Designing a Statewide Hospital Equity Initiative: A Qualitative Formative Evaluation.

Area of Science:

• Healthcare equity
• Maternal health
• Implicit bias training

Background:

• Implicit bias training is recommended for health professionals to reduce maternal health inequities, but evidence of its effectiveness is limited.
• Experts advocate for integrating bias training with systems-level equity interventions in hospitals.
• Actionable guidance for implementing hospital-based maternal health equity programs is scarce.

Purpose of the Study:

• To inform the design and implementation of a statewide maternal health equity initiative.
• To gather data on hospital needs, preferences, and expert input for bias training and systems-level interventions.
• To develop responsive and effective equity-focused programs.

Main Methods:

• Qualitative formative evaluation using in-depth interviews.
• Conducted interviews with maternal health leaders from Maryland birth hospitals and maternal health equity experts.
• Explored current equity work, strategies, barriers, and facilitators.

Main Results:

• Seventeen interviews were conducted with hospital representatives and experts.
• Hospitals reported limited experience with implicit bias training and systems-level interventions.
• Participants recommended aligning interventions with existing recommendations and suggested practical implementation approaches.

Conclusions:

• Formative work is crucial for understanding hospital barriers and support needs in maternal health equity initiatives.
• This understanding can enhance the effectiveness of implemented interventions.
• Tailoring programs to specific hospital contexts is key for success.