpsyg.2020.617001/full Chapman, S. B., Fratantoni, J. M., Robertson, I. H., D’Esposito, M., Ling, G. S. F., Zientz, J., Vernon, S., Venza, E., Cook, L. G., Tate, A., & Spence, J. S. (2021). A Novel BrainHealth Index Prototype Improved by Telehealth-Delivered Training During COVID-19. Frontiers in Public Health, 9. https://doi. org/10.3389/fpubh.2021.641754 Chapman, S. B., Aslan, S., Spence, J. S., Hart, J. J., Bartz, E. K., Didehbani, N., Keebler, M. W., Gardner, C. M., Strain, J. F., DeFina, L. F., & Lu, H. (2013). Neural Mechanisms of Brain Plasticity with Complex Cognitive Training in Healthy Seniors. Cerebral Cortex, 25(2), 396–405. https:// doi.org/10.1093/cercor/bht234 Chapman, S. B., & Mudar, R. A. (2014). Enhancement of cognitive and neural functions through complex reasoning training: evidence from normal and clinical populations. Frontiers in Systems Neuroscience, 8. https://doi.org/10.3389/fnsys.2014.00069
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