This proposal aims to support a research partnership between Multnomah County’s Healthy Birth Initiative (HBI) and Dr. Dawn Richardson, a physician in the OHSU-PSU School of Public health. HBI targets significant perinatal health disparities for African-American women, specifically low birth weight and infant mortality, using a culturally specific approach that includes health education, home visits, and case management. Dr. Richardson is a social epidemiologist who examines the impact of social stress on birth outcomes. Dr. Richardson and HBI are in the early stages of exploring research questions to (1) identify sources of maternal stress and pathways linking stress to adverse birth outcomes, and (2) examine how HBI’s model may mitigate stressors and enhance outcomes.
HBI participants have lower rates of adverse outcomes than do other African Americans in the project area, and we are particularly focused on determining the effectiveness of the HBI model as compared with “traditional” prenatal care and on identifying key aspects of model effectiveness. Recently conducted focus groups with HBI participants pointed to racism and discrimination as social stressors, potentially mitigated by the social support received through HBI. We plan to engage HBI participants and relevant stakeholders (e.g., providers) to further explore these emerging questions as a research partnership, with the ultimate goal of pursuing funding for a patient-centered comparative effectiveness research (CER) study. We will develop a formal partnership with this funding, including an advisory board comprising HBI participants and relevant stakeholders to guide the development (via focus groups, a survey, and partnership meetings) of CER questions that will drive a research proposal.