The COMSS ADVancing Ongoing Community AcTivities for Equitable Systems (COMSS ADVOCATES) - Community-based Maternal Support Services (COMSS), delivered by doulas and community health workers, address social determinants of health aspects such as transportation, housing, education, trauma and abuse, health literacy, financial planning, and more. These services go beyond standard forms of prenatal, pregnancy, and post-partum care. COMSS have been shown to improve birth outcomes and reduce health disparities. Our project, COMSS ADVOCATES (ADVancing Ongoing Community AcTivities for Equitable Systems), will work with two demonstration sites (Minneapolis, MN and Nashville, TN). Representatives from the local health department within each demonstration site will convene a community coalition, which will include community residents, COMSS practitioners, medical providers, staff from the local health department and representatives from local community-based organizations. The Minneapolis site will focus on promoting COMSS for American Indian and Alaska Native populations, and the Nashville site will focus on promoting COMSS for African American populations. During year one of the project, the coalition within each demonstration site will ensure that all the needed partners are invited to participate and will work to gather relevant local data and create vision, mission, values, roles, and responsibilities to guide their work. In year two, the coalitions will identify settings and select implementation strategies for COMSS integration into existing health care systems and providers. In years three and four, the community coalition within each demonstration site will oversee COMSS integration according to the plans they developed and will work continuously to improve services and processes. Throughout the project, the coalitions will receive support from CityMatCH, a national membership organization with strong staffing, project management capacity, and over 30 years of experience working with local health departments and their community partners to improve maternal and child health outcomes and reduce health disparities. In addition to CityMatCH, a team of community-engaged scholars will work with the coalitions, providing technical assistance to help create community-driven, equity-focused interventions to promote the integration of COMSS into community-based perinatal systems of care. An external evaluator located at the University of Kansas Medical Center will ensure an unbiased assessment of the project and its impact on local systems of care, health outcomes, and reductions in health disparities.
