{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:27:40Z","timestamp":1791671260231,"version":"4.3.4"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Perspect Sexual Reproductive"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Community\u2010based doulas, who provide nonclinical perinatal support and are often from the same communities as the families they serve, are increasingly recognized as a strategy to ameliorate racialized perinatal health inequities. However, little is known about the successful implementation and sustainability of community\u2010based doula programs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using an explanatory sequential mixed methods design, we examined the implementation and health outcomes of a community\u2010based doula program serving low\u2010income families and the barriers and facilitators that influence these outcomes. We analyzed programmatic and health outcome data among all families enrolled in the program from January 2016 through December 2022. Four in\u2010depth listening sessions with the program's direct service providers were conducted and analyzed using thematic analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the over 1800 families served, the majority of whom identified as either Asian, Black, Indigenous, Latina\/e\/x, or multiracial, there were 14,672 total home visits that totaled 17,774\u2009h. Over $87,000 in direct funds and 7000 tangible items (e.g., diapers) were dispersed to families. Preterm birth ranged from 4% to 9% across programs and most participants (&gt;\u200994%) were breastfeeding\/chestfeeding at birth. Direct service providers identified holistic, culturally\u2010matched services and \u201cdoula\u2010ing the doula\u201d (organizational infrastructure to support doulas) as facilitators. Barriers included the intersecting systems of oppression that underlie the primary challenges faced by birthing families and direct service providers, including lack of community resources and power asymmetries within birth settings, that can lead to provider burnout.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings document the positive impact of community\u2010based doula programs and bolster calls for increased compensation and structural supports for doulas.<\/jats:p><\/jats:sec>","DOI":"10.1111\/psrh.70015","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T11:45:06Z","timestamp":1749815106000},"page":"219-230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the Implementation and Outcomes of a Community\u2010Based Doula Program in Washington State: A Mixed\u2010Methods Analysis"],"prefix":"10.1111","volume":"57","author":[{"given":"Taylor","family":"Riley","sequence":"first","affiliation":[{"name":"Department of Epidemiology University of Washington  Seattle Washington USA"},{"name":"Carolina Population Center, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeruiah V.","family":"Buchanan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dila","family":"Perera","sequence":"additional","affiliation":[{"name":"Open Arms Perinatal Services  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate Wilhite","family":"Brickell","sequence":"additional","affiliation":[{"name":"Open Arms Perinatal Services  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Turrietta","sequence":"additional","affiliation":[{"name":"Open Arms Perinatal Services  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janae","family":"Teal","sequence":"additional","affiliation":[{"name":"The Capacity Collective  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jami","family":"Bess","sequence":"additional","affiliation":[{"name":"Open Arms Perinatal Services  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Celis","sequence":"additional","affiliation":[{"name":"Open Arms Perinatal Services  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawa","family":"Egal","sequence":"additional","affiliation":[{"name":"Open Arms Perinatal Services  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Memorie","family":"Gladstone","sequence":"additional","affiliation":[{"name":"Open Arms Perinatal Services  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betty","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Open Arms Perinatal Services  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vonda","family":"Prioleau","sequence":"additional","affiliation":[{"name":"Open Arms Perinatal Services  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mienah Z.","family":"Sharif","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Washington  Seattle Washington USA"},{"name":"Division of Community Health Sciences University of California at Berkeley School of Public Health  Berkeley California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010soc\u2010073014\u2010112305"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2020.8882"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(17)30569\u2010X"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615\u2010017\u20100444\u2010z"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.13976"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302613"},{"key":"e_1_2_7_8_1","volume-title":"Racial\/Ethnic Disparities in Pregnancy\u2010Related Deaths\u2014United States, 2007\u20132016","author":"Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion","year":"2022"},{"issue":"14","key":"e_1_2_7_9_1","first-page":"1","article-title":"Infant Mortality in the United States, 2019: Data From the Period Linked Birth\/Infant Death File","volume":"70","author":"Ely D.","year":"2021","journal-title":"National Vital Statistics Reports"},{"issue":"17","key":"e_1_2_7_10_1","first-page":"1","article-title":"Births: Final Data for 2020","volume":"70","author":"Osterman M.","year":"2022","journal-title":"National Vital Statistics Reports"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2024.116793"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2022.102923"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003766.pub5"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003766.pub6"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1891\/1058\u20101243.22.1.49"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301201"},{"issue":"8","key":"e_1_2_7_17_1","first-page":"e340","article-title":"Potential Benefits of Increased Access to Doula Support During Childbirth","volume":"20","author":"Kozhimannil K. B.","year":"2014","journal-title":"American Journal of Managed Care"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0002\u20109378(11)90770\u20104"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995\u2010023\u201003883\u20102"},{"key":"e_1_2_7_20_1","volume-title":"Advancing Birth Justice: Community\u2010Based Doula Models as a Standard of Care for Ending Racial Disparities","author":"Bey A.","year":"2019"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2016.03.150300"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/01459740.2018.1549389"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1089\/heq.2021.0033"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1089\/heq.2018.0045"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13305"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13493"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1363\/psrh.12203"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12673"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2022.04.004"},{"key":"e_1_2_7_30_1","volume-title":"Black Feminist Thought: Knowledge, Consciousness, and the Politics of Empowerment","author":"Collins P. H.","year":"1991"},{"key":"e_1_2_7_31_1","unstructured":"Combahee River Collective \u201cThe Combahee River Collective Statement \u201d1977accessed June 9 2022 https:\/\/www.blackpast.org\/african\u2010american\u2010history\/combahee\u2010river\u2010collective\u2010statement\u20101977\/."},{"key":"e_1_2_7_32_1","first-page":"8","volume-title":"Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics","author":"Crenshaw K.","year":"1989"},{"key":"e_1_2_7_33_1","volume-title":"Designing and Conducting Mixed Methods Research","author":"Creswell J. W.","year":"2011"},{"key":"e_1_2_7_34_1","unstructured":"Dedoose \u201cVersion 9.0.17 Cloud Application for Managing Analyzing and Presenting Qualitative and Mixed Method Research Data \u201d2021 www.dedoose.com."},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"issue":"2","key":"e_1_2_7_36_1","first-page":"41","article-title":"Meaningful Member\u2010Checking: A Structured Approach to Member\u2010Checking","volume":"7","author":"McKim C.","year":"2023","journal-title":"American Journal of Qualitative Research"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003\u2010066X.32.7.513"},{"key":"e_1_2_7_38_1","unstructured":"March of Dimes \u201cPeristats: State Summary for Washington \u201d2021 accessed November 17 2023 https:\/\/www.marchofdimes.org\/peristats\/state\u2010summaries\/washington?lev=1&obj=3&reg=99&slev=4&sreg=53&stop=55&top=3."},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995\u2010021\u201003363\u20105"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2024.116576"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.43225"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303268"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/imhj.22091"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745505723115530"}],"container-title":["Perspectives on Sexual and Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psrh.70015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T14:49:24Z","timestamp":1751035764000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/psrh.70015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":43,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/psrh.70015"],"URL":"https:\/\/doi.org\/10.1111\/psrh.70015","archive":["Portico"],"relation":{},"ISSN":["1538-6341","1931-2393"],"issn-type":[{"value":"1538-6341","type":"print"},{"value":"1931-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"2024-04-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}