Effect of Doula Care on Social Determinants of Health: Doulas as a Tool to Address Nonmedical Health Care Disparities Within the Health Care System [ID 1505]

INTRODUCTION: Doulas are trained patient care advocates who provide educational, emotional, and physical support to patients throughout their reproductive journeys. Doula care is associated with improved outcomes for both birthing individuals and neonates and is a promising strategy for reducing inequities in birth outcomes. One mechanism by which community-based doula support is effective is through addressing social determinants of health (SDOH). The HoPE Doula Program was designed to promote reproductive health equity in Queens, New York, by providing community-based doula care to birthing individuals at local public hospitals. The program integrates community-based doulas into the clinical care system to help patients achieve better social and medical outcomes. This study explores how HoPE doulas have an extensive effect on SDOH, beyond the scope of traditional doula care and traditional health care. METHODS: We conducted key informant interviews in English (n=8) and Spanish (n=2) with 10 doulas serving birthing clients through the HoPE Doula Program. Qualitative data was recorded and transcribed via Zoom (video conferencing) and translated by Acolad, if applicable. The data was collected from May to July 2023, and Dedoose analysis software was utilized to support thematic analysis. RESULTS: Doulas highlighted their abilities to affect SDOH such as housing, food insecurity, transportation, and access to other resources and services through trust-building, education, culturally responsive care, and advocacy. Doulas discussed collaboration with local community-based organizations and hospitals. CONCLUSIONS/IMPLICATIONS: Doula care offers a comprehensive and culturally responsive approach for addressing underlying SDOH affecting underserved and underresourced birthing individuals.