Project Grant R01MD021578

The National Institute for Minority Health and Health Disparities awarded the University of Hawaii $644,528 on September 1, 2026, under the Minority Health and Health Disparities Research program (CFDA 93.307) to measure the impact of a Native Hawaiian community-based birth preparation program on maternal health outcomes and prenatal care engagement.

The recipient will conduct a quasi-experimental cohort study of Ka Lahui O Ka Po, an established, culturally grounded birth preparation program operated by Kokua Kalihi Valley, a federally-qualified health center on Oahu. The study employs community-based participatory research methods and has two primary components. First, the research team will analyze five or more years of existing evaluation data from Ka Lahui O Ka Po to identify program features and resources supporting maternal health, with particular focus on the introductory session and participant birth stories to develop patient-centered vignettes. Second, a prospective observational cohort study will survey 320 pregnant women across three settings—women completing Ka Lahui O Ka Po and counterparts receiving standard prenatal care at two large healthcare facilities in Hawaii—to assess primary outcomes including prenatal care engagement, perinatal depression, postpartum visit completion, and pregnancy empowerment.

The research responds to documented disparities: Native Hawaiian and Pacific Islander women in Hawaii account for 44 percent of maternal deaths despite representing 22 percent of reproductive-age women, with a maternal mortality ratio of 63 deaths per 100,000 births, the highest among any racial or ethnic group in the state. Place of performance is Honolulu, Hawaii. The period of performance runs from September 1, 2026, through March 31, 2031.