Utilizing community partnerships to implement and evaluate a culturally competent prenatal education curriculum

Becoming a Mom/Comenzando bien is a 9 session Spanish bilingual, prenatal education curriculum facilitated by trained lay health educators. March of Dimes California Chapter formed partnerships with Early Head Start programs, promotoras associations, secondary schools, hospitals, and private obstetric practices in Los Angeles and Imperial Counties to implement and evaluate Comenzando bien with the goal of improving knowledge and health behaviors that promote healthy pregnancies.

Comenzando bien was implemented in 9 sites reaching 298 women. The majority of participants were Hispanic (90%), between the ages of 16-30 (76%), spoke Spanish at home (79%), and were insured through Medicaid (90%). Pre- and post-test survey analysis demonstrated statistically significant change (p<.05) on questions including: agreeing that a pregnant woman should receive prenatal care even if she feels healthy, appropriately identifying preterm labor signs and postpartum symptoms and agreeing that a woman should take a multi-vitamin after having a baby. The program completion rate was 80%. Eighty two percent of participants rated their experience as excellent, 94% said that the program provided them with social support, 98% said that they learned new information, 90% reported having a postpartum appointment, and 63% reported taking a multivitamin with folic acid daily postpartum.

By forming partnerships with local organizations, the March of Dimes was able to implement and evaluate the program in diverse settings. The improvement in participants' knowledge and behaviors suggests that Comenzando bien may be an effective intervention to promote prenatal and postpartum health and may represent an opportunity to improve upon birth outcomes.