RESUMO
BACKGROUND: Pregnant obese women have an increased risk for infant mortality and poor maternal outcomes. Environmental and social conditions pose barriers for less-advantaged overweight women to participate in weight loss interventions. The B'more Fit for Healthy Babies Program aimed to address existing gender inequities that persist where exposure to community-level trauma is present. METHODS: A gender-based analysis using qualitative and quantitative approaches informed B'more Fit's intervention and identified opportunities for trauma-informed care policies. Key data sources for analyses included two series of focus groups and a quantitative survey. Review of additional Baltimore-based literature and research also informed policy development. RESULTS: A workgroup formulated policies for B'more Fit staff and participants. Policies involved technical assistance, staff consultation, and gender-sensitive counseling sessions. These activities gained the attention of the Baltimore City Health Department's leadership, and department-wide trainings were conducted. Highly publicized violence in Baltimore led to expanded trauma-informed care training and policy development in all local government agencies through a partnership between the Baltimore City Health Department and Behavioral Health Systems Baltimore, Inc. CONCLUSIONS: The development and monitoring of trauma-informed interventions and policies within governmental and human service agencies can counterbalance social and environmental exposures. Applying a gender-based and trauma-informed program provided B'more Fit participants with strategies for weight loss, improved nutrition, and better parenting. Coordinated policies and interventions are underway in city institutions to address residents' behavioral health needs and improve citywide services.