LeMasters Katherine H, Bledsoe Sarah E, Brooks Jada, Chavis Stephanie, Little Erica, Pevia Kim, Daniel Leah, Jordan Kiva, Schindler Ann, Lightfoot Alexandra F
The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
The University of Maryland, Baltimore, Baltimore, MD, USA.
Health Educ Behav. 2021 Dec 28:10901981211057095. doi: 10.1177/10901981211057095.
Despite the persistent health inequities faced by rural women in the United States, few researchers have partnered with women in rural communities to co-create sustainable change. To fill this gap, Mothers Improving Pregnancy and Postpartum Health Outcomes Through stOry Sharing (MI-PHOTOS) employed a community-based participatory research (CBPR) approach by partnering with mothers, community leaders, and community-based organizations in Robeson County, North Carolina, a rural, racially diverse county. The project's aims were (a) to promote maternal health by listening to mothers' stories of having and raising children in their community and (b) to develop a shared understanding of these mothers' strengths and challenges. MI-PHOTOS utilized photovoice, an exploratory and qualitative CBPR methodology. Grounded theory guided data analysis. During photovoice discussions, conversation focused on maternal experiences and evoked strengths, facilitators, and barriers impacting maternal health. Themes focused on (a) MI-PHOTOS serving as a social support group for the community and family stressors that mothers faced and (b) the necessity of professional support programs. Three overarching findings emerged during this process: (a) MI-PHOTOS as an informal support group, (b) mental health stigmatization, and (c) the need to bridge home visiting programs with peer and confidential therapeutic services. Future work should incorporate mothers' and communities' strengths into program development by drawing on existing home visiting programs, identifying opportunities for peer-support, and creating referral networks for individual, confidential therapeutic services. Through continued community partnership, we can generate fuller understandings of mothers' experiences of having and raising children and ultimately promote health equity among rural mothers.
尽管美国农村妇女一直面临着健康不平等问题，但很少有研究人员与农村社区的妇女合作共同创造可持续的变革。为了填补这一空白，“通过故事分享改善孕产妇和产后健康结果的母亲们”（MI-PHOTOS）采用了基于社区的参与性研究（CBPR）方法，与北卡罗来纳州罗伯逊县的母亲们、社区领袖和社区组织合作，该县是一个农村地区，种族多样。该项目的目标是：（a）通过倾听母亲们在其社区生育和抚养孩子的故事来促进孕产妇健康；（b）就这些母亲的优势和挑战形成共同的理解。MI-PHOTOS采用了摄影声音法，这是一种探索性的定性CBPR方法。扎根理论指导数据分析。在摄影声音讨论中，对话聚焦于孕产妇经历以及引发的影响孕产妇健康的优势、促进因素和障碍。主题集中在：（a）MI-PHOTOS作为社区和母亲们所面临的家庭压力源的社会支持团体；（b）专业支持项目的必要性。在此过程中出现了三个总体发现：（a）MI-PHOTOS作为一个非正式支持团体；（b）心理健康污名化；（c）需要将家访项目与同伴和保密治疗服务相衔接。未来的工作应通过借鉴现有的家访项目、确定同伴支持的机会以及创建个人保密治疗服务的转诊网络，将母亲们和社区的优势纳入项目开发。通过持续的社区合作，我们可以更全面地了解母亲们生育和抚养孩子的经历，并最终促进农村母亲之间的健康公平。
