Mom and Baby prenatal visits

REACH - Prenatal

STAR Mom - Prenatal

Hair Collection Instructions for Mom

Thank you for your participation in the REACH study. Our study is interested in learning about how the environment affects our bodies. We are asking for a hair sample, which you can collect by following the instructions below. Your hair can tell us about your typical environmental exposures you have, like exposure to metals. This can help to advance the future of mom’s health. Feel free to call us at (313) 874-3151 if you have any questions or would like to have a staff member walk you through the process.

What’s in your kit:

• (1) Small white envelope
• (1) Biohazard bag
• (1) Sample collection sheet

Tips:

• Your hair does not need to be freshly washed for collection. It is also okay if your hair is bleached, dyed, or treated. We want this to be as simple and convenient as possible.
• Only use hair that has been collected directly from your head. Do not use hair from the face or other parts of the body. Do not use hair that falls out naturally or hair left on a brush or comb. 
• If you have active head lice, please provide the sample when lice treatment is complete, and you no longer have lice. 
• If your hair is braided or styled such that no loose strands are available, collect the sample the next time your hair is re-styled (you can bring the collection envelope to your hair appointment). 
• We only need 5 strands of hair. This helps us get accurate information, but it’s also barely noticeable that it was cut.

Instructions:

 

1. Choose a small section of hair to cut wherever is easiest for you. We recommend the back or an inside layer so that it’s not noticeable.
2. Cut 5 strands of hair as close to your scalp as possible. Avoid plucking, ripping, or tearing strands from your head.
3. Place the strands of hair into the small white envelope provided to you.
4. Seal the envelope and place it in the small biohazard bag provided.
5. Place the biohazard bag in the sample bag provided to you.*
6. Mark the date and time of your hair sample collection on your sample collection sheet.
7. At your next scheduled visit, please bring this hair sample with you.
   
   *The samples you are collecting can all go in the sample bag together! It is also okay for all the samples to be refrigerated

Toenail Collection Instructions for Mom

We appreciate your participation in the REACH study. We are asking that you collect toenail samples following the instructions below. This sample can show us a lot of information, like metal exposures or other environmental chemicals. It is a great example of how our environment impacts our bodies! This information will go on to advance mom and baby health in the future. If you have any questions or concerns, call us at (313) 874-3151 and a study staff member will be happy to talk you through it. 

What’s in your kit:

• (1) Small white envelope
• (1) Biohazard bag
• (1) Sample collection sheet

Tips:

• It is okay if your nails are painted.
• If you regularly get pedicures, feel free to bring the collection envelope with you and ask your nail tech to put your clippings inside.
• Sometimes toenail clippings like to fly across the room. To prevent you from losing too many, here are some ideas:
  • One strategy is to clip your nails after you shower. Your nails will be softer, and some people find that this helps the nails stick to the clippers.
  • Try clipping your nails into an empty grocery bag or trash bag. Open the bag on the floor, place your foot partially inside the bag and then trim! Simply collect the toenails from the bottom when completed and put them into the collection envelope.
  • Clip nails on top of a dark surface such as a rug or towel. Then it will be easier to see them once they are clipped off. You can pick up these fallen nail clippings and put them into the collection envelope.

Instructions:

1. Using your own nail clippers, trim your toenails as you normally would. Try to collect from all 10 toes.
2. Place as many of the toenail clippings as you can into the collection envelope.
3. Before your scheduled visit, seal the envelope and place it into the biohazard bag.
4. Place the biohazard bag in the sample bag provided to you*.
5. Record the date of clippings on the sample collection sheet.
6. Check off that the toenail sample is completed!
7. At your next scheduled visit, please bring this toenail sample with you.

*The samples you are collecting can all go in the sample bag together! It is also okay for all the samples to be refrigerated. 

Vaginal Swab Collection Instructions for Mom

Thank you for your participation in REACH. An important part of our study is collecting specimens that will help us learn more about how the environment affects our bodies. This information could help improve the health of moms and babies for years to come. We are asking you to provide a vaginal swab using the instructions below. This swab will be able to give us insight in to how a pregnant person’s body changes throughout their pregnancy! If you have any questions or concerns, please call us at (313) 874-3151. A member of our study team will be happy to walk you through the process or answer any questions you might have. 

What’s in your kit:

• (1) Swab + Red-Capped Tube  
• (1) Small ClearTube containing liquid 
• (1) Sample collection sheet 
• (1) Biohazard bag 
• (1) Ice pack 

Tips:

• If at any point you feel confused about the collection instructions, please call us.
• Please do not touch the tip of the swab or lay it down on any surface. If this happens, contact us and we will send you a new kit.
• If the liquid from the collection tube spills, contact the study team and we will send you a new stool collection kit!
• Wash your hands with plenty of water if any of the liquid gets on your skin.

Instructions:

1. Place the provided ice pack in the freezer.
2. Wash your hands with soap and water for at least 20 seconds.
3. Remove the small clear tube from the kit bag and place on a flat surface. Be careful not to spill the liquid.
4. Undress from the waist down. You can sit or stand to collect the sample—whichever is most comfortable for you!
5. Pull the swab out from the red-tipped packaging. Be careful to only touch the top of it! 
6. Gently open the folds of the skin at the vaginal opening. Insert the swab 2-3 inches into the vagina.
7. Gently rotate the swab in a full circular motion for 10 seconds. This ensures that the sample is collected on all sides of the swab tip.
8. While still holding the vaginal lips apart, carefully remove the swab from the vagina.
9. Place the swab into the blue-capped Falcon tube containing liquid..
10. Use your hands to break off the handle of the swab. Hold the tube in one hand pointing the opening of the tube away from your face. With the other hand, grasp the swab handle and close the top of the tube. Lean the swab handle against the rim of the tube and bend the handle down until the handle breaks off. If the handle does not break off, repeat the steps and bend the handle in the opposite direction. Throw out the top part of the handle after you break it off, leaving the swab tip and the lower part of the handle in the tube. Screw the cap back on the tube tightly. 
11. Shake the small clear tube with swab in it vigorously for about 30 seconds. 
12. Place the blue-capped falcon tube into the biohazard bag. 
13. The swab shaft, paper/plastic wrapping and white-capped tube with liquid can be thrown in the trash. 
14. Wash your hands.
15. Place the collected sample in the REACH sample bag with the frozen ice pack. If the sample was collected before the day of your appointment, place the collected sample in the sample bag and place the sample bag in the refrigerator.* 
16. Mark the date and time of your vaginal swab collection on your sample collection sheet. Check off that the vaginal swab is completed!
17. Please bring this sample with you to your appointment.

*The samples you are collecting can all go in the sample bag together! It is also okay for all the samples to be refrigerated. 

Stool Collection Instructions for Mom

Thank you for your participation in REACH! An important part of our study is collecting specimens that will help us learn more about how the environment affects our bodies. We are asking for a sample of your stool to learn more about your gut microbiome and the bacteria that naturally live there. This information could help improve the health of moms and babies for years to come! We are asking you to provide a stool sample using the instructions below. If you have any questions, please call us at (313) 874-6433. A member of our study team would be happy to walk you through the process.

What’s in your kit:

• (1) Pair of gloves
• (1) Extra glove
• (1) Swab + White-Capped Tube with liquid
• (1) Stool hat
• (1) Brown-Capped stool tube with spoon attached to the lid
• (1) Biohazard bag
• (1) Sample collection sheet
• (1) Ice pack

Important:

• Gel ice packs should be placed in the freezer for 24 hours or longer prior to stool collection.
• If stool sample is not normal (diarrhea or loose stool), wait to collect until bowel movements return to normal.
• Make sure you keep all the liquid inside the collection tube.
• The liquid inside the tube is harmful if it is swallowed or eaten, so keep out of reach of children and pets.
• Make sure the liquid does not touch your skin.

Tips and Tricks:

• If at any point you feel confused about the collection instructions, please call us.
• Aim to fill the brown-capped tube about half to three quarters of the way full.
• If the liquid from the collection tube spills, contact the study team and we will send you a new stool collection kit!
• Wash your hands with plenty of water if any of the liquid gets on your skin.

Instructions:

1. When you are ready for a bowel movement, prepare your sample collection kit. 
2. If you need to urinate before providing the stool sample, make sure to do so before you place the stool hat onto the toilet seat. Please make sure you do not urinate on the collection hat or stool. 
3. Prepare the paper sample collection hat: 
   a. Do not touch the inside of the collection hat. 
   b. Place the collection hat on a flat surface with the writing side up. Fold the side flaps up. 
   c. Peel the backing off the adhesive tape on both sides of the hat. 
   d. Place the hat into the toilet bowl, towards the back. Attach tape to the top side of the toilet seat. Shape the paper dish into the bowl by gently depressing the center. Be careful not to rip the collection hat. 
4. Stool into the collection hat just as you would into the toilet. When you are finished with your bowel movement, you can: 
   a. Stand up to wipe and discard the toilet paper directly into the toilet bowl, in front of or behind the collection hat. 
   b. Discard the toilet paper into a trash can or bag. 
   c. Discard the toilet paper by setting it in one corner/side of the collection hat, making sure that some stool is untouched by the toilet paper. If the stool collection does not have any toilet paper in it, your sample will be ok! 
5. Following the bowel movement and after you wipe, you may stand up from the toilet, leaving the collection hat on the toilet bowl. At this point, you may put on gloves. 
   
   Stool Swab and Liquid-Filled Tube 
   
   
6. Remove the cap from the tube and place it on the counter. Make sure all of the liquid stays inside the collection tube. 
7. Unwrap the swab from its packing. Make sure you only touch the top half of the swab handle. 
8. Run the swab through the stool while twirling so that you evenly coat the swab with stool on all sides. There is no need to “dig” into the stool. The stool at the surface will work. 
9. The stool should just coat the swab. Make sure that the stool does not come up any further than where the plastic handle starts. The swab should be used as a probe. Refer to the images below if there is any confusion:
   a. Correct amount of stool
   b. Not enough stool  
   c. Too much stool 
10. Place the swab inside the tube with the liquid. Make sure that the swab goes completely into the liquid in the tube. Smush the swab against the side of the tube while mixing to get as much stool as possible off the swab and into the liquid. 
11. Break off the handle of the swab. Hold the tube in one hand, pointing the opening of the tube away from your face. With the other hand, grasp the swab handle and close the top of the tube. Lean the swab handle against the rim of the tube and bend the handle down until the handle breaks off. If the handle does not come off, repeat the steps and bend the handle in the opposite direction. Throw out the top part of the handle after you break it off, leaving the swab tip and the lower part of the handle in the tube. Screw the cap back on the tube tightly. 
12. Shake the tube with the swab in it vigorously for 30 seconds to mix the stool with the liquid. It is normal for the liquid to foam or froth during mixing. 
    
    Stool Large Tube
     
13. Unscrew the lid of the brown top sample collection tube. The lid has a scoop attached. Using the scoop, collect several large scoopfuls of stool and place inside the brown-capped container. 
14. Fill the container at least ¾ full. 
15. Recap the tube tightly. 
16. The remaining stool and the paper collection device may be flushed down the toilet. Avoid flushing the cardboard parts of the stool collection device. The paper “bowl” can be pulled apart from the cardboard holder. 
17. Place both sample collection tubes into the biohazard bag and seal. 
18. Discard the gloves and wash your hands with soap and warm water. 
19. Mark the date and time of your stool sample collection on your sample collection sheet. Check off that the stool sample is completed! 
20. Place the collected sample in the REACH sample bag with the frozen ice pack. If the sample is collected earlier than the day of your appointment, place the collected sample in the sample bag and place the sample bag in the refrigerator. On the day of your appointment, place the frozen ice pack into the sample bag with your samples.* 
21. At your next visit, bring your stool sample with you. 
    
    *The samples you are collecting can all go in the sample bag together! It is also okay for all the samples to be refrigerated. 

Shipping Instructions: 

1. Samples need to be shipped back to the REACH study on a Monday, Tuesday, or Wednesday. 
2. Place the biohazard bag into the shipping box along with any other collected samples and place the return label on the box. 
3. On the day you ship samples back, please contact the REACH team to let them know. You can text (313) 207-1483 or email REACH@hfhs.org. 
4. Take to your nearest FedEx location and drop box off. 

What is Diet ID?

Diet ID is a platform that will allow us to get a general idea of your diet and nutrition. 

• Website
• Instructional Video

Keep in mind:

• You may be used to getting your survey links emailed to you, however Diet ID works a bit differently. You will be emailed your log in information and will then be able to click on the website link to log in! 
• You will complete this in the 1st trimester, 2nd trimester, and 3rd trimester and again at 1 month postpartum 
• You will receive an infographic as a reminder to complete this at all time points
• As a thank you for completing your Diet ID questions, we want to offer you the opportunity to schedule a 30-minute phone call with our dietitian to have your results explained to you!

Prenatal Visits at NCO

Who do I give my samples to?

Before or after your appointment you will be giving your samples to the REACH study team. If you do not see any of the team in the waiting room, you can let the front desk receptionists know that you are a participant in the REACH study and they will take your samples for you. 

What if I forget my samples?

Scenario 1: If you forget your samples and have already completed them, you may bring them back to the clinic within 24 hours of collection.
Scenario 2: If you forget your samples early in the trimester and you have not yet collected them, you can bring them to your next appointment.
Scenario 3: If you forget your samples late in the trimester and you have not yet collected them, you can mail them in. 

Will I still be paid if I forgot my samples?

You will be paid for each sample you provide and can earn up to a certain amount for full participation which can be seen in the table above.

How do I use the ClinCard?

1. In-Store Purchases (by selecting either the “Credit” or “Debit” option)
   a. Using the “Debit” option required a PIN (see “How to set Pin” below)
2. Online purchases
3. ATM to get cash (requires PIN)
4. Cash advance at a bank:
   a. You must know your available balance and inform the teller of the amount you would like to withdraw. Tellers are unable to check your balance (see “How to check your balance” below).
   b. Present the teller with your signed ClinCard and a valid government-issued photo ID
   c. The ClinCard is accepted at all MasterCard member banks (look for a MC logo on the bank/window entrance)

How do I activate my ClinCard?

Your ClinCard is activated once your first payment is loaded. Please sign the back of the card and then you can immediately begin using it by selecting “credit” option in stores or for online purchases. If you would like to use the card at an ATM or get cash-back with the debit function, you will need to create a PIN.

How do I set a PIN?

Call Customer Service at 1-866-952-3795 and follow the prompts through the interactive voice response (IVR).

How do I check my available balance?

1. Call Customer Service (866) 952-3795 and follow the prompts through the IVR
2. Login to MyClinCard.com
   a. Navigate your web browser to www.myclincard.com
   b. Register Account
   c. View Balance
3. Balance Inquiry at ATM (requires PIN)
4. Inquire at your next office visit

Are there any fees when using my ClinCard?

There are no fees* for:

• Making online or in-store purchases
• Cashing out the card by presenting it to a teller at any major bank
• Calling the automated system for balance inquiries
• Calling the Customer Service number and speaking to a live agent
• Addition of funds to the card (Note: Funds can only be added to the card by the site)

The following activities will incur a fee* to the balance on your ClinCard:

• Not using the card or having funds added for 12 months. Please contact (866) 952-3795 if you receive an inactivity fee. 
  • We have scheduled our payments to you to keep your account active.  If you complete all the sample collections/surveys you will not incur this fee during the study.
• ATM withdrawals (fees vary based on location)
• Requesting a paper statement. Instead, you can always check your available balance online or by calling Customer Service.
• Requesting a replacement card through Customer Service. Instead, your study site can replace your card at no charge.
  *See Terms and Conditions for additional information. 

What if the amount of the purchase is for more than the balance on my ClinCard?

If the payment due is for more than the available balance on your card, be sure to inform the cashier of the designated amount you would like to use. Otherwise, if the card is authorized for an amount higher than the available balance, it will be declined. 

What should I do if my ClinCard is lost, stolen or damaged?

If your card is lost/damaged, notify your point of contact at the study site (email: REACH@hfhs.org, phone number: (313) 874-3151, and they will be able to replace it for you at your next appointment at no charge. This will deactivate your old card, transferring any remaining balance to your new card. If you prefer to contact customer service, there is a $7.00 fee for replacement, and it will take 7-10 days to receive by mail.

If your card is stolen, call Customer Service (866) 952-3795. Customer Service will mark the card “stolen” and will assist you in contacting MasterCard to open a case.

Can I use my ClinCard at a restaurant?

Yes. However, please take your ClinCard inside to the cashier and ask them to run the card for a specific amount. Otherwise, if you use the card at the pump, the gas station will preauthorize your card for up to $100 or more. While the preauthorization is not a charge made to the account, as long as it is in place, it factors into the calculation of the available balance. It can then take several days for the preauthorization amount to be removed.

If you schedule a research visit or sample drop-off with us at One Ford Place, please follow these parking instructions: