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Advancing Birth Equity Through Quality Improvement Education: The SPEAK UP Champion Course
Renée Byfield1,2, Debra Bingham1,3
1Institute for Perinatal Quality Improvement, Milton, Maryland, USA.
Health Equity
|July 31, 2026
Summary
The SPEAK UP Champion course improved healthcare professionals' awareness of racial bias and their ability to develop strategies to reduce disparities in perinatal care. This training offers a promising approach to advancing health equity for Black, non-Hispanic, and Indigenous patients.
Area of Science:
- Perinatal Health
- Health Equity
- Racial Bias in Healthcare
Background:
- Black, non-Hispanic, and Indigenous populations face disproportionately high maternal mortality and morbidity rates in the U.S.
- Structural racism and implicit bias significantly impact patient-provider interactions and care quality, driving these disparities.
Purpose of the Study:
- To evaluate the SPEAK UP Champion course's impact on perinatal health professionals' knowledge, attitudes, and preparedness to mitigate racial bias.
- To assess changes using a health equity lens before and after the implicit and explicit racial bias training.
Main Methods:
- Analysis of 1,303 pre-course, 772 post-course, and 48 implementation surveys from 28 courses (2021-2023).
- Surveys assessed knowledge, attitudes, awareness, and bias-mitigation strategies.
- Univariate analyses and chi-square tests examined outcomes and racial differences.
Main Results:
- Post-course surveys showed improved understanding of race as a social construct and increased recognition of racism's role in perinatal disparities.
- Participants reported enhanced preparedness to identify bias and develop equity-focused quality improvement (QI) goals, with some implementing bias-mitigation strategies.
- Implementation surveys indicated practice changes among a subset of participants.
Conclusions:
- The SPEAK UP Champion course increased racial bias awareness and participants' capacity to create bias-mitigation QI plans.
- Integrating equity education with QI methods is a promising systems-level approach for advancing perinatal health equity, warranting further evaluation.
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