University of Wisconsin–Madison Medical College of Wisconsin

Impact Evaluation of Patient-Centered, Community-Engaged Health Modules for Homeless Pregnant Women

Shelby Nelipovich, MD; Nayanika Kotagiri, MD; Esha Afreen, MD; Morgan A. Craft, MD; Sara Allen, BS; Caroline Davitt, MD; Leslie Ruffalo, PhD; Sabina Diehr, MD

WMJ. 2022;121(2):99-105

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Purpose: Pregnant women who experience homelessness are at a greater risk for poor birth outcomes than the general population. This pilot study describes results of a service-learning program informed by previously identified unmet perinatal health needs. In this patient-centered service-learning program, medical students partnered with homeless women currently residing in a shelter in Milwaukee, Wisconsin.

Methods: Medical students in the Health Advocacy in Pregnancy and Infancy (HAPI) project at the Medical College of Wisconsin developed and taught 6 service-learning modules to shelter residents: healthy cooking, mental health, perinatal nutrition, infant care/safety, breastfeeding, and contraception. Implemented between 2018 and 2021, modules were hosted in person and via electronic videoconferences. We gathered qualitative data on participants’ perceived impact of the modules and used grounded theory analysis to examine written comments and verbal feedback.

Results: A total of 141 participants attended 42 learning sessions. Participants included pregnant and postpartum mothers and women interested in learning about pregnancy-related health. Qualitative analysis revealed 3 universal themes regarding the impact of the sessions on participants: “Knowledge,” “Intention to Change,” and “Empowerment.”

Conclusions: Our community-engaged health education partnership program between homeless pregnant women and medical students focused on perinatal health. This well-received, effective strategy cultivated new knowledge, empowering participants to not only change their own behaviors, but to teach and support others. This study demonstrates the ability of using community-based teaching sessions to enhance participants’ understanding of pregnancy and postpartum health and empower others to implement changes.

Author Affiliations: Medical College of Wisconsin (MCW), Milwaukee, Wisconsin (Nelipovich, Kotagiri, Afreen, Craft, Allen, Davitt); Department of Family & Community Medicine, MCW, Milwaukee, Wisconsin (Ruffalo, Diehr).
Corresponding Author: Shelby Nelipovich, MD, Family and Community Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226; phone 414.955.8664; email; ORCID ID 0000-0001-5267-1760
Acknowledgements: The authors are grateful for the collaboration and support of all the residents and staff at the Milwaukee Women’s Center, with a special thank you to the shelter manager Penelope Dixon. We also thank the staff and the leadership of the Department of Family and Community Medicine at MCW for their unwavering support.
Financial Disclosures: None declared.
Funding/Support: This research was supported in part by the Medical College of Wisconsin’s Community of Innovators Award.
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