This research aims to evaluate the effectiveness of maternal health policy interventions in reducing Black maternal mortality rates in the United States. Despite progress in maternal healthcare, Black women continue to experience disproportionately high maternal mortality rates. Maternal health policy interventions have been implemented to address this issue, but their effectiveness remains unclear. This study will use a systematic review of existing literature to assess the impact of maternal health policy interventions on Black maternal mortality rates. The findings of this study can inform policymakers and healthcare professionals about the effectiveness of current policies and help identify gaps in maternal health policy interventions. By improving the effectiveness of these interventions, we can work towards reducing maternal mortality rates for Black women and improving maternal health outcomes overall.

Background: Racial disparities in pregnancy-related cardiovascular morbidity and mortality are largely preventable and warrant community-engaged action. Counseling women pre-pregnancy on healthy lifestyle behaviors can reduce their heart disease risk up to 82%. There is limited information about implementing preconception counseling with Black women/men in community-based settings. We developed a culturally tailored preconception/inter-conception counseling program, Project IMPACT, through engaging in academic-community partnerships built on mutual trust and collaboration. The objective of this study was to understand the contextual determinants of the successful implementation of Project IMPACT among the participating community-based sites.

Methods: Guided by the Practical, Robust, Implementation and Sustainability Model (PRISM), we conducted a mixed methods contextual assessment of: 1) Staff/community perspectives on Project IMPACT; 2) Characteristics of site staff/communities; 3) Factors that support delivery of Project IMPACT; 4) External incentives or penalties for delivery of Project IMPACT. Each community organization (n=10) completed a survey, staff and community focus group and participated in regional advisory board meetings and a larger multi-site community strategy session.

Results: Findings indicated support for preconception counseling, as it aligns with site missions. This support was present despite many sites not currently providing preconception counseling. We learned information about site capacity and infrastructure, referral networks, and perceptions of preconception health.

Conclusion: Across our Project IMPACT community partners, we identified a high priority to deliver Project IMPACT and several characteristics that will warrant tailoring to successfully collaborate with these partners. In particular, this offered an opportunity to recognize and address the unique needs of our partners.

Background: Maternal morbidity and mortality in Texas occur at high rates and preeclampsia, specifically, has increased by 37% since 2017. Preeclampsia increases risk for delivery complications, cesarean, and preterm birth and increases risk of future cardiovascular disease. Early prenatal care access in the Texas Panhandle is poor, and preeclampsia prevention necessitates early care access. Improved implementation of evidence-based interventions for preeclampsia screening and prevention are needed in this region. The aim of this study is to understand the implementation landscape for preeclampsia screening and prevention by applying the Consolidated Implementation Research Framework 2.0 (CFIR2) and a mixed-methods approach.

Methods: A mixed-methods, community-based participatory research approach will be used to examine implementation constructs of the five CFIR2 domains. Inpatient data from maternity hospitalizations over 5 years will be analyzed to provide baseline prevalence of preeclampsia and related morbidities. A community health needs assessment survey will be used to understand access to prenatal and postpartum care. These data will be used alongside qualitative data to establish maternal health priorities. Focus groups with the priority population and interviews with stakeholders will identify feasibility and acceptability of proposed implementation strategies (community health workers, telehealth, and group prenatal care) at the individual level, within organizations, and across the communities more broadly.

Objective: Implementation strategies to improve preeclampsia screening and prevention will be identified, refined, and revised as needed during this Phase I study and verified through community engagement. Results will inform development of a Phase II implementation trial for preeclampsia screening and prevention.

Background:

Systemic oppression has thwarted Black perinatal/reproductive/maternal health workers from gaining adequate platforms and resources to learn and create change. We possess the knowledge and expertise to generate solutions that will improve maternal and reproductive health, rights, and justice for our communities. The Black Maternal Health Incubator Hub (BMH-IH) was born out of an expressed need for trainings, guidance, tools and education that centers Black thought and leadership by utilizing reproductive justice, birth justice, disability justice and holistic care principles.

Methods/Implementation:

The BMH-IH Pilot Cohort included a nine week virtual learning cohort in the Fall of 2023. Four Black subject matter expert trainers were employed under the topic of Inclusive Perinatal Care for Black Paraprofessionals which included trainings on birth justice, reproductive justice and disability justice frameworks as it connects to concepts of inclusivity, care and support of disabled and/or Queer families/birthing people in the perinatal period. The cohort included individuals representing nine Black-led/centered organizations across the United States that provide direct care perinatal services to Black Queer and/or disabled clients.

Results/Conclusions:

Learning hubs that center teachings from Black thought leaders and provide a supportive environment for the Black perinatal care workforce is an effective approach to addressing the Black Maternal health crisis in the US as it fills a very critical need gap experienced by the workforce largely tapped to support Black birthing people. Additionally, results from evaluative feedback which informed the future ahead for building out educational offerings within the BMH-IH will be addressed in the session.