(483) Black and Hispanic patient-centered voices of antepartum anemia: a community engaged approach

Black pregnant people have the highest rates of anemia, contributing to disparities in severe maternal morbidity in the United States. Our objective was to conduct community-centered research to identify barriers to and opportunities to care for antepartum anemia among historically underserved communities. 

Study Design: We applied Howell’s conceptual framework on reduction of peripartum racial and ethnic disparities (Obstet Gynecol 2018) and the Public Health Critical Race Praxis to identify community stakeholders and distill research objectives. In collaboration with our community partners, we created a semi-structured interview guide. People with a history of antepartum anemia were eligible and participated in focus groups and interviews aimed at providing insight into patient perceptions of diagnosis, management, and treatment of anemia offered and received during pregnancy. Cultural congruency between the interview facilitators and interviewees was maintained by race and ethnicity when possible. We analyzed the interviews using the grounded-based theory approach. 

Results: We conducted  one-one interviews and virtual focus group sessions with 15 people with a history of antepartum anemia, facilitated by our community partner and academic research team. 11 focus group participants were Black, 3 were Hispanic/Latinx, and 1 was Multiracial, and all resided in California. Our analysis identified five major themes around barriers to care: 1) lack of information/education from the provider regarding anemia; 2) dismissal of patient’s reported experiences with anemia symptoms; 3) treatment challenges with nutrition, oral, and intravenous iron; 4) perception of race and culture as a contributing factor to maternal care; and 5) role of patient support system.

Conclusion: Our qualitative community-engaged approach identified specific challenges and opportunities for patient-informed solutions to improve antepartum anemia care among Black and Hispanic pregnant patients. Community-informed interventions are needed to achieve equitable, evidence-based treatment and care of anemia in pregnancy.