Tuck Stacey G, Summers Amber C, Bowie Janice, Fife-Stallworth Donnica, Alston Chase, Hayes Stephen, Alexander Stephanie
Baltimore City Health Department, Bureau of Maternal and Child Health, Baltimore, Maryland.
Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Womens Health Issues. 2017 Oct 17;27 Suppl 1:S38-S45. doi: 10.1016/j.whi.2017.09.002.
Pregnant obese women have an increased risk for infant mortality and poor maternal outcomes. Environmental and social conditions pose barriers for less-advantaged overweight women to participate in weight loss interventions. The B'more Fit for Healthy Babies Program aimed to address existing gender inequities that persist where exposure to community-level trauma is present.
A gender-based analysis using qualitative and quantitative approaches informed B'more Fit's intervention and identified opportunities for trauma-informed care policies. Key data sources for analyses included two series of focus groups and a quantitative survey. Review of additional Baltimore-based literature and research also informed policy development.
A workgroup formulated policies for B'more Fit staff and participants. Policies involved technical assistance, staff consultation, and gender-sensitive counseling sessions. These activities gained the attention of the Baltimore City Health Department's leadership, and department-wide trainings were conducted. Highly publicized violence in Baltimore led to expanded trauma-informed care training and policy development in all local government agencies through a partnership between the Baltimore City Health Department and Behavioral Health Systems Baltimore, Inc.
The development and monitoring of trauma-informed interventions and policies within governmental and human service agencies can counterbalance social and environmental exposures. Applying a gender-based and trauma-informed program provided B'more Fit participants with strategies for weight loss, improved nutrition, and better parenting. Coordinated policies and interventions are underway in city institutions to address residents' behavioral health needs and improve citywide services.
肥胖孕妇的婴儿死亡风险和不良孕产结局风险会增加。环境和社会状况给处于劣势的超重女性参与减肥干预措施带来了障碍。“巴尔的摩健康宝宝更健康计划”旨在解决在存在社区层面创伤暴露的情况下持续存在的现有性别不平等问题。
采用定性和定量方法进行基于性别的分析，为“巴尔的摩健康宝宝更健康计划”的干预措施提供了依据，并确定了实施创伤知情护理政策的机会。分析的关键数据来源包括两组焦点小组讨论和一项定量调查。对巴尔的摩其他相关文献和研究的回顾也为政策制定提供了参考。
一个工作组为“巴尔的摩健康宝宝更健康计划”的工作人员和参与者制定了政策。这些政策包括技术援助、工作人员咨询以及对性别敏感的咨询会议。这些活动引起了巴尔的摩市卫生部门领导层的关注，并开展了全部门范围的培训。巴尔的摩备受关注的暴力事件促使通过巴尔的摩市卫生部门与巴尔的摩行为健康系统公司之间的合作，在所有地方政府机构中扩大了创伤知情护理培训和政策制定。
在政府机构和人类服务机构内制定和监测创伤知情干预措施及政策，可以抵消社会和环境暴露的影响。实施基于性别的创伤知情计划为“巴尔的摩健康宝宝更健康计划”的参与者提供了减肥、改善营养和更好育儿的策略。城市机构正在实施协调一致的政策和干预措施，以满足居民的行为健康需求并改善全市的服务。
