Enhancing the Capacity of Local Health Departments to Address Birth Equity: The Institute for Equity in Birth...

Significant and persistent racial and ethnic disparities exist related to infant mortality and other birth outcomes. Few models exist that aim to prepare organizations to implement essential features, such as community engagement or intervening on social determinants of health.

Between 2013 and 2015, teams from seven local health departments participated in the Institute for Equity in Birth Outcomes (EI) with the goals of building capacity and implementing changes to address equity in birth outcomes. Four of the teams enrolled in the first cohort (2013-2015), and three enrolled in cohort two (2014-2015). To examine the EI effort and its impact on capacity and implementation of changes, two types of assessments were completed. Capacities of the teams in specific key areas were assessed using "Best Change Process" instruments at the completion of participation in the EI. Teams also documented on an ongoing basis implementation of interventions. The data were analyzed using descriptive statistics and Pearson Correlation tests.

Best Change Process capacity scores were higher in the first cohort than in the second and were highly correlated with implementation of changes (Pearson's Correlation = 0.838, p = 0.037). Collectively, the teams implemented about 32 new programs, policies, practices, and systems changes aimed at addressing equity in birth outcomes. Most interventions were based on scientific recommendations and local epidemiologic data.

The results of the study suggest the EI is a promising approach that may result in strong capacity and ability to implement interventions aimed at addressing equity in birth outcomes.