Addressing Black Infant Mortality in Wisconsin through a Collaborative Health Equity Approach to Community-Based, Group Prenatal Care and Infant Support
This project, led by Dr. Jasmine Zapata, aimed to evaluate the feasibility and preliminary outcomes of the Today Not Tomorrow Pregnancy and Infant-Support Program (TNT-PISP). TNT-PISP is a collaborative community-based prenatal care and support group in Dane County that was uniquely designed to serve Black women and infants. Wisconsin’s Black infant mortality rate is the highest in the nation and there is increasing evidence that models of prenatal care that are community-driven, group-based, culturally-relevant and family-centered have the potential to significantly improve maternal and infant health outcomes.
The TNT-PISP generated significant short-, medium- and long-term impacts. The program provided valuable peer support and resources for Black mothers, with 98 percent of participants sharing that they would be willing to return. Thematic analyses highlighted positive effects of the program, including providing peer support, a safe space for Black mothers to share their experiences and valuable information about resources for parents, breastfeeding and community-based doula programs.
The Challenge
Wisconsin’s Black infant mortality rate is the highest in the nation as Black babies are almost three times as likely to die before their first birthday compared to white babies. The number one cause of infant mortality among Black babies are complications of prematurity. The factors leading to inequities in preterm birth and infant mortality are complex and multifactorial; therefore, multidisciplinary and innovative approaches to prenatal and interconception care are critical to improve these outcomes. There is increasing evidence showing that models of prenatal care that are community-driven, group-based, culturally-relevant and family-centered have the potential to significantly decrease Black prematurity rates and improve other maternal and infant health measures. Evidence-based community interventions that have shown promise thus far include community-based doula programs, group-based models of prenatal care and community-based pregnancy support groups.
Project Goals
This project proposed the implementation of a novel approach that combines aspects of all three of the aforementioned evidenced-based models: the Today Not Tomorrow Pregnancy and Infant-Support Program (TNT-PISP). TNT-PISP is a collaborative community-based prenatal care and support group in Dane County that was uniquely designed to serve Black women and infants. This project aimed to launch a program of clinical research on the TNT-PISP that would:
Determine the feasibility and acceptability of TNT-PISP.
Investigate systems-level facilitators and barriers to this collaborative academic health care/community-based partnership.
Assess preliminary outcomes of this novel approach.
Results
The TNT-PISP generated significant short-, medium- and long-term impacts throughout the grant period. The sessions, which included welcome activities, educational presentations by doulas and discussion time, were initially held in person from January through March 2020 before being shifted to a virtual format due to the pandemic. Each monthly support session was attended by about ten women, and 98 percent of survey respondents said they would return again in the future. Despite the transition to virtual sessions, the researchers were able to collect qualitative data from over 50 Black women in Dane County. Thematic analyses from focus groups, surveys and interviews highlighted the sessions’ positive effects, such as providing peer support, a safe space for Black mothers to share their experiences and valuable information about resources for parents, breastfeeding and community-based doula programs. Medium-term impacts included the use of post-session surveys to inform community partners, facilitating tailored wrap-around services and social support on an as-needed basis. Long-term, the project has contributed to improved birth outcomes by strengthening support and protective factors for Black mothers.
