Zimmermann Kristine, Haen Lisa S, Desloge Allissa, Handler Arden
Department of Family and Community Medicine, University of Illinois College of Medicine Rockford, Rockford, Illinois, USA.
Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA.
Health Equity. 2023 Oct 23;7(1):703-712. doi: 10.1089/heq.2023.0104. eCollection 2023.
Racial and ethnic inequities persist among birthing families in urban U.S. communities, despite public health efforts to improve outcomes. To address these inequities, in 2020, the Chicago Department of Public Health (CDPH) launched Family Connects Chicago (FCC), an evidence-based, universal, postpartum home visiting program. We examine CDPH's transition from "high risk" to universal home visiting to determine whether and how this change represent an explicit commitment to advancing maternal and child health equity.
We conducted a secondary analysis of key informant interview data (=45 interviews) collected from stakeholders involved in FCC's early implementation. Our analysis involved identifying processes used by CDPH in their planning and early implementation of FCC and examining the alignment of these processes with approaches for promoting health equity proposed by Calancie et al.
The processes used by CDPH to plan and implement the FCC pilot are reflected in two major themes: (1) CDPH emphasized improving outcomes for all birthing families, and (2) CDPH prioritized engaging multiple stakeholders throughout planning and implementation. Alignment of these themes and their subthemes with the approaches proposed by Calancie et al. demonstrated that CDPH's implementation of FCC represents a commitment to advancing health equity.
In their planning and implementation of FCC, CDPH appears to have exhibited a concerted effort to address Chicago's persistent health inequities. Institutional commitment, continued stakeholder engagement, ongoing data sharing, and sustainable funding will be crucial to implementing and expanding FCC.
The implementation of FCC, a new service delivery approach for maternal and infant health, marks a new beginning in tackling inequities for Chicago's birthing families.
尽管公共卫生部门努力改善分娩结果，但美国城市社区中分娩家庭的种族和族裔不平等现象依然存在。为解决这些不平等问题，2020年，芝加哥公共卫生部（CDPH）推出了“芝加哥家庭连接”（FCC）项目，这是一项基于证据的、面向所有产妇的产后家访计划。我们研究了CDPH从“高风险”家访向全面家访的转变，以确定这种变化是否以及如何体现了对促进母婴健康公平的明确承诺。
我们对从参与FCC早期实施的利益相关者那里收集的关键信息访谈数据（45次访谈）进行了二次分析。我们的分析包括确定CDPH在FCC规划和早期实施过程中使用的流程，并研究这些流程与卡兰西等人提出的促进健康公平方法的一致性。
CDPH用于规划和实施FCC试点的流程体现在两个主要主题中：（1）CDPH强调改善所有分娩家庭的结果；（2）CDPH在整个规划和实施过程中优先让多个利益相关者参与。这些主题及其子主题与卡兰西等人提出的方法的一致性表明，CDPH实施FCC体现了对促进健康公平的承诺。
在FCC的规划和实施过程中，CDPH似乎做出了一致努力，以解决芝加哥长期存在的健康不平等问题。机构承诺、持续的利益相关者参与、持续的数据共享和可持续的资金对于实施和扩大FCC至关重要。
实施FCC这一母婴健康新的服务提供方式，标志着芝加哥分娩家庭解决不平等问题的新开端。
