RESUMEN
The United States has one of the highest infant mortality rates among developed countries. When stratified by race, disparities are more evident: Black infant mortality rates are 2.5 times higher than non-Hispanic white infants. Structural, systemic racism is a contributing cause for these racial disparities. Multisector collaborations focused on a common agenda, often referred to as collective impact, have been used for infant mortality reduction interventions. In addition, community-based participatory approaches have been applied to incorporate those with lived experience related to adverse pregnancy outcomes. This article critically describes the transition of an infant mortality collective impact initiative from being led by a multisector organizational group to being community led over a 5-year period, 2015-2020. A 34-member community leaders group was developed and determined four priorities and corresponding strategies for the initiative. Findings show that community participatory approaches are a way to address racial equity for public health initiatives.
Asunto(s)
Negro o Afroamericano , Investigación sobre Servicios de Salud , Mortalidad Infantil , Femenino , Humanos , Lactante , Embarazo , Participación de la Comunidad , Disparidades en el Estado de Salud , Estados UnidosRESUMEN
Introduction Racial disparities in birth outcomes are a significant problem in the U.S. The St. Louis Healthy Start (SLHS) program, funded for 14 years, had a goal of reducing disparate rates of poor birth outcomes in three disadvantaged communities in the St. Louis area. The Making Change Happen Leadership Academy (MCHLA) was an unanticipated community-driven effort that grew out of SLHS and continues today. The primary goal of the MCHLA is to empower women to gain mastery over their lives and use their power to improve birth outcomes in their communities. Methods Qualitative interviews were conducted with MCHLA participants to determine the impact of participation in the MCHLA on their leadership skills and attitudes. Results Participants reported positive attitudes about themselves including increased confidence and improved parenting skills. Through active participation in project work, they noted increased professional and advocacy skills and recognition of the importance of their voice. As leaders, they recognized the importance of giving and receiving emotional, tangible, and information social support. The small sample prevents us from confidently reporting that findings directly relate to the MCHLA. Discussion Leaders exist in all communities. Public health practitioners may help enhance and develop leaders with tangible support. We need to encourage more MCHLA type programs while systematically evaluating their impact on empowerment in underserved women.