Implementation Barriers to Incorporating a Community-Based Doula Program to Improve Birth Outcomes for Black Patients in an Academic Medical Center.

There are significant racial disparities in maternal health and birth outcomes in the USA that disproportionately affect Black individuals. Incorporating community-based doula programs into hospital settings may be an effective intervention to reduce these disparities. However, little research has e...

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Publicado en:Journal of Racial & Ethnic Health Disparities Vol. 13; no. 4; pp. 2629 - 2641
Autores principales: Quinn, Katherine G., Marion, Erica, Williams, Joni S., Blackwell, Dalvery, Olson, Jessica, Palatnik, Anna
Formato: research Journal Article
Publicado: Springer Nature Aug2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2026
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s40615-025-02444-3
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        atl: Implementation Barriers to Incorporating a Community-Based Doula Program to Improve Birth Outcomes for Black Patients in an Academic Medical Center.
      aug:
        au:
          Quinn, Katherine G.
          Marion, Erica
          Williams, Joni S.
          Blackwell, Dalvery
          Olson, Jessica
          Palatnik, Anna
        affil: https://ror.org/00qqv6244 Department of Psychiatry & Behavioral Medicine, Medical College of Wisconsin, Milwaukee, USA
      sug:
        subj:
          Doulas Education
          Community Programs Evaluation
          Program Evaluation
          Program Implementation Evaluation
          Pregnancy Outcomes
          Quality Improvement
          African Americans
          Collaboration
          Academic Medical Centers Wisconsin
          Health Services Accessibility
          Healthcare Disparities
          Maternal Health Services Wisconsin
          Human
          Funding Source
          Pregnancy
          Female
          Wisconsin
          Qualitative Studies
          Semi-Structured Interview
          Focus Groups
          Interview Guides
          Thematic Analysis
          Nursing Staff, Hospital
          Physicians
          Female
      ab: There are significant racial disparities in maternal health and birth outcomes in the USA that disproportionately affect Black individuals. Incorporating community-based doula programs into hospital settings may be an effective intervention to reduce these disparities. However, little research has examined potential barriers and identified strategies to optimize the implementation of a community-based doula program in an academic hospital setting. This study used in-depth interviews with clinicians and nurses (n = 19) and focus groups with doulas (n = 11) to identify multi-level barriers to implementing a doula program for Black pregnant patients in a single academic hospital setting in Milwaukee, WI. Data were analyzed using thematic analysis, and we developed four themes that highlight potential implementation barriers: (1) doulas' advocacy efforts were met with resistance from the healthcare team; (2) there was a lack of trust and established relationships between doulas, clinicians, and nurses; (3) there was a hierarchy of knowledge within medical settings that diminished the value of doulas' expertise; and (4) system-level barriers prevented sustained integration of doula programs. Despite the promise of community-based doula programs, significant investment and resources are needed to support implementation and ensure sustainability.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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