Neighborhood context and pregnancy health: Perspectives from community-based doulas and mothers using Concept Mapping

Persistent racial disparities in adverse birth outcomes exist in the US. Researchers are increasingly exploring neighborhood residential contexts as fundamental determinants of the racial disparities in birth outcomes because individual risk factors do not completely explain the disparities. Still, the pathways between neighborhood context and adverse birth outcomes are not well understood. This study explored the conceptualization and relationship of neighborhood context with pregnancy health using a community-engaged approach and Concept Mapping, a participatory research method. The specific aims were to: 1) Identify the perceptions of neighborhood factors that influence maternal and infant health among community-based doulas and mothers; 2) Examine the relative importance of the neighborhood factors to preconception health, pregnancy health, postpartum health, and birth outcomes; 3) Determine how these neighborhood factors are related to preconception health, pregnancy health, postpartum health, and birth outcomes. Eighteen community-based doulas and mothers participated in the study. Participants generated a total of 79 unique neighborhood factors they believed to influence perinatal health at different stages (pre-pregnancy, pregnancy, post-partum, birth outcomes). Most of these factors were seen as equally important across the stages studied. Overall, most participants rated the various neighborhood items as either highly or moderately important for all stages. Results from this study contribute to future quantitative research and can be used to inform perinatal health interventions, including community doula programs. Additional details regarding the method and results (including visual diagrams (concept maps) of perceived similarities between neighborhood items and relative importance to perinatal health) are presented.