Dr. Sarah-Bianca G. Dolisca, MD, MPH, is an obstetrician/gynecologist at Kaiser Permanente Antioch Medical Center in Antioch, CA. Prior to the Commonwealth Fund Fellowship, she was chief resident in Obstetrics and Gynecology at Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA. While in medical school, Dr. Dolisca received the Linnane Scholarship, a need-based prize for students who exhibit academic excellence and HMS community leadership. She aims to remain clinically active and fashion a career reducing disparities in reproductive health and perinatal outcomes. She served as co-chair of the Diversity and Inclusion Committee in the Ob-Gyn Department at Brigham and Women’s Hospital. Dr. Dolisca is currently a lead investigator on an IRB-approved funded study assessing the impact of web-based residency selection. Additionally she is examining the COVID-19 pandemic’s impact on timing of conception in a fertile and infertile patient population in another IRB-approved funded study. Dr. Dolisca received her medical degree from Harvard Medical School in 2017.
Sarah-Bianca G. Dolisca, MD, MPH
Obstetrician/Gynecologist, Kaiser Permanente Antioch Medical Center, Antioch, CA
Developing a Framework to Improve Maternal Child Wellbeing Inequities Through a Goal-Oriented Coaching Intervention
Objectives:
- To advise further development of the Family Partnership Program by strengthening its ability to impact social determinants of maternal health
- To inform incorporation of clinical indicators to assess the ability of the Family partnership program to improve maternal outcomes
Background: In recent years, the rising rate of adverse maternal outcomes compared to other developed countries has been an area of concern. There are also vast disparities in perinatal outcomes when disaggregated by race with elevated risk of maternal mortality in non-Hispanic Black women. Non-Hispanic Black women, American Indian and Alaska Natives (AIAN), and Native American and Pacific Islanders have also been associated with a greater incidence of adverse pregnancy outcomes including elevated rates of low-birth-weight infants, higher rates of preterm birth, and greater incidence in inadequate prenatal care.
A key driver of the susceptibility and risk for disparities in maternal child health are the social determinants of health. Novel community and individual level interventions provide a unique opportunity to address the upstream factors that result in these inequities.
The Family Partnership Program (FPP) enrolls patients with identified socioeconomic vulnerabilities in a longitudinal program that aims to cultivate the ability for participants to enhance their individual circumstance through a goal-oriented coaching intervention. The program aims to improve participant knowledge and skill in the areas of: Health and Wellness, Economic Mobility, Family Stability, Education/Employment, and Parenting and Life Skills.
Methods:
- Performed a literature review to inform understanding of opportunities for enhancing clinical maternal health indicators and social determinants of maternal health indicators assessed in participants of this intervention
- Audited Family Partnership Program and incorporated stakeholder interviews to complete a programmatic analysis
Findings:
- Enhanced social determinants of maternal health indicators
- Expanded clinical maternal health indicators
- Completion of a SWOT analysis
Recommendations:
- Communicated opportunities discovered for improving the process of Family Partnership Program
- Complete a rigorous research study of the proposed indicators in a sample population of patients with and without Family Partnership Program intervention to assess impact
Preceptor: Ariel Childs, MPH Stronger Generations Initiative
