Share ThisHighmark Bright Blue Futures is the organization’s charitable giving and community involvement program. This series provides in-depth articles on its work, community partners, and leaders as they advance their goals around Community Health and Community and Economic Resilience. In this article, we learn about the P3 Program from Mon Health in West Virginia, one of five organizations recognized with a top-level grant as part of the 2023 Highmark Bright Blue Futures Awards Program.
The Highmark Bright Blue Futures Awards Program launched in 2023 to recognize nonprofit organizations for their leadership and exemplary programming. The awards are an expansion of Highmark Bright Blue Futures, a corporate giving and community involvement program that works to ensure “healthier, brighter, stronger futures for all.”
The inaugural awards, made possible by the Highmark Foundation, celebrated organizations throughout Highmark’s four-state health insurance footprint with $465,000 in grants for their work. An awards event had the theme: A Look at Health Equity, Social Determinants of Health, and Philanthropy to Advance Community Health.
In a press release announcing the winners, Kenya T. Boswell, senior vice president, Community Affairs, Highmark Health, said, “with the introduction of the Highmark Bright Blue Futures Awards Program, we are able to celebrate the difference-making organizations that positively impact countless individuals and families.”
In the same release, Yvonne Cook, president, Highmark Foundation, added that, “we are honored to partner alongside these outstanding organizations that embody the values of the Highmark Foundation as they facilitate lasting outcomes that help improve the health and well-being of our neighbors with the support of grants like these.”
From over 170 applications received, five organizations stood out for exemplary work creating healthier, safer, and more equitable communities. In the area of “Impactful Programming,” the top-level grant went to Mon Health’s P3 Program in West Virginia. Their intervention-based program tackles at-risk maternal health in the Appalachian region where the organization has established itself as an effective and trusted community partner.
Mental health has long been a sensitive and stigmatized subject in American culture. But the reality of the suffering is backed by disturbing statistics. For example, although often considered the backbone of American culture, mothers and pregnant women increasingly struggle with perinatal mental health conditions. As many as 1 in 5 women in the U.S. suffer from mental health issues like depression, anxiety and substance use disorders. Of those, an even more concerning 75% never receive treatment, a statistic that can carry fatal consequences; 23% of maternal deaths in the U.S. are linked to perinatal mental health conditions.
In rural and underserved communities, this gap in care is largely due to lack of screening and access to quality maternal care providers. This is the very situation facing pregnant women and mothers across West Virginia. According to data, 1 in 5 West Virginian babies are born in maternity care deserts. These areas present a “lack of maternity care resources, with no hospitals or birth centers offering obstetric care.” For women in these areas (which comprise a shocking 49.1% of West Virginia counties) lack of maternal health care acts as a key social determinant of health and provides often insurmountable obstacles for mothers seeking help.
In 2019, Progressing Through Postpartum (P3), a Mon Health System program, was formed to combat these disparities, and provide the women of West Virginia with screening and intervention that can be lifesaving during pregnancy, and in the critical post-natal period. “Lifesaving” is not too strong a word — one national study of the impacts of postpartum mental health challenges found that suicide risk increases dramatically and is nearly “300 times higher in women with postpartum psychiatric illness” than women without these issues.
P3 begins by screening pregnant women each trimester of their pregnancy with a comprehensive intake process that identifies their mental health risk factors and establishes a psychiatric history. As they attend their prenatal appointments, the screening continues, with the goal of identifying women who are at risk of developing mood disorders such as anxiety and depression.
Many women screen as at-risk for severe mood changes — and that’s when P3 and lead nurse navigator Jennifer Bender, RN, get involved to address the risks. Bender says the priority is to intervene and support women before issues reach critical or life-threatening stages.
“We will never get rid of hormone changes,” she explains. “But if we can interrupt the severity and the duration of them, everyone benefits.”
She adds that P3’s proactive approach allows for quicker and more measurable progress, something she feels bolsters not only the mental health of program participants, but their mindset as well. “If you wait until you’re at the bottom of a pit, one step up doesn’t get you much closer to the light,” she says. “If we stop you before you get there, it’s much easier to dig out.”
Within the West Virgina landscape, P3 had to be innovative in their approach. How could they effectively reach West Virginian mothers in an area where resources are already scarce? As Bender explains, most state and county-based pregnancy resources have a meager 30% reply rate for those eligible individuals who receive outreach. Challenges include a general distrust of health care and system intervention within much of the community and time constraints.
To close communication gaps, P3 used text messaging as a primary form of outreach. The program collaborated with Moodr Health to provide a text messaging system and user-friendly platform custom-crafted for their participants. This cutting-edge technology and digital approach, supported by grants from organizations like Highmark, helps P3 break down barriers and provide intervention and support in an effective way that meets patients where they are.
The results of this approach are astounding: P3 boasts an 85.5% reply rate. As Bender points out, that means many more mothers are connecting with critical supports and interventions like medication management, therapy referrals and psychiatry resources, allowing them to address mental health before it reaches emergent stages.
Lora McDonald, a perinatal social worker with P3, points out that another aspect of the program’s success is its ability to build a network of experts and providers to act as a true support community to the mothers of West Virginia. “We like to call ourselves the bridge to next steps,” she explains.
Their integration with Mon Health’s birthing centers and OB/GYN offices allows them to reach large numbers of new mothers quickly and easily in the community. All patients who deliver at one of these centers — about 1,000 patients per year — automatically receive outreach from P3, regardless of typical eligibility requirements. “If you’re a patient of these hospital systems, you are a patient of ours,” McDonald continues.
For these patients, a network of fully vetted expert services and providers is right at their fingertips. For example, a new mother within P3 gets access and referral to therapists’ offices that accept a wide range of insurance. P3 even assists with getting them quickly scheduled for appointments, removing that stressor from a new or expecting mom’s already full mental plate.
Once connected with a provider, the P3 staff checks in with the patient to ensure their experience with their doctor and their course of treatment is working well for them.
With front-line and local clinicians providing valuable insights and referrals to P3, the program establishes itself as a trusted entity to patients. And with their digital tools at the ready, P3 can “follow up and reinforce that we are a helping hand, and really reduce the barriers these women are facing for a more holistic service approach,” says McDonald.
Their partnership with the HAPI Project, a West Virginia University School of Medicine initiative, allows them to work with community partners to ensure a “warm handoff,” connecting women with the education, resources, and services they trust and will utilize long-term.
Jennifer Bender, RN: My name is Jennifer Bender. I’m a registered nurse and a board-certified lactation consultant. I am a perinatal nurse navigator with the P3 Program at Mon Health Medical Center, and I’ve been with the Medical Center for 17 years.
P3, Progressing Through Postpartum, is a comprehensive follow-up program for Mon Health’s obstetric population. We message every patient that delivers at Mon Health Network — within four days of delivery is our goal — and over the first three months several times postpartum. This is a free service, currently supported by charitable contributions.
We know that as high as one in five moms and one in ten partners will have mood changes related to pregnancy and postpartum. By proactively outreaching to these patients, we are able to provide support to all families.
Lora McDonald, Perinatal Social Worker: My name is Lora McDonald. I am a Perinatal Social Worker for Mon Health’s P3 Program. I’ve been here for a little over a year now.
We applied for the Impactful Programming category, specifically addressing health care disparities. We chose to focus on the moms that we serve in relation to the risk factors that are especially prevalent in West Virginia moms. We take an innovative approach to addressing these issues through our use of text messaging and an integrated health framework to help make sure we’re mitigating all of the barriers that might be preventing our patients from seeking mental health care.
The P3 Program does not charge for our services at all, and we are completely charitably funded, so Highmark’s support will help ensure that we’re able to keep this program going and even grow out reach to impact the lives of more patients.
I think we have known, intuitively, that we’re doing really good work and that we have a unique and beneficial modality, but to have Highmark affirm that the work we are doing is really impactful and beneficial to our patients is just really validating and encourages us to keep going so that we can make a meaningful change in the lives of all Appalachian families.
Bender emphasizes that another important component of P3’s impact comes from the program’s long-term approach to postpartum support.
“We know that mood changes can happen throughout that first year postpartum,” she says. “And with suicide risk actually increasing later in that first year, we continue to reach out to women at three months, six months, nine months, and twelve months.”
This long-term approach is reinforced by the data P3 collects through internal surveys. These surveys, which have been implemented since 2021, focus on patient satisfaction, their experience with timely connections, and most importantly, how long it took for them to see a reduction in their symptoms.
Survey responses, while anonymous, give P3 critical insight into the success of the program, and the need for continued contact and support. The results also speak to the efficacy of the program’s work; Bender says they have seen a 40% reduction in markers on the Edinburgh Postnatal Depression Scale from pre- to post-intervention.
With continued support and investment from organizations like Highmark, P3’s capabilities continue to grow, ensuring that its secure platform and robust, proactive resources meet the needs of mothers in their community. Such partnerships also help raise awareness of the critical work P3 does to address maternal mental health issues.
Highmark Bright Blue Futures Award was another boost to P3’s efforts.
“This award signifies that women do not have to suffer in silence and recognizes the 3,673 women that we have screened and supported since January 2020,” said Bender in a 2023 article announcing the award. “We are passionate about this work, and we are thrilled that the Highmark Foundation and Highmark Bright Blue Futures are coming alongside us to share in this passion.”
Jennifer Bender, RN, has been a labor and delivery nurse for 21 years, is an Internationally Board-Certified Lactation Consultant, and has completed Perinatal Mental Health training through Postpartum Support International. In 2020, she stepped into the role of Perinatal Nurse Navigator alongside the launch of Mon Health’s Progressing through Postpartum (P3) Program. She provides comprehensive follow-up to all postpartum patients that deliver at Mon Health through proactive outreach, and offers feeding support, virtual support groups, and care coordination for those experiencing perinatal mood and anxiety disorders.
Lora McDonald is a recent graduate with dual Master’s degrees in Social Work and Public Administration and has completed Perinatal Mental Health training through Postpartum Support International. She joined Mon Health's P3 Program in 2023 after working as an intern during the last year of her social work program and has stepped into a role as a Perinatal Social Worker. Lora provides outreach and care coordination to pregnant patients that screen at-risk for perinatal mood and anxiety disorders, facilitates virtual support groups, and engages in research and evaluation on behalf of the program.
Highmark Health and its subsidiaries and affiliates comprise a national blended health organization that employs more than 42,000 people and serves millions of Americans across the country.
Entire contents © Highmark Health. All Rights Reserved.
Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.
Need to find info about providers, prescriptions, coverage, claims, ID cards, or health spending or savings accounts? If so, your Highmark member site is the place to go. (It’s separate from this blog.)