Exploring Views of Technology to Inform Maternal and Child Health Interventions for Black Birthing People

Background Black birthing people experience disproportionately higher rates of morbidity and mortality, and poorer infant health outcomes than all other racial and ethnic groups. Statewide in Wisconsin, an alarming disparity exists between Black and Non-Hispanic White (NHW) breastfeeding initiation rates (54% and 87%, respectively). For the last fourteen years, the African American Breastfeeding Network (AABN) has operated in Milwaukee County, where 70% of the state’s Black population lives. AABN’s mission is to improve maternal health and champion breastfeeding equity for Black birthing families. In 2018, AABN received more referrals than could be served by their team of doulas, lactation consultants, and advocates, leading our team to pursue ways to expand their reach through technology-based approaches. With the onset of COVID-19, the need for telehealth support increased drastically, as referrals for AABN services tripled. In this study, we explore the use of technology to support Black birthing families in Wisconsin and beyond, in the hopes of expanding the capacity of organizations like AABN. Methods A survey was conducted amongst 21 Black women who were pregnant or had given birth in the last year, regarding perceptions of technology. Women were split equally into three focus groups to discuss survey results further and provide context. Focus groups were recorded, transcribed, and coded for themes. Results Participants were “Likely” to use their phone or the internet to look for general or health-related information, but only “Somewhat Likely” to trust either general or health-related information. Participants were “Somewhat Likely” to trust the information on the phone or the internet as much as their healthcare provider (doctor, nurse, doula) in person. In the focus groups, all participants agreed that the phone or the internet was the first place looked to for information, ahead of consulting a healthcare professional. A comprehensive list of desired features was generated to guide the development of a resource to support AABN. Conclusions Study findings support exploring mobile technology-based approaches for breastfeeding support and education. Participants emphasized that to be relevant for them, a telehealth resource would need to: 1) Build meaningful connections between patients and providers, 2) Treat diverse opinions with trust and respect, and 3) Offer multiple sources and formats for information that can be easily cross-referenced. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: All data collection and research-related actions were completed under approval from the Medical College of Wisconsins Institutional Review Board (PRO#00032076). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.