CARE Program: Compassionate and Rewarding Education for Expectant African American Mothers in Prince George’s County, Maryland: A Program Plan and Evaluation

A country’s success or progress is often marked by its health care status. One such marker of nationwide health status is infant mortality. Infant mortality rate is defined as the number of infants that pass away within one year of life for every 1000 live births. From the year 1980 to 2000, rates of infants born with low birth weight rose to 12 percent in the United States. However, over the same time period, improvements were seen in preventing infant deaths, with infant mortality rates declining by 46 percent. Whereas these improvements in maternal and child health are successes to the United States health care system, there are still wide racial disparities in infant mortality rates. The relative infant mortality rate for African American women increased from 2.04 times that of Caucasian women in the year 1980 to 2.46 in the year 2000. These statistics poignantly demonstrate an example of how health disparities in the United States dramatically affect Black Americans. In the year 2000, the five leading causes of infant deaths in the United States were: 1.) congenital malformations; 2.) complications of the cord, placenta, or membranes; 3.) sudden infant death syndrome, 4.) complications during the mother’s pregnancy; and 5. disorders associated with a short gestational period. When comparing African American and White American women, the greatest rate ratios were in the maternal pregnancy complications (3.1) and short gestational disorders (3.9). Therefore, greater education and social support during the pregnancy months might be a significant method to help lower these causes of infant death. Studies have also found that African American women with a college education and adequate prenatal care have greater than two times the likelihood of having a low birth weight infant than their Caucasian counterparts. This data shows that the problem of higher infant mortality rates in African American women is not solely attributable to socioeconomic status. Higher rates of infant mortality are also evident in African American women in my hometown of Prince George’s County, Maryland. It is a predominantly African-American county (64.5 percent African American) and has an infant mortality rate of 11.7 deaths per 1000 births. This rate is greater than the state average of 8 deaths per 1000 births. Therefore, there is a wide health disparity seen in African American women in regards to infant mortality. There is a great need to address infant mortality in African American women through public health programming, especially in places like Prince George’s County, Maryland. On systematic review, several articles were found containing different approaches to prenatal education programming. Some focused solely on education, such as proper nutrition or smoking abstinence during pregnancy. Others included social support sessions, prenatal care coordination, case management, education for fathers, and exploration of social determinants of health in the African American community. This masters paper will discuss an original program entitled, “Compassionate and Rewarding Education Program for Expectant African American Mothers (CARE).” The CARE Program will integrate some of the previously mentioned educational programs and add other new elements to bring a unique program to Prince George’s County, Maryland. Core components will include an educational curriculum, group therapy, mental support sessions, and Lamaze classes, free of charge. There are four primary sections of this paper on the CARE Program. First, the literature review will analyze research studies that look into the causes of the infant mortality health disparity in African Americans, and strategies and programs that target this population. The program plan will describe the goals, objectives, design, and overall plan for the intervention. Next, the evaluation plan will explain how I intend to examine and report the program’s progress, as well as detailing the evaluation methods and design. Lastly, the discussion section will provide conclusions, reflections, and future implications of this program plan and evaluation.Master of Public Healt