"MAMA's is like a second mom:" Client and Staff Experiences in a Comprehensive Social Risk Care Management Program Within a Perinatal Medical Home.

Publisher: Kluwer Academic/Plenum Publishers Country of Publication: United States NLM ID: 9715672 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-6628 (Electronic) Linking ISSN: 10927875 NLM ISO Abbreviation: Matern Child Health J Subsets: MEDLINE

Publication: 1999- : New York, NY : Kluwer Academic/Plenum Publishers
Original Publication: New York : Plenum Press, c1997-

COVID-19*/epidemiology ; COVID-19*/prevention & control ; Racism*/psychology ; Social Determinants of Health*; Humans ; Female ; Pregnancy ; Adult ; Los Angeles ; SARS-CoV-2 ; Perinatal Care/methods ; Patient-Centered Care ; Qualitative Research ; Premature Birth/ethnology ; Interviews as Topic ; Black or African American/psychology ; Stress, Psychological

Introduction: Addressing persistent racial inequities in preterm birth requires innovative health care approaches. The Los Angeles County Maternity Assessment and Management Access Service Synergy Neighborhood program (MAMA's) is a perinatal medical home program designed to alleviate the impacts of chronic stress by addressing social determinants of health. It reduced odds of preterm birth rates in Black participants, yet it is unclear which program components most contributed to this reduction. This study seeks to understand the experiences of staff and clients within the MAMA's program to identify what factors decrease stress, how the program addresses racism and the challenges and opportunities of optimizing health during the COVID-19 pandemic.
Methods: 21 staff and 34 clients completed semi-structured interviews from November 2020-December 2021. Separate interview guides for staff and clients explored experiences within the program, experiences during the COVID-19 pandemic, and how racism affects clients. Interviews were recorded and transcribed. Analysis used a phenomenologic framework. Coding was performed using grounded theory to identify themes.
Results: Analysis revealed six key themes: Stressors clients face, barriers for undocumented, Latina, and Spanish-speaking clients, exceptional care, emotional support, naming and responding to racism and discrimination, and impacts of COVID-19 pandemic.
Discussion: Staff and clients work together to address social needs in order to address chronic stress and racism in their lives, especially during the COVID-19 pandemic. Interviews revealed relationship building is a cornerstone of the program's success and plays a significant role in alleviating chronic stress in this population.
(© 2024. The Author(s).)

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K23 HD099308 United States HD NICHD NIH HHS; H49MC32718 United States HRSA HRSA HHS; UA6MC32492 United States HRSA HRSA HHS; K23HD099308 Eunice Kennedy Shriver National Institute of Child Health and Human Development

Keywords: COVID-19; Discrimination; Preterm birth; Racism; Social determinants of health

Date Created: 20240131 Date Completed: 20240615 Latest Revision: 20240619

20240619

PMC11180014

10.1007/s10995-024-03896-5

38294604