Within a culturally affirming environment and honoring the unique history of Black birthing people, the Black Infant Health (BIH) Program uses a group-based approach with complementary participant-centered life planning to help pregnant and parenting Black birthing people develop life skills, set and attain goals, learn strategies for managing stress, build social support and reduce isolation. Each participant attends weekly group sessions (10 prenatal and 10 postpartum) and works individually with BIH staff through life planning meetings to recognize and build on her own personal strengths, set and make progress toward meeting their personal goals, connect with their community and social services to meet their needs, and develop a long term life plan that can guide their continued progress after the intervention (Figure 1). Each group session includes activities specifically designed to address internalized racism, for example by including a discussion of a "Black icon"—a Black individual who has made significant contributions to society. Participating in a group with other Black birthing people, with opportunities to appreciate each other's thoughts and feelings and potentially form bonds of friendship, may also be an antidote to internalized racism and promote self-esteem (Braveman et al., unpublished).
Program
eligibility is based upon being a pregnant, self-identified Black birthing person 18 years of age or older and no greater than 30 weeks gestational age.[1]To enroll, individuals must sign a
consent form. After enrollment, participants complete a
baseline assessment (Assessment 1), administered by a mental health professional (MHP)[2], and initiate the prenatal component of the BIH Program.
The
prenatal component of BIH consists of group sessions and 1:1 life planning meetings. Participants attend the
prenatal group series (10, 2.5-hour sessions with a recommended minimum of seven sessions) with other recent enrollees (8-12 participants per series, five minimum, two facilitators per group session), starting within 30 to 45 days of enrollment. Participants are expected to initiate and move through the 10-session series with the other Individuals who start off with them in session 1, 2 or 3.
Complementary to the group, participants engage in
1:1 life planning meetings (a minimum of four recommended) with their assigned family health advocate (FHA). These life planning meetings include connecting the participant to services (i.e., providing referrals) along with identifying strengths, challenges, and resources in the context of goal setting to formulate her life plan. Additionally, prior to delivery, a public health nurse (PHN) or the assigned FHA discusses a
birth plan and conducts a
home safety checklist with the participant. As participants progress through the prenatal phase of the program, a
second assessment (Assessment 2) is completed, ideally between 33 to 36 weeks gestation but by no later than before her delivery. These activities are complemented with
referrals to services in the community. BIH sites also offer
motivators for participation such as food during group sessions, transportation, child watch and gift cards.
Once participants deliver, they are allowed up to six months to start the
postpartum component of BIH, which begins when the woman joins a postpartum group. During this variable period, staff administers both a
third assessment (Assessment 3) and
postpartum depression screening by no later than two months postpartum, and also conduct monthly individual life planning meetings until the participant joins postpartum group.
As with the prenatal component, the
postpartum component of BIH consists of group sessions and 1:1 life planning meetings. The
postpartum group series is also
10, 2.5 hours sessions and covers a range of topics and activities. Participants are grouped with other individuals who have delivered recently (8-12 participants per series, five minimum, two facilitators per group session). Upon conclusion of the postpartum group, the participant concludes her participation in the BIH Program by completing a
final assessment (Assessment 4), confirming her life plan (including setting short- and long-term goals), and completing a satisfaction survey.
Participants can be in the BIH Program up to one year postpartum based on the above outlined specifications from the MCAH
BIH Policies and Procedures (P&P).
[1]The program was originally designed to enroll individuals prior to 26 weeks but was extended to 30 weeks in September 2016, to allow a greater number of individuals to participate.
[2] MHP do not offer clinical services.