The purpose of this qualitative study is to use community stories to identify barriers of prenatal and pediatric health care by members of communities with the highest rates of black fetal and infant mortality.

Design:

The study is a qualitative descriptive study and is informed by Story Inquiry (Liehr & Smith, 2007). Participants were a convenience sample of African American community members who choose to attend a discussion in their community about the health of pregnant women and babies and consented to share their stories. The five inquiry process of that guides the study are: gathering stories about complicated health issues; begin to decipher the complicating health challenge; describe the developing story plot; identify movement toward resolving and synthesize findings to address the research question.

Setting:

The setting for this research study is in housing complexes located in the communities with the highest rates of black fetal and infant mortality in Broward County, Florida.

Patients/Participants:

Participants were a convenience sample of African American community members who choose to attend a discussion in their community about the health of pregnant women and babies and consented to share their stories.

Methods:

Community meetings were held in gathering places within the identified zip codes that have the highest rates of black infant mortality. IRB approval was obtained through Florida Atlantic University Institutional Review Board. Verbal consent statements were read prior to the story inquiry, with a written copy provided to all participants. Sessions were recorded, transcribed and analyzed. All data was de-identified. The Atlas program was used in the analysis of the qualitative data.

Results:  

The themes that emerged from the analysis included access issues to health care including Medicaid insurance barriers, lack of referral to specific health care sources, lack of availability except emergency rooms for after hours health care question and lack of coordination of care.

Conclusion/Implications for nursing practice:

Identification of barriers to care that may prevent infant mortality assists in multidisciplinary planning to overcome these barriers. Informing at risk communities of risks to health supports community involvement in solution planning.

Keywords:  

Infant Mortality

Community Care

Access to care

Disparity