TARRANT COUNTY INTERCONCEPTION CARE INTERVENTION: FORMATIVE RESEARCH

Purpose: The purpose of the formative stage of this interconception intervention is to conduct stakeholder focus groups and individual interviews to guide the development of an intervention for women who have experienced a previous adverse birth or maternal health outcome. Methods: Focus groups and semi-structired interviews with stakeholders were conducted to ascertain their perspective on designing the intervention. Study participants are continually being enrolled because data saturation has not yet been achieved, i.e. the interviews will finish once no new information is being ascertained from the stakeholders. Interviews and focus group recordings were transcribed and will be entered into the NVivo 8 Database for data management and analysis. Results: So far, a total of two focus groups of fifteen people have been conducted, as well as sixteen individual interviews with key stakeholders. The stakeholders come from a variety of backgrounds that play an important role in the target population, such as pregnancy services, early childhood development organizations, UNT Health Science Center School of Public Health, March of Dimes, Fetal Infant Mortality Review (FIMR) and medical providers (JPS, UNTHSC, Cook Children's Hospital). Key recommendations from the perspective of stakeholders have included using community health workers that have had similar experiences as the participants in implementing program components and utilizing home visitations. Many stakeholders also voiced concerns about the fragmentation of health services in Tarrant County and that this intervention should work to connect women to existing services in the community. Interviewees tended to emphasize larger issues related to adverse birth outcomes, such as those related to poverty, which is beyond the scope of this intervention's ability to address. Conclusions: Stakeholder involvement is an essential component for program buy-in, cooperation and collaboration because of their experience with the target population. Through this process we have identified unexpected opportunities to strengthen health and social service agencies' ability to prevent infant mortality through better coordination and communication between organizations. In addition, these interviews have allowed us to identify the best approaches for successfully implementing the multi-year program. The next step in the formative research phase of the project is to conduct in-depth interviews with women who have experienced a previous poor birth outcome.