Elevating Voices, Addressing Depression, Toxic Stress, and Equity Through Group Prenatal Care: A Pilot Study

Introduction: Elevating Voices, Addressing Depression, Toxic Stress and Equity (EleVATE) is a group prenatal care (GC) model designed to improve pregnancy outcomes and promote health equity for Black birthing people. This article outlines the foundational community-engaged process to develop EleVATE...

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Main Authors: Shannon N. Lenze, Kelly McKay-Gist, Rachel Paul, Melissa Tepe, Katherine Mathews, Sara Kornfield, Cheron Phillips, Richelle Smith, Amanda Stoermer, Ebony B. Carter
Format: Article
Language:English
Published: Mary Ann Liebert 2024-12-01
Series:Health Equity
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Online Access:https://www.liebertpub.com/doi/10.1089/heq.2023.0160
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author Shannon N. Lenze
Kelly McKay-Gist
Rachel Paul
Melissa Tepe
Katherine Mathews
Sara Kornfield
Cheron Phillips
Richelle Smith
Amanda Stoermer
Ebony B. Carter
author_facet Shannon N. Lenze
Kelly McKay-Gist
Rachel Paul
Melissa Tepe
Katherine Mathews
Sara Kornfield
Cheron Phillips
Richelle Smith
Amanda Stoermer
Ebony B. Carter
author_sort Shannon N. Lenze
collection DOAJ
description Introduction: Elevating Voices, Addressing Depression, Toxic Stress and Equity (EleVATE) is a group prenatal care (GC) model designed to improve pregnancy outcomes and promote health equity for Black birthing people. This article outlines the foundational community-engaged process to develop EleVATE GC and pilot study results. Methods: We used community-based participatory research principles and the Ferguson Commission Report to guide creation of EleVATE GC. The intervention, designed by and for Black birthing people, centers trauma-informed care, antiracism, and integrates behavioral health strategies into group prenatal care to address unmet mental health needs. Using a convenience sample of patients seeking care at one of three safety-net health care sites, we compared preterm birth, small for gestational age, depression scores, and other pregnancy outcomes between patients in individual care (IC), CenteringPregnancy™ (CP), and EleVATE GC. Results: Forty-eight patients enrolled in the study (n=11 IC; n=14 CP; n=23 EleVATE GC) and 86% self-identified as Black. Patients participating in group prenatal care (EleVATE GC or CP) were significantly less likely to experience a preterm birth <34 weeks. Rates of small for gestational age, preterm birth <37 weeks, depression scores, and other pregnancy outcomes were similar across groups. Participants in CP and EleVATE GC were more likely to attend their postpartum visit and breastfeed at hospital discharge than those in IC. Discussion: Our findings model a systematic approach to design a feasible, patient-centered, community-based, trauma-informed, antiracist intervention. Further study is needed to determine whether EleVATE GC improves perinatal outcomes and promotes health equity.
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institution Kabale University
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publishDate 2024-12-01
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spelling doaj-art-b164b29a1cad4c3a9e5935fb9d7e67ab2025-08-20T03:49:37ZengMary Ann LiebertHealth Equity2473-12422024-12-0181879510.1089/heq.2023.0160Elevating Voices, Addressing Depression, Toxic Stress, and Equity Through Group Prenatal Care: A Pilot StudyShannon N. Lenze0Kelly McKay-Gist1Rachel Paul2Melissa Tepe3Katherine Mathews4Sara Kornfield5Cheron Phillips6Richelle Smith7Amanda Stoermer8Ebony B. Carter9Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.St. Louis Integrated Health Network, St. Louis, Missouri, USA.Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA.Affinia Healthcare, St. Louis, Missouri, USA.SSM Health St. Mary's and Department of Obstetrics, Gynecology, and Women's Health, St. Louis University, St. Louis, Missouri, USA.Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.St. Louis Integrated Health Network, St. Louis, Missouri, USA.St. Louis Integrated Health Network, St. Louis, Missouri, USA.St. Louis Integrated Health Network, St. Louis, Missouri, USA.Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA.Introduction: Elevating Voices, Addressing Depression, Toxic Stress and Equity (EleVATE) is a group prenatal care (GC) model designed to improve pregnancy outcomes and promote health equity for Black birthing people. This article outlines the foundational community-engaged process to develop EleVATE GC and pilot study results. Methods: We used community-based participatory research principles and the Ferguson Commission Report to guide creation of EleVATE GC. The intervention, designed by and for Black birthing people, centers trauma-informed care, antiracism, and integrates behavioral health strategies into group prenatal care to address unmet mental health needs. Using a convenience sample of patients seeking care at one of three safety-net health care sites, we compared preterm birth, small for gestational age, depression scores, and other pregnancy outcomes between patients in individual care (IC), CenteringPregnancy™ (CP), and EleVATE GC. Results: Forty-eight patients enrolled in the study (n=11 IC; n=14 CP; n=23 EleVATE GC) and 86% self-identified as Black. Patients participating in group prenatal care (EleVATE GC or CP) were significantly less likely to experience a preterm birth <34 weeks. Rates of small for gestational age, preterm birth <37 weeks, depression scores, and other pregnancy outcomes were similar across groups. Participants in CP and EleVATE GC were more likely to attend their postpartum visit and breastfeed at hospital discharge than those in IC. Discussion: Our findings model a systematic approach to design a feasible, patient-centered, community-based, trauma-informed, antiracist intervention. Further study is needed to determine whether EleVATE GC improves perinatal outcomes and promotes health equity.https://www.liebertpub.com/doi/10.1089/heq.2023.0160mental healthhealth equitygroup prenatal carepatient-centered outcomes research
spellingShingle Shannon N. Lenze
Kelly McKay-Gist
Rachel Paul
Melissa Tepe
Katherine Mathews
Sara Kornfield
Cheron Phillips
Richelle Smith
Amanda Stoermer
Ebony B. Carter
Elevating Voices, Addressing Depression, Toxic Stress, and Equity Through Group Prenatal Care: A Pilot Study
Health Equity
mental health
health equity
group prenatal care
patient-centered outcomes research
title Elevating Voices, Addressing Depression, Toxic Stress, and Equity Through Group Prenatal Care: A Pilot Study
title_full Elevating Voices, Addressing Depression, Toxic Stress, and Equity Through Group Prenatal Care: A Pilot Study
title_fullStr Elevating Voices, Addressing Depression, Toxic Stress, and Equity Through Group Prenatal Care: A Pilot Study
title_full_unstemmed Elevating Voices, Addressing Depression, Toxic Stress, and Equity Through Group Prenatal Care: A Pilot Study
title_short Elevating Voices, Addressing Depression, Toxic Stress, and Equity Through Group Prenatal Care: A Pilot Study
title_sort elevating voices addressing depression toxic stress and equity through group prenatal care a pilot study
topic mental health
health equity
group prenatal care
patient-centered outcomes research
url https://www.liebertpub.com/doi/10.1089/heq.2023.0160
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