Indiana University Purdue University at Indianapolis, Indianapolis, IN, USA.
Health Promot Pract. 2024 Jan;25(1):127-136. doi: 10.1177/15248399221151175. Epub 2023 Jan 23.
Our Grassroots Maternal and Child Health (MCH) Initiative works to build the capacity of individuals and organizations in zip codes with persistently high infant mortality rates to bring about systems change that will improve maternal and child health (MCH) outcomes. Foundational to the Initiative is the training and mentoring of local women to become Grassroots MCH Leaders. We greatly honor that these women possess community expertise, essential to the Initiative's success. Our training equips them with strategies they can use to bring about changes in social, economic, political, and/or cultural systems that underlie poor birth outcomes. One impactful strategy they learn is the use of critical narrative intervention (CNI). This approach, grounded in the crafting and sharing of stories, complements statistical, behavioral, and medical approaches to improve MCH outcomes. This article describes the impact of CNI within the Grassroots MCH Initiative. Drawing from 14 Grassroots MCH Leaders' narratives, we present five significant maternal traumas and influential supports in their surrounding contexts. We explore the leaders' reflections on the impact of story development and dissemination. Our findings reveal that situating CNI within the context of a grassroots initiative provides opportunities for leaders to use their stories to advocate for systems change. Personal MCH narratives provide a powerful and respectful approach to public health promotion, as they highlight important systems-level failures that need to be addressed to sustainability improve MCH outcomes.
我们的基层母婴健康(MCH)计划致力于培养在婴儿死亡率持续居高不下的邮政编码地区的个人和组织的能力,以实现改善母婴健康(MCH)结果的系统变革。该计划的基础是培训和指导当地妇女成为基层 MCH 领导者。我们非常荣幸这些女性拥有社区专业知识,这对计划的成功至关重要。我们的培训为她们提供了可以用来改变社会、经济、政治和/或文化系统的策略,这些系统是不良生育结果的基础。她们学到的一个有影响力的策略是使用关键叙事干预(CNI)。这种方法基于故事的创作和分享,补充了统计、行为和医学方法,以改善 MCH 结果。本文描述了 CNI 在基层 MCH 计划中的影响。我们从 14 位基层 MCH 领导者的叙述中,呈现了他们周围环境中的五个重大产妇创伤和有影响力的支持。我们探讨了领导者对故事发展和传播的影响的反思。我们的研究结果表明,将 CNI 置于基层计划的背景下为领导者提供了机会,让他们可以利用自己的故事来倡导系统变革。个人 MCH 叙事提供了一种强大而尊重的公共卫生促进方法,因为它们突出了需要解决的重要系统层面的失败,以可持续地改善 MCH 结果。