Evaluating Hospital Staff Perceptions of Community-Based Doula Care: A Mixed-Methods Study on Birth Outcomes and Program Integration [ID 1494]

INTRODUCTION: Community-based doulas promote birth equity by providing culturally sensitive care that addresses challenges faced by marginalized populations, and improving maternal and infant health outcomes. Following the implementation of the Helping Promote Birth Equity (HoPE) program through community-based doula care in two safety-net hospitals, understanding hospital staff’s perceptions of doulas is essential for successfully integrating the program into standard clinical care. METHODS: Using a mixed-methods approach, we surveyed 82 obstetrics staff at two safety-net hospitals and conducted qualitative interviews with eight health care staff to assess views on the HoPE program. Quantitative data were analyzed using descriptive statistics and chi-squared tests in SAS, whereas qualitative data were examined in Dedoose using thematic analysis following the RE-AIM implementation framework. RESULTS: The survey revealed moderate to high average agreement rates with the program’s implementation, with 77% of staff rating it as appropriate, 72% finding it feasible, and 67% rating it as acceptable. Qualitative interviews highlighted the doulas’ key roles in providing emotional and physical support, enhancing communication, and empowering patients, while also identifying barriers such as the need for more staff education on the role of doulas in patient care and how it differs from clinical roles, the need for increased accessibility of doula services, and challenges in building trusting relationships between patients, doulas, and staff. CONCLUSIONS/IMPLICATIONS: Understanding hospital staff perceptions is crucial for successful implementation of doula programs in clinical settings. Our results guided us on how to improve HoPE program implementation to foster a collaborative environment for respectful maternity care.