Improving perinatal outcomes in African American women: The Aintie Tia Program

While a large proportion of adverse perinatal outcomes remains unexplained, psychological stress has been hypothesized as an important influence, especially when social support is inadequate. This prospective epidemiologic study uses a community-based participatory approach to extend and improve upon the scientific evidence by exploring the relationship between stress, experiences before and during pregnancy, social context, and the provision of social support in explaining racial disparities in perinatal outcomes. Working collaboratively with the Fort Worth/ Dallas Birthing Project, the study three specific aims: 1) to determine whether the provision of social support improves perinatal outcomes among African American women; 2) to determine whether experiences before or during pregnancy and social context contribute to perinatal outcomes; and 3) to determine the extent to which interactions between social support and social context contribute to perinatal outcomes. The social support intervention, named the Aintie Tia Program after terms used to characterize an aunt (aintie, or tia in Spanish) or other family member who may provide such support, trains and supports community health workers to provide prenatal education during pregnancy, labor support during the birthing process, and breastfeeding and infant care education and support up to 4 months after delivery. African American women in their first or second trimester who enroll in the study complete a questionnaire, are matched with an Aintie Tia, and are followed for outcomes including preterm delivery, low birth weight, and breastfeeding. This partnership approach to improve perinatal outcomes has the potential to reduce persistent and pervasive disparities.