Integrated culturally affirming perinatal home-visiting initiative: douly model, washington county, or - emerging national research indicates birth doula (BD) care is among the most…

Integrated culturally affirming perinatal home-visiting initiative: douly model, washington county, or - emerging national research indicates birth doula (BD) care is among the most promisingapproaches to addressing racial disparities in maternal health and improving birth outcomes. BDS are trained in pregnancy health, childbirth preparation, labor support, lactation, and newborn care. However, the period of reimbursable care and training excludes key developmental stages and transitional periods in supporting the whole family's health and wellness beyond six-weeks postpartum. Community health workers (CHWS) are trained in areas related to system navigation, home-visiting, resource eligibility, health education, and cultural mediation across the lifespan. Yet, CHWS are not formally trained in the provision of prenatal through postpartum health care. Our proposed integrated culturally affirming perinatal home-visiting initiative: douly model enhances the role of a traditional health worker (THW) through dual-certification as a BD/CHW including additional perinatal enhanced education, who would also engage in home-visiting services (douly model). This initiative will identify and develop a COHORT of douly care providers, who are dual-certified perinatal focused traditional health workers, to partner with families from conception through 12-months postpartum to address systemic barriers and increase access to culturally sensitive perinatal care and community resources. Eligible families will be referred to a perinatal family advocate within WC's coordinated referral system, help me grow. The perinatal family advocate will assist with connecting the family to a douly care provider, participating in the douly COHORT (COHORT). COHORT members will obtain support to complete registration and certification as BD and CHW per the rules and procedures of oregon health authority's traditional health worker program. Additional partners will include culturally specific community-based organizations who will be eligible to apply for funding to: 1) support BD/CHW dual training certification; 2) provide stipends during the completion of practicum requirements; 3) support the development of billing pathways and business acumen; and 4) increase douly provider capacity and fiscal support for enhanced perinatal service delivery from conception through 12-months postpartum. Pregnant people of color encounter racist structures both inside and outside the health care system resulting in long-term health disparities. At the root of these disparities is systemic racism and lack of prioritization of perinatal health, reflected not only in the type of care people receive but also in who is providing the care and how the care is supported by the broader society and systems. These systemic barriers and access to culturally responsive perinatal care is a problem in washington county, oregon and confirmed by a recent community-needs assessment where black, african and african american families and providers reported a variety of perinatal care challenges including delayed care, communication barriers with providers, and extended wait times for appointments. Additionally, perinatal families shared their desire for advocacy, culturally responsive support, and connection to their peers with similar lived experiences. The douly model will provide the necessary depth and breadth of care to impact short- and long-term outcomes related to maternal physical and mental health, social and economic challenges, and provide an enhanced and holistic focus on the perinatal period.