Introduction: Increasingly, community-based models of doula care are receiving attention as possible interventions to address racial inequities in maternal health care experiences and outcomes. In 2018, community-based organization SisterWeb launched to provide free culturally congruent community doula care to advance birth equity for Black and Pacific Islander pregnant people, with funding from the San Francisco Department of Public Health. We conducted a process evaluation of SisterWeb's first 1.5 years of existence to identify multilevel barriers and facilitators to implementation of their programs.
Methods: Guided by the Equitable Evaluation Framework™, we conducted 46 in-depth interviews with individuals from 5 groups: SisterWeb leadership, doulas, doula mentors, and clients, and external stakeholders.
Results: Barriers included having diverse clientele groups with unique needs, an ineffective payment model, and simultaneously building an organization and developing and implementing programs. Facilitators included the presence of established strategic partnerships, positive reception of services due to an unmet need for culturally and linguistically congruent pregnancy and birth support among SisterWeb's clients, a clear organizational vision and mission, and a unique doula cohort model.
Discussion: Our findings suggest developing community doula programs pay close attention to the difference between launching a program versus an organization, including the required resources of each, the sustainability of payment models for community doulas, and the provision of culturally relevant, needed services within priority communities. Furthermore, strategic partnerships with maternal health stakeholders in birthing sites, particularly hospitals, are vital to the success of a community doula program.
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http://dx.doi.org/10.1007/s10995-022-03373-x | DOI Listing |
J Evid Based Soc Work (2019)
December 2024
Rural Institute for Inclusive Communities, University of Montana, Missoula, Montana, USA.
Purpopse: There is a gap in the current literature regarding how doula care may be implemented into existing systems in Montana to best address the needs of individuals with substance use disorders (SUDs) during the perinatal period. Doulas may be particularly well positioned to reach a diverse range of patients, allowing them to feel supported and advocated for within the medical system. This study aims to illustrate the perspectives and experiences of doulas, individuals who have experienced perinatal SUDs, and maternal and mental health providers.
View Article and Find Full Text PDFMidwifery
December 2024
Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA. Electronic address:
Problem: Doulas are perinatal support professionals who increasingly serve parents across socioeconomic levels in the U.S. Although present during a time of significant emotional upheaval, doulas receive limited training in emotional support.
View Article and Find Full Text PDFBirth
December 2024
Community Doula, Albuquerque, New Mexico, USA.
Background: Black, Indigenous, and people of color (BIPOC) families comprise a disproportionately low percentage of home and freestanding birth center births in New Mexico (NM), despite NM Medicaid coverage of care by Licensed Midwives (LMs) in these settings. The purpose of this study was to examine why low income BIPOC seek out LM care, how they benefit from this model of care, and which factors facilitate and obstruct access.
Methods: We conducted 7 focus groups with 55 low income BIPOC individuals who had birthed in New Mexico in the past 5 years.
BMC Public Health
December 2024
Angered Hospital, Hospitals West, Region Västra Götaland, Gothenburg, Sweden.
Background: In most countries, lower rates of COVID-19 vaccination have been observed in foreign-born individuals, yet little is known about the underlying reasons, especially as reported by these individuals themselves. This exploratory interview study investigated lack of information access and hesitancy towards taking the COVID-19 vaccine among foreign-born individuals in Sweden.
Methods: We used purposive sampling to recruit foreign-born adults who expressed being hesitant towards getting vaccinated, as well as health guides and doulas who were assigned to spread COVID-19 related information in immigrant-dense urban areas.
J Public Health Manag Pract
December 2024
Author Affiliations: Public Health Department, NORC at the University of Chicago, Bethesda, Maryland (Mss Van Vleet, Chitwood, Hallman, Heffernan, Fromknecht, and O'Leary); and U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, Washington, District of Columbia (Mss Lin and Hoyer).
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