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Published on: July 27, 2018
Going beyond participation: community-led design and evaluation of the Philly Joy Bank
Allison K Groves1, Nia Coaxum2, Ayomide Sokale2
1Drexel University Dornsife School of Public Health, Philadelphia, PA, United States.
Insights
Guaranteed income (GI) programs like the Philly Joy Bank can reduce financial stress and improve health outcomes for Black birthing people and infants. This community-centered approach aims to advance health equity during the critical perinatal period.
Area of Science:
- Public Health
- Health Equity
- Social Interventions
Background:
- Racial disparities in perinatal health outcomes persist in Philadelphia, disproportionately affecting Black infants and parents.
- Structural racism and poverty are key drivers of these health inequities.
- Guaranteed income (GI) offers a promising, evidence-based strategy to enhance financial security and health during the perinatal period.
Purpose of the Study:
- To describe the community-centered design of the Philly Joy Bank (PJB), a perinatal GI program.
- To outline the community-based participatory research approach for evaluating PJB's impact on financial security, parental stress, mental health, and infant prematurity.
Main Methods:
- Community-centered design involving Lived Experience Experts (Black birthing people in Philadelphia).
- Community-based participatory research (CBPR) principles for co-designed evaluation.
- Mixed methods including descriptive statistics, regression analyses, and qualitative analysis.
Main Results:
- The study protocol outlines the feasibility and acceptability assessment of PJB (Aim 1).
- It details the examination of GI's effects on basic needs and parental stress (Aim 2).
- Exploration of PJB's impact on parental mental health and infant prematurity is also described (Aim 3).
Conclusions:
- GI is a vital upstream intervention to address perinatal health inequities.
- Evidence on GI's impact can inform policies and implementation strategies to advance health equity for birthing people and infants.
Introduction:
In Philadelphia there are racial disparities in health outcomes during the perinatal period, such that Black infants and their parents experience a disproportionately higher burden of poor outcomes compared to their White counterparts. These excess risks are driven at least in part by high rates of poverty and other manifestations of structural racism. The provision of guaranteed income (GI) or unconditional cash payments during and after pregnancy, is a bold and evidence-based approach to advancing equity in financial security and health. The objective of this protocol paper is to describe the community-centered approach to the design of (a) the Philly Joy Bank (PJB), a perinatal GI program in Philadelphia, and (b) the evaluation of PJB's impact.
Methods:
PJB was conceived by an established coalition of community partners through a collective impact model. Decisions related to the design and implementation of PJB are made through a consensus building process that centers the voices of Lived Experience Experts (i.e., Black birthing people in Philadelphia). Congruent with the community-driven design of PJB, the evaluation of the impact of PJB is grounded in the principles of community-based participatory research and is co-designed by the community.
Results:
The study purpose is to assess the feasibility and acceptability of PJB (Aim 1); to examine whether and how GI affects ability to meet basic needs and parental stress (Aim 2); and to explore the impact of PJB on parental mental health and the preliminary impact on infant prematurity (low birthweight and preterm birth) (Aim 3). Descriptive statistics, mixed effects regression analyses, and participatory qualitative analysis approaches will be used to achieve study aims.
Discussion:
GI is a promising upstream structural intervention to address persistent health inequities during the perinatal period: a critical period of the life course. Understanding if and how GI improves health for birthing people and their infants can inform implementation and policy to advance health equity.
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