(Pt. 2) We Need Your Support: Supporting Life for Black Mothers and their Children

Build with Humanity exists to overcome systemic inequities through equity centered design and innovation. We specialize in bringing underserved minorities into the product and service design process. We aim to target 4 key areas of inequity: Health, Education, Affordability /Financial inclusion, and Social Justice.

Photo by Sai De Silva on Unsplash

Weekly Updates

We have been focused on completing the following:

1. Completing and submitting our initial proposal The Maternal and Child Health Bureau (MCHB), part of the U.S. Health Resources and Services Administration (HRSA). We completed the second iteration of innovation development and successfully submitted our proposal.
2. We launched version 1 of our website at buildwithhumanity.com
3. We have continued to build our community of people interested in participating in our research studies. We have placed a special emphasis on recruiting individuals that are members of traditionally undeserved sections of the population. We will eventually will recruit members to become apart of our apprenticeship / fellowship program where they will have the chance to gain valuable skills in design, strategy, and business while working with innovation experts.
4. We are actively looking for expert designers and innovators to join our team. The jobs listing can be found on our website.

Better Prenatal Care for Black Women

Below is a summary of our Phase I concept. Further plans will be made to continue co-creation with passionate members of our community panel and members.

Overview

We are designing a mobile application that supports prenatal health by connecting expectant mothers to virtual peer support groups. The app includes the following features:

1. Virtual Prenatal Care Group Sessions. Our app hosts ten monthly 2-hour chat-based prenatal group sessions. Each group of 8 to 12 women is assigned to a prenatal care professional who facilitates each virtual session, which includes health assessments, learning about self-care activities, and discussions on topics related to pregnancy, childbirth, and parenting.
2. Peer Support Forum. In between virtual care sessions, our chat-based community forum provides a way for mothers to hold each other accountable and receive the emotional support needed during pregnancy.
3. Ongoing Monitoring. Our platform leverages artificial intelligence via natural language processing (NLP) to mine and assess patients’ text data in order to alert prenatal care providers of any mental or physical risks mothers may be experiencing. This allows the facilitating care provider to intervene when needed, scaling prenatal care efforts by supporting up to 10x more patients than usual.

Evidence-Based Model of Care

Our virtual care sessions are based on the CenteringPregnancy model, an innovative, evidence-based model of prenatal care that emphasizes risk assessment, education, and support within a group setting (1, 2). In the CenteringPregnancy model, individual prenatal care includes ten 2-hour prenatal group sessions with 8 to 12 women who share similar due dates. Women are invited to join the group sessions after an initial prenatal assessment and laboratory testing with their prenatal care provider is completed. The sessions comprise of prenatal health care and education and begin at 12 to 16 weeks of pregnancy, concluding in the early postpartum phase.

Within the group space, women learn self-care skills, including measuring their own blood pressure and weight, which they record in their medical record. They also discuss issues around the content of pregnancy, childbirth, and parenting. The topics of the group discussion, facilitated by a prenatal care provider, is personalized using self-assessment reports.

Overcoming Barriers to Prenatal Care

CenteringPregnancy is the leading model of group-based prenatal care, with standard processes and a national organization, the Centering Healthcare Institute (CHI), that provides training and implementation support. Our goal, therefore, is to make this model of care more accessible for expectant mothers and their care providers.

Currently, implementing a centering pregnancy program is too expensive for maternal healthcare providers, suffering from limitations such as inflexibility in scheduling, high barriers to access for those without transportation, and failure to address cultural barriers. By introducing virtual peer groups, we aim to: 1) make communication among peer networks and providers more accessible, and 2) reduce physical and economic barriers by providing low-cost, virtual care that does not require travel to a healthcare facility.

Furthermore, we aim to introduce a more culturally sensitive and responsive approach to prenatal, group-based care. In addition to matching women by their due dates, the our app will give women the option to be matched by cultural background, creating a safe space to engage in unique discussions, such as the historical mistrust of healthcare institutions and the impact of racism on mental health among expectant African American mothers.

Measuring Impact

CenteringPregnancy is a proven and highly effective group-based model of prenatal care (3–5). This approach is effective because it is patient-centered, increases engagement through peer learning and support, and lowers the final cost of prenatal care to hospitals by reducing pregnancy complications (e.g. preterm birth). It is also been proven to provide better outcomes for women, while improving breastfeeding rates, prenatal knowledge, and satisfaction.

Self-efficacy theory is a supportive framework for the model. This theory proposes that perceptions of agency affect the achievement of specific outcomes. For example, a woman’s sense of her own ability to handle life stresses may predict her success in coping with the challenges of birth and parenting. The support a woman receives from the group may also motivate her to engage in healthy behavioral changes, leading to healthier pregnancy outcomes (6, 7). Learning from other women in the app will help each woman apply group strengths to the context of her own life, potentially enhancing her personal self-efficacy.

Table 1 — Logic Model

Product Development

Initial Target Population

In a national study that evaluated the common causes of maternal death and injury, black women were 2 to 3 times more likely to die than white women (8). Due to the inequitable maternal health outcomes experienced by minorities, our initial target population will be African American expectant mothers. The equity-centered community design (ECCD) framework, which focuses on cultural and community needs, will be used in the product development process (9).

Phase II — Product Development and Small Scale Testing

Team

Brannon Veal — Engineer, Community Builder and Advocate

Raven L. Veal, PhD — Advisor, Design Researcher in Healthcare

References

1. Rising S. Centering pregnancy: An interdisciplinary model of empowerment. J Nurse-Midwifery 1998;43:46–54.
2. Rising S, Powell-Kennedy H, Klima C. Redesigning prenatal care through centering pregnancy. J Midwifery Womens Health 2004;49:398–404.
3. Picklesimer, A.H., Billings, D., Hale, N., Blackhurst, D., and Covington-Kolb, S. The effect of CenteringPregnancy group prenatal care on preterm birth in a low-income population. Am J Obstet Gynecol. 2012; 206: 415.e1–415.e7
4. Ickovics, J.R., Kershaw, T.S., Westdahl, C. et al. Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstet Gynecol. 2007; 110: 330–339
5. Klima, C., Norr, K., Vonderheid, S., and Handler, A. Introduction of CenteringPregnancy in a public health clinic. J Midwifery Womens Health. 2009; 54: 27–34
6. Dunkel-Schetter C, Sagrestano L, Feldman P, Killingsworth C. Social support and pregnancy: A comprehensive review focusing on ethnicity and culture. In Pierce G, Sarason B, Sarason I, editors. The handbook of social support and the family. New York: Plenum, 1996:375–412.
7. Feldman P, Dunkel-Schetter C, SandmanC, Pathik D.Maternal social support predicts birth weight and fetal growth in human pregnancy. Psychosom Med 2000;62:715–25.
8. Tucker MJ, Berg CJ, Callaghan WM, HsiaJ: The black-white disparity in pregnancy-related mortality from 5 conditions: differences in prevalence and case-fatality rates. Am J Public Health, 2007;97:247–251.
9. http://www.creativereactionlab.com/eccd-field-guide/

What we need from you

1. If you are interested in participating in paid community research opportunities please sign up on our website (here)
2. If you are a designer, product innovator, or passionate and experience maker with a desire to increase equity and inclusion in Austin please sign up (here)
3. If you are a health institution interested in becoming an institutional partner on our project please contact us! (here)

We look forward to seeing you at the Impact Hub Showcase on December 17th!