| Title: |
Study Protocol: A Mixed-methods Study of the Implementation of Doula Care to Address Racial Health Equity in Six State Medicaid Programs |
| Authors: |
Jarlenski, Marian; Kennedy, Susan; Johnson, Annaliese; Hale, Caroline; D'Angelo, Zoe; Nedhari, Aza; Coffee, Gerria; Chappell-McPhail, Molly; Green, Kiddada; Méndez, Dara D; Goetschius, Leigh G; Gareau, Sarah; Ashford, Kristin; Barnes, Andrew J; Ahrens, Katherine A; Zivin, Kara; Mosley, Elizabeth; Tang, Lu; Writing Committee for Medicaid Outcomes Distributed Research Network |
| Source: |
Publications |
| Publisher Information: |
Scholar Commons |
| Publication Year: |
2024 |
| Collection: |
University of South Carolina Libraries: Scholar Commons |
| Subject Terms: |
doula care; Medicaid; health equity; Social Work |
| Description: |
Background Racial inequities in severe maternal morbidity (SMM) and mortality constitute a public health crisis in the United States. Doula care, defined as care from birth workers who provide culturally appropriate, non-clinical support during pregnancy and postpartum, has been proposed as an intervention to help disrupt obstetric racism as a driver of adverse pregnancy outcomes in Black and other birthing persons of colour. Many state Medicaid programs are implementing doula programs to address the continued increase in SMM and mortality. Medicaid programs are poised to play a major role in addressing the needs of these populations with the goal of closing the racial gaps in SMM and mortality. This study will investigate the most effective ways that Medicaid programs can implement doula care to improve racial health equity. Methods We describe the protocol for a mixed-methods study to understand how variation in implementation of doula programs in Medicaid may affect racial equity in pregnancy and postpartum health. Primary study outcomes include SMM, person-reported measures of respectful obstetric care, and receipt of evidence-based care for chronic conditions that are the primary causes of postpartum mortality (cardiovascular, mental health, and substance use conditions). Our research team includes doulas, university-based investigators, and Medicaid participants from six sites (Kentucky, Maryland, Michigan, Pennsylvania, South Carolina and Virginia) in the Medicaid Outcomes Distributed Research Network (MODRN). Study data will include policy analysis of doula program implementation, longitudinal data from a cohort of doulas, cross-sectional data from Medicaid beneficiaries, and Medicaid healthcare administrative data. Qualitative analysis will examine doula and beneficiary experiences with healthcare systems and Medicaid policies. Quantitative analyses (stratified by race groups) will use matching techniques to estimate the impact of using doula care on postpartum health outcomes, and will use time-series ... |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
https://scholarcommons.sc.edu/instituteforfamiliesinsociety_pub/61; https://scholarcommons.sc.edu/context/instituteforfamiliesinsociety_pub/article/1060/viewcontent/s12961_024_01185_9__1_.pdf |
| DOI: |
10.1186/s12961-024-01185-9; |
| Availability: |
https://scholarcommons.sc.edu/instituteforfamiliesinsociety_pub/61; https://doi.org/10.1186/s12961-024-01185-9;; https://scholarcommons.sc.edu/context/instituteforfamiliesinsociety_pub/article/1060/viewcontent/s12961_024_01185_9__1_.pdf |
| Rights: |
© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modifed the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ . |
| Accession Number: |
edsbas.A89904FD |
| Database: |
BASE |