CDC Grant to Improve Prenatal Awareness and Reduce Infant Mortality Among African American Women

By Sathya Achia Abraham

Virginia Commonwealth University has received a nearly $2 million grant from the Centers for Disease Control and Prevention to improve pregnancy outcomes among African American populations in Richmond.

VCU was one of 40 institutions selected nationwide to receive funding through the CDC's Racial and Ethnic Approaches to Community Health (REACH) U.S. program.

The REACH program will target five racial and ethnic groups: African Americans, Hispanics/Latinos, Asian Americans, Hawaiians/Pacific Islanders and American Indians/Alaska Natives. REACH U.S. activities focus on a range of key health areas that contribute to health disparities, including cardiovascular disease, diabetes, breast and cervical cancer, hepatitis B, asthma, infant mortality and adult immunizations.

Through the five-year grant, principal investigator Dace Svikis, Ph.D., deputy director of the VCU Institute for Women's Health, professor of psychology, and director of Promoting Healthy Pregnancies in the VCU Department of Obstetrics and Gynecology, will support local efforts to address infant mortality and prenatal awareness among economically disadvantaged African American populations in Richmond. The program will be a collaboration between the VCU Institute for Women's Health and the VCU Center on Health Disparities. 

"We have proposed an intervention model to improve infant mortality among this population with a focus on the cultural, social and environmental barriers to care," Svikis said.

According to Svikis, the model involves three components. The first calls for each expectant mother to be assigned a case navigator, who will guide each woman through the system of care and teach her the skills to eventually navigate on her own. The second component will help the case navigator increase a woman's level of motivation to participate in prenatal care by offering modest monetary incentives such as gift certificates to reward successful follow-through. The third component focuses on the practitioner, including educational training in health disparities as well as in how to identify personal biases and how to use empathic and culturally sensitive approaches when providing care to patients.

"We are truly invested in making a difference in our community, and we are pleased to have received significant input from various community partnership groups," said Sheryl Garland, vice president for the Department of Community Outreach for the VCU Health System and administrative director of the VCU Center on Health Disparities.

"This is the first successful research collaboration between the VCU Institute for Women's Health and Center on Health Disparities," said Susan Kornstein, M.D., executive director of the Institute for Women's Health. "This is clearly an area that faculty involved in both institutes care deeply about."

Through the REACH U.S. initiative, 18 national and regional Centers of Excellence in the Elimination of Disparities (CEEDs) and 22 Action Communities will be established throughout the country. The CEEDs will serve as national resource centers with expertise in specific ethnic populations and will train additional communities to further spread the impact of REACH activities. The Action Communities will implement and evaluate successful approaches within a specific community to impact population groups, rather than individuals, and focus on key health conditions that contribute to health disparities.

Other VCU faculty involved in the project include Judith Bradford, Ph.D.; Susan Lanni, M.D.; Lori Keyser-Marcus, Ph.D.; Saba Masho, Ph.D.; and Tatyana Thweatt, Ph.D.

The proposed model was developed by the Promoting Healthy Pregnancies Coalition (PHPC), a group of community care providers that includes Richmond Healthy Start, the VCU Health System, Children's Health Involving Parents, Richmond Behavioral Health Authority, Healthy Families of Richmond, Virginia Premier Health Plan and Richmond City Health District.  PHPC has focused on infant mortality for more than 15 years and has established a network of services designed to meet the multiple needs of the predominantly African American community that they serve.

Since 1999, the REACH program has demonstrated that fully engaging communities in health strategies that address the unique social, economic and cultural circumstances of racial and ethnic minority groups can reduce health disparities. For more information about the REACH program, visit CDC's Web site at www.cdc.gov/reach.