Developing a Culturally Appropriate Perinatal Mental Health Program for Black Mothers with Preterm Birth in the United States: A Mixed-Method Study

Abstract

Perinatal mental health disorders are prevalent among mothers with preterm infants in the neonatal intensive care unit (NICU). Existing institutional and societal racism amplifies the psychological burden of Black mothers in the NICU. Yet, perinatal mental health interventions employ a singular approach involving predominantly non-Hispanic white women. As a result, these programs are limited in addressing external drivers, such as the sociocultural context negatively impacting the mental health of Black mothers with preterm infants. This dissertation utilized a mixed method approach to tailor an existing mental health program for Black mothers with preterm infants in the United States. Three studies were conducted to 1) synthesize the literature on Black mothers' NICU experiences and assess the cultural representation of literature; 2) examine Black mothers' mental health experience in the NICU and to gather their recommendations in culturally adapting the Mothers and Babies online course (eMB) using qualitative methods; and 3) validate the new, culturally-adapted program using a two-phase Delphi technique. The resulting program, eMB 4 Blackmamas, which was tailored for Black mothers in the NICU, uses the existing Mothers and Babies online course. Findings from this dissertation revealed that studies exploring the intersection of NICU experience and Black maternal mental health are limited, with only a handful using socioculturally conceptualized methodologies. Furthermore, mental health services in the NICU are not widely available. Black mothers supported the new mental health program and considered the content important. This dissertation demonstrates it is essential to culturally adapt resources to healthcare experiences, specifically that of Black mothers, in order to advance equitable maternal health. Moreover, digital health has the potential to close gaps in access to evidence-based mental health interventions and treatments. This study offers a foundation for future research and interventions for researchers, policymakers, health providers, and public health professionals.