We care about Brooklyn: A remote precision support intervention designed to improve maternal health and well-being

Black maternal mortality is an urgent public health crisis in the United States. Community-based interventions show promise in addressing this crisis but remain underutilized.

Using New York City (NYC) as a case study, we describe a formative study of a comprehensive community health worker (CHW)-led intervention, We Care About Brooklyn (WeCAB), designed to address structural drivers of NYC's maternal health crisis: fragmented care and unmet health-related social needs (HRSNs), such as food insecurity and unstable housing.

Guided by the transcreation framework, we conducted a community-engaged, mixed methods formative study to design an intervention prototype.

We conducted a document review (N = 7 HRSN screening tools), documentary film analysis, and primary qualitative data collection. We interviewed 10 key informants representing diverse community expertise. Interpretative phenomenology guided qualitative data analysis.

Analysis elaborated on five central themes-trust and rapport building, frequency of patient engagement and critical time periods, system fragmentation and care coordination challenges, technology for care coordination, and provider and client expectations. These findings, along with the document review, results of the film analysis, and evidence-based intervention inputs, informed the design of a remote precision support intervention with two core activities: (1) a digital closed-loop care navigation platform (Unite Us^©) using a 41-item maternal HRSN screener, and (2) CHW check-in schedules based on gestational age and social risk, including care reminders, escalation protocols for patient concerns, urgent warning signs education, and linkage to urgent care.

WeCAB was designed to enable CHWs to function as a human safety net and provide continuity of care in the context of a fragmented healthcare landscape. We propose that this approach fosters trust and patient empowerment, promoting physical and emotional well-being and engagement in care.