Background: Inequities in perinatal mental healthcare treatment are contributing to the maternal mortality crisis among Black and Indigenous birthing people. The imperative to address perinatal mental health inequities has only increased, in light of the disproportionate impact of the COVID-19 pandemic on Black and Indigenous communities.
Proposed Solution to the Problem: System-level interventions, such as Perinatal Psychiatry Access Programs, hold unique opportunities to provide scalable solutions to address these inequities. Yet, limited evidence exists on the comparative effectiveness of system-level interventions to address perinatal mental health inequities and building this evidence will require partnership with relevant stakeholders. Accordingly, three research collaboratives were proposed, composed of community members critical to partnerships for future PCOR/CER research, including: 1) birthing individuals from communities underserved by mental healthcare systems, 2) obstetric and childbirth professionals that serve these communities, and 3) mental health equity advocates, healthcare system leaders, and PCOR/CER researchers.
Objectives: This project will build the capacity of relevant stakeholders and researchers to partner in the planning, completion, and dissemination of patient-centered outcomes research/comparative effectiveness research (PCOR/CER) studies to address perinatal mental health inequities among Black and Indigenous communities. Over the course of this 24-month project, the aims include:
Aim 1: To convene three collaboratives through interactive workshops that will build capacity for stakeholder-engaged PCOR/CER studies to address perinatal mental healthcare inequities.
Aim 2: To develop and disseminate a Roadmap generated during the interactive PCOR/CER workshop series.
Aim 3: To conduct both formative and summative evaluations of our engagement approach and the work products developed to support PCOR/CER.
Activities: Interactive workshops will generate journey maps, research questions, infographics, and brief videos that will be collated into a Roadmap to promote partnership in future PCOR/CER studies of system-wide interventions to address perinatal mental health inequities.
Projected Outcomes and Outputs:
The short-term outcomes are to: 1) assemble and convene three collaboratives, 2) foster co-learning through interactive workshops, and 3) develop a Roadmap to promote partnership in PCOR/CER to address perinatal mental health inequity. After the project period, the mid- and long-term outcomes are to disseminate the Roadmap through our community partnerships and to advance perinatal mental health equity by deepening capacity for PCOR/CER partnerships in research.
Patient and Stakeholder Engagement Plan: The engagement strategy for this project engages the six PCORI Engagement Principles, catalyzing and expanding upon the existing collaborations and a PCORI-funded award, Comparative Effectiveness of Perinatal Psychiatry Access Programs. Engagement includes partnership with stakeholder groups holding complementary and relevant expertise, including birthing people with lived experience, perinatal mental health disparities researchers, the perinatal professionals that serve these communities, mental health equity advocates, federal agency and healthcare system leaders, and PCOR/CER researchers.
Project Collaborators: This engagement project is a collaboration with a multidisciplinary team from SUNY Downstate Health Sciences University School of Public Health (DPL: Thomas Mackie), University of Illinois at Urbana-Champaign School of Social Work (DPL: Karen Tabb Dina), University of Massachusetts Chan Medical School (Site PL: Nancy Byatt), and Postpartum Support International (Site PL: Wendy Davis). The team brings the expertise required to build capacity for future PCOR/CER studies to identify patient-centered and evidence-based system-wide solutions to perinatal mental health inequities.