Service Delivery Models to Reduce Maternal and Child Health Disparities

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DESCRIPTION (provided by applicant): The District of Columbia has long had unacceptably poor pregnancy outcomes, as indexed very high rates of infant mortality, prematurity, low birth weight, and very low birth weight. Children in the District of Columbia are at elevated risk for respiratory problems (especially asthma), overweight, and developmental delays in language and cognition. For most families, health care and social services for families in the District of Columbia are fragmented, complicated, frequently changing, and not neighborhood-based. A notable exceptional is the Developing Families Center, a multi-service, highly innovative, and responsive form of care for pregnant women, children, and fathers. This application focuses on how to build research capacity and then conduct scientific inquiry about promising service delivery approaches to improve the heath and well-being of inner city, African American, predominately low income families. The specific aims are to: 1) expand and evaluate a community-university research partnership designed to advance knowledge about health of inner city families; 2) implement a computerized information system regarding prenatal, birth, post- partum, and pediatric care; social services and supports, and early child development; 3)refine, and develop innovative, valid methods to study health disparities; to incorporate local, cultural, and ethnic perspectives; 4) conduct a series of descriptive studies on health disparities topics of mutual interest -including Study 1 on neighborhood knowledge and perceptions related to the Developing Families Center, well-being of pregnant women and their families, and experiences with service delivery and Study 2 focused on the inter-pregnancy interval and factors associated with positive health and well-being indicators for mothers, fathers, and young children; 5) to disseminate research findings from our partnership and document the use of these findings; and 6) work with other innovative (non-conventional) community-based service providers to create a network for conducting multi-site research trials. Overall, we seek to create a partnership that will promote both receptivity to new knowledge (research findings) and innovation in community service delivery and research on service delivery.