Background: Nationally, Black women experience severe maternal morbidity and mortality (M3) at a notably higher rate than their non-Black counterparts. In Colorado, approximately 5 percent of births are to Black women—yet, they represent nearly 10 percent of maternal deaths. Reviews examining maternal health disparities indicate that research projects targeting disparities and building a culture of equity are needed to improve maternal health outcomes for Black women. Historically, despite willingness to participate, Black people have been underrepresented in health research. Community engagement and community-based participatory research (CBPR) are recommended for engaging racial minorities in patient-centered outcomes research (PCOR). In Denver, a small number of community groups have begun to engage Black women on this issue. However, these existing groups lack partnerships with researchers and universities. As such, a lack of engagement of Black women and communities in the planning/development of research poses a particular threat to advancing maternal health PCOR.
Proposed Solution to the Problem: To address the lack of engagement in maternal health PCOR by Black women/community groups, the project team proposes creating a sustainable Black Maternal Research Coalition (BMRC) in the Denver metro area. Compared to areas with larger Black populations, Black women in Denver have fewer protective factors against adverse birth outcomes due to the lack of community-led organizations partnered with each other and with researchers on this issue. BMRC will be an alliance between Black women, community groups, providers, and researchers. The team seeks to increase the capacity of Black women and community groups to participate in collaborative development of maternal health research questions and PCOR. BMRC will engage and apply the voices of Black women in partnership to identify, prioritize, and carry out PCOR using community-driven and sustainable methodologies. BMRC will be designed and implemented with Black women, community stakeholders, and providers in order to ensure engagement, inclusivity, long-term sustainability, and impact on Black maternal health.
The aims and long-term objectives are to:
- Develop a sustainable, collaborative, and culturally informed BMRC to engage in maternal health outcomes research as it relates to Black women in the Denver area
- Identify maternal health PCOR priorities from the perspective of Black women, community stakeholders, and providers
- Create infrastructure for dissemination of maternal health research findings among Black women and stakeholders in the community
Using the principles of CBPR, the team will:
Aim 1 Methods
- Recruit Black women, community groups, and providers to the BMRC using existing networks and recommendations
- Connect patients, providers, community groups, and researchers
- Conduct community-engaged research trainings/workshops with BMRC members
Aim 2 Methods
- Use qualitative methods with BMRC to learn maternal health experiences and identify research priorities
Aim 3 Methods
- Elicit BMRC input to identify culturally and resource-appropriate dissemination delivery methods
- Discuss recent findings related to maternal health and associated outcomes at quarterly meetings
Projected Outcomes and Outputs:
- An enhanced infrastructure to conduct maternal health PCOR via a culturally informed, CBPR-trained BMRC in Denver
- Tools for engaging Black women in relevant PCOR studies, including a culturally informed community-engaged research training curriculum for Black women, a list of maternal health issues, a prioritized health research agenda for PCOR in this community, and a template for developing similar BMRCs in communities demographically similar to Denver
- A qualitative report of perceived barriers to equitable maternal health care
- A tailored dissemination plan targeted at communicating PCOR findings among Black women
The creation of a sustainable BMRC in the Black community in Denver is significant as it lays the foundation to (a) conduct community-relevant PCOR studies with Black women in the community, (b) disseminate PCOR findings to this community, and (c) engage Black women in PCOR research broadly, a novel approach to PCOR in Black communities.
Patient and Stakeholder Engagement Plan: The team will leverage principles of CBPR and PCOR strategies, including (a) fostering unity in identifying maternal health research priorities/strategies; (b) emphasizing stakeholder-driven priorities, research, and solutions; and (c) building capacity of community stakeholders and researchers to engage in research collaboratively. The project team has extensive experience working in and with diverse communities to improve health. This project currently has support from a collaborative group of Black health providers with affiliations throughout the Denver area. The team will recruit community groups and Black women to the BMRC using a combination of word-of-mouth, advertisements in community venues and clinics, and recommendations from existing community organizations in the area. Together, the team will collaborate to build capacity for engagement, data collection/analysis, dissemination of findings, and community self-efficacy for health research partnerships incorporating strengths identified by the community.
Christina Studts, PhD
Nathalie Dieujuste, BA