{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:07:46Z","timestamp":1788847666503,"version":"build-2803163510"},"reference-count":64,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008900","name":"University of South Florida","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008900","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Currently, more than half of the US states have either expanded Medicaid to cover doula care or will implement doula care into Medicaid services. However, little is known about doulas' experiences with Medicaid. Doula uptake of these services is critical to support low\u2010income clients. We explored Florida doulas' experiences and perceptions of Medicaid reimbursement to identify barriers and facilitators to implementing doula benefits in Florida.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted seven focus groups and seven in\u2010depth interviews during Spring and Summer 2022 with 31 doulas who have provided perinatal support to at least two families in Florida in the past year. We used Braun and Clarke's codebook thematic analysis, combining team\u2010based inductive coding with deductive theme development guided by the theoretical domains framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Most participants (71%;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922) reported not engaging with Medicaid due to misinformation, low reimbursement rates, and a complicated reimbursement structure. Doulas who work with Medicaid patients reflected on frustrations with insurers and the financial impact of delayed reimbursements. Misinformation spread among doula communities about the Medicaid reimbursement process poses a significant barrier to implementation. Doulas relied on one another for information, as they reported that few resources have been made available by Medicaid or managed care organizations for guidance on reimbursement processes. This highlights an opportunity for Medicaid education to ensure client access to doula services and to support the maintenance of the doula workforce.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Doula care is associated with improved perinatal outcomes, yet structural barriers hinder access to doula care for low\u2010income families in Florida (and beyond), creating further health inequities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/birt.70106","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:34:39Z","timestamp":1788845679000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Applying the Theoretical Domains Framework to Explore Doula Perceptions of Medicaid Coverage: Barriers and Facilitators in Florida"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6698-8555","authenticated-orcid":false,"given":"Janelle","family":"Applequist","sequence":"first","affiliation":[{"name":"Zimmerman School of Advertising &amp; Mass Communications University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2499-3487","authenticated-orcid":false,"given":"Rone\u00e9","family":"Wilson","sequence":"additional","affiliation":[{"name":"College of Public Health University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Perkins","sequence":"additional","affiliation":[{"name":"College of Nursing University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Evans","sequence":"additional","affiliation":[{"name":"College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Daniel","sequence":"additional","affiliation":[{"name":"Family Centered Birth Services  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Averjill","family":"Rookwood","sequence":"additional","affiliation":[{"name":"Doula Friendly Initiative Team  Boynton Beach Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0057-7032","authenticated-orcid":false,"given":"Seun M.","family":"Ajoseh","sequence":"additional","affiliation":[{"name":"Department of Sociology and Criminology &amp; Law University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Simmons","sequence":"additional","affiliation":[{"name":"The Doula Network  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Jayaraj","sequence":"additional","affiliation":[{"name":"Zimmerman School of Advertising &amp; Mass Communications University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2119-9739","authenticated-orcid":false,"given":"Adetola F.","family":"Louis\u2010Jacques","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s10995-018-2537-7","article-title":"Randomized Controlled Trial of Doula\u2010Home\u2010Visiting Services: Impact on Maternal and Infant Health","volume":"22","author":"Hans S. 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