Black Women for Wellness

The United States ranks among the worst high-income countries for maternal health outcomes, with Black women experiencing disproportionately high and alarming rates of maternal mortality and morbidity. In Los Angeles County, Black women are four times more likely to die from pregnancy-related causes than women of other racial and ethnic groups. These disparities may partially be attributed to social determinants of health, including transportation access. Lack of transportation can hinder access to healthcare, with significant consequences for reproductive health. This study investigates how transportation barriers affect Black birthing people’s access to maternal healthcare in Los Angeles. In partnership with Black Women for Wellness, we conducted a descriptive, observational study using an online survey completed by 235 respondents, all of whom self-identified as women. Findings reveal that Black women in Los Angeles face substantial transportation barriers when seeking maternal healthcare, including limited public transportation, lack of personal vehicles, and challenges in securing rides. Many participants reported that these issues caused delayed or missed prenatal appointments. These results underscore the urgent need for policy interventions and systems-level solutions to improve transportation access. Addressing these barriers is essential for reducing maternal health disparities and improving outcomes for Black women.

Background: Text messaging may offer health systems a low-cost, user-friendly method to provide social resource information at hospital discharge.Assessing equitable reach and engagement is paramount prior to wide-scale implementation.Objective: To compare reach and engagement of a novel, text message intervention to address Food Insecurity (FI) between English-and Spanish-speaking caregivers.Methods: We conducted a one-year prospective pilot to evaluate a novel, automated text messaging system designed to deliver geographically-tailored food resource information to families with FI after hospital discharge.English-and Spanish-speaking caregivers of hospitalized children with a positive FI screen documented during routine clinical care were included.Caregivers received a food resource text message 1 day and 4 days after discharge and two interactive text message surveys.Primary outcomes were systemcollected measures of reach and engagement.Among survey respondents, caregiver-reported measures of reach and engagement were also measured.We compared outcomes by language using Chi-Squared tests.We also conducted semistructured interviews with 20 English-and 11 Spanishspeaking caregivers to understand intervention usability and acceptability.Results: Of 190 caregivers, 134 (71%) spoke English and 56 (29%) spoke Spanish.There were no differences in system-or caregiver-reported reach by language.As compared to Englishspeaking caregivers, Spanish-speaking caregivers more frequently engaged by clicking the FindHelp link (49% vs. 32%, p = 0.028) and responding to follow-up surveys (67% vs. 45%, p = 0.009), but less frequently used the information to search for food resources (68 vs. 93%, p = 0.021).In interviews, Spanishspeaking caregivers expressed mistrust in information received from a text message and preference for discussing resources with someone.Conclusion: Our text message intervention for FI equitably reached English-and Spanish-speaking caregivers.Spanishspeaking caregivers may need additional interpersonal contact by phone or in person to use the resources provided.

Background: Rigid protocols can hamper translation of evidence-based interventions from research to real-world settings. This investigation aimed to develop procedures for modifying the study protocol of a community-based participatory research (CBPR) project and to analyze the theoretical constructs that underlie this process. Methods: The research project is a dissemination and implementation study of the Educational Program to Increase Colorectal Cancer Screening (EPICS), an evidence-based intervention targeting African Americans in the United States. The study is being conducted in a partnership with community coalitions in 15 different cities. Each site initially presented unique issues that required modification of the study protocol. Results: In order to honor underlying CBPR theory, it was necessary to negotiate protocol changes with the community coalition at each site, while insuring preservation of the core elements of the intervention. Conclusions: We discuss the ways in which this represents a narrowing of the gap between CBPR and traditional research approaches. Keywords: Community-based participatory research, colorectal cancer screening, evidence-based intervention, implementation and dissemination, sustainability

Los Angeles is the largest urban oil field in the United States and one of the most oil rich basin in the world. In low-income neighborhoods of color with cumulative vulnerabilities (such as greater linguistic isolation and higher percentages of renters), active drilling occurs much closer to homes, schools, playgrounds, and other sensitive land uses with fewer protections such as emissions control equipment and covered fields. In collaboration with a community-based network of promotoras, (community health workers), we assessed the ability to collect daily acute symptoms and well-being information using a phone-based platform among predominantly Latino residents in South Los Angeles living within 500m of an oil well. Here, we describe the process to develop a bilingual daily digital health log.Using a text messaging system, we aimed to pilot a mixed methods approach to log information about health and social stressors. Our research was informed by a prior community health survey that supported community research capacity building within promotora networks (Shamasunder et al, 2018). 113 people participated in the 7-day study with a 77% response rate (n=87). 76% of study respondents were women. In the preliminary analysis, we coded qualitative reports on stress from the daily logs among participants. Responses to digital daily logs indicate responses within individuals change daily. Women note a greater number and variety of stressors. Stress was associated with reports of headaches, anxiety, fatigue, work, and lack of work. Residents' concerns over children's schooling was a top concern. Social stressors may make residents more vulnerable to impacts of pollution. Headaches, for example, have been associated with oil extraction, and were ascribed by residents to other life stresses. This novel approach can help facilitate collection of symptoms and stress data in an environmental justice community.