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Purpose: In an effort to address persistent inequities in maternal and infant health, policymakers and advocates have pushed to expand access to doula care. Several states, including California, now cover doula services through Medicaid. As coverage expands, research on the impact of doula care will likely increase. To develop best practices for research, it is critical to engage community doulas, clients, and other key stakeholders. Description: Our overarching goal was to build capacity for future doula- and client-centered research on community doula care. First, we established a Steering Committee with members from seven relevant stakeholder groups: community doulas, former or potential doula clients, clinicians, payers, advocates, researchers, and public health professionals. Second, we conducted a needs assessment to identify and understand stakeholders' needs and values for research on community doula care. Findings from the needs assessment informed our third step, conducting a research prioritization to develop a shared research agenda related to community doula care with the Steering Committee. We adapted the Research Prioritization by Affected Communities protocol to guide this process, which resulted in a final list of 21 priority research questions. Lastly, we offered a training to increase capacity among community doulas to engage in research on community doula care. Assessment: Our findings provide direction for those interested in conducting research on doula care, as well as policymakers and funders. Conclusion: The findings of our stakeholder-engaged process provide a roadmap that will lead to equity-oriented research centering clients, doulas, and their communities. Significance: What is Already Known on this Subject?: Doula care is often cited as a cost-effective intervention to improve maternal and infant health and health care experiences. However, research that focuses on the community-based model of doula care is limited. What this Study Adds?: This paper describes a stakeholder-engaged process that identified important understudied research questions about community doula care. Researchers can further refine these questions to conduct partnered research with multiple stakeholder groups, including community doulas, former or potential doula clients, clinicians, payers, advocates, and public health professionals. Further, this paper outlines best practices for research on community doula care. [ABSTRACT FROM AUTHOR]

Purpose: This paper describes the approach used to develop the Adolescent Family Life Program (AFLP) Positive Youth Development (PYD) Model within the structure of an existing state government-run program. Description: The California Department of Public Health, Maternal, Child and Adolescent Health (CDPH/MCAH) Division undertook an innovative approach to develop a program model to help expectant and parenting youth build resilience. CDPH/MCAH started by assessing existing program efforts and theory to develop and test new strategies in the field, structure a program model, and build toward broader expansion and sustainability. CDPH/MCAH engaged local organizations from across the state, their staff and enrolled youth, experts, and evaluators in an iterative program development process to standardize an effective model that could be replicated and evaluated. Assessment: Key lessons for program developers and administrators are to ensure adequate staffing with diverse expertise related to the topic and content to support the multiple components of program development and implementation, evaluation, and training; identify the guiding theory and framework early and link them with clearly articulated core components to ensure the final model reflects the intended purpose and is structured to support implementation; engage implementation staff on the ground and focus early and often on processes for supporting people through change. Conclusion: The lessons learned can guide others working with existing programs to develop standardized program models or translate new science and theory into practice. [ABSTRACT FROM AUTHOR]

Objectives: With funding from the Pregnancy Assistance Fund, the Maternal, Child, and Adolescent Health Division (MCAH) of California redesigned its existing Adolescent Family Life Program (AFLP) for expectant and parenting young women into a more intensive and structured intervention, AFLP with positive youth development (PYD). This paper presents key findings from a federally funded, rigorous implementation study of the two programs. Methods: This implementation study collected data from 13 agencies from January 2016 through December 2017, including interviews with 69 case managers and 18 supervisors; focus groups with 130 program participants; surveys of 66 case managers and 1330 young women; and observations of 42 visits with program participants. The study combined qualitative and quantitative analysis methods. Results: As designed, PYD was a much more structured and intensive program than AFLP. Case managers and supervisors saw value in the PYD model and new approach but needed more support and guidance than expected in order to deliver it with fidelity. MCAH provided additional trainings and technical assistance to address challenges. In practice, although staff noted differences in approach and content, the youth experience with the two programs was similar. Conclusions for Practice: Integrating the PYD framework into case management systems may foster youth self-sufficiency and resiliency. However, the rigid structure of the program was often challenging to implement in practice. Organizations interested in implementing prescribed case management approaches should consider allowing opportunities for flexibility in implementation and providing more detailed preservice training to prepare staff for real-world implementation. [ABSTRACT FROM AUTHOR]