Teach-With-Stories: Lay Educator Prenatal Outreach Program for Hispanics

描述（由申请人提供）：考虑到西班牙裔妇女在家庭中的核心作用，接触和吸引她们是减少这些社区中差异和改善成人和儿童健康结果的一项关键战略。高质量的产前护理旨在促进妇女、婴儿和家庭在怀孕前、怀孕期间和怀孕后的健康和减少风险。不幸的是，西班牙裔女性接受产前护理的时间较晚或没有产前护理的可能性是非西班牙裔白人女性的两倍。目前为1100万，在接下来的几十年里，处于生育年龄的西班牙裔妇女的数量预计将呈指数增长。拟议项目的长期目标是改善西班牙裔妇女获得高质量、在语言和文化上适当的产前教育和护理的机会。该计划将以“故事教学法”（TWS）为基础，该方法是为以赋权为基础的团体教育而开发的。现有的De Madre a Madre/From Mother to Mother产前护理光子小说将根据第一阶段开发的原型进行重新设计，并通过“有故事的教学”免费出版网络分发。第二阶段的目标将集中于制定方案组成部分，解决第一阶段确定的实施因素，以促进采用、整合和可持续的“讲故事的教学”模式。该项目旨在建立社区能力，在以社区为基础或以诊所为基础的地点提供和评估产前教育，目标是增加西班牙裔妇女获得产前教育的机会，并促进与护理系统合作的机会。此外，研究小组将为随后的正式控制设计研究开发和测试研究仪器和数据收集协议。研究小组将通过协作、参与式的开发过程，以及计划-执行-研究-行动（PDSA）的持续质量改进方法来实现这些目标。这将确保产品在医学上准确，文化上敏感，并在实践中有效。西班牙裔消费者将实地测试这些光电小说的可读性、文化和语言的适宜性。此外，将对整个计划进行测试，以确定其有效性，并与接受常规护理的对照组西班牙裔妇女进行比较。

DESCRIPTION (provided by applicant): Reaching and engaging Hispanic women, given their central role in families, is a critical strategy in efforts to reduce disparities and improve health outcomes for adults and children in these communities. Quality prenatal care is designed to promote health and reduce risks for women, infants, and families before, during, and after pregnancy. Unfortunately, Hispanic women are twice as likely to receive late or no prenatal care as non-Hispanic white women. Currently at 11 million, over the next several decades the number of Hispanic women in their childbearing years is projected to increase exponentially. The long-term goal of the proposed project is to improve access to quality, linguistically and culturally appropriate prenatal education and care for Hispanic women. The program will be based on the Teach-With- Stories (TWS) Method" developed for empowerment-based group education. The existing De Madre a Madre/From Mother to Mother prenatal care photonovels will be redesigned according to the prototype developed in Phase I to be distributed via the Teach-With-Stories Free Publication Network. Phase II aims will focus on the development of program components that address implementation factors identified in Phase I to facilitate the adoption, integration, and sustainability of a Teach-With-Stories lay health educator model. The program will be designed to build community capacity to offer and evaluate prenatal education in community-based or clinic-based sites The goal is to increase access for Hispanic women and foster opportunities for partnership with systems of care. In addition, the research team will develop and test study instruments and data collection protocols for a subsequent formal control design study. The study team will achieve these aims through a collaborative, participatory-based development process coupled with a Plan-Do-Study-Act (PDSA) continuous quality improvement methodology. This will ensure that the products are medically accurate, culturally sensitive, and effective in practice. Hispanic consumers will field-test the photonovels for readability and cultural and linguistic appropriateness. In addition, the complete program will be tested to determine its effectiveness as compared to a control-match group of Hispanic women who receive usual care. PUBLIC HEALTH RELEVANCE: Positive, culturally sensitive experiences in prenatal care can have a long-term impact on the use of healthcare services by Hispanic women and their families. An empowerment-based lay educator model designed to address system and provider needs unique to prenatal care could help generate cost-savings to the health care system, improve quality of care, and address the multiple needs of this growing population. A commercially successful model for prenatal education could be adapted for other health topics and potentially for other traditionally underserved populations.