B'More Fit for Healthy Babies: Using Trauma-Informed Care Policies to Improve Maternal Health in Baltimore City.

BACKGROUND: Pregnant obese women have an increased risk for infant mortality and poor maternal outcomes. Environmental and social conditions pose barriers for less-advantaged overweight women to participate in weight loss interventions. The B'more Fit for Healthy Babies Program aimed to address existing gender inequities that persist where exposure to community-level trauma is present. METHODS: A gender-based analysis using qualitative and quantitative approaches informed B'more Fit's intervention and identified opportunities for trauma-informed care policies. Key data sources for analyses included two series of focus groups and a quantitative survey. Review of additional Baltimore-based literature and research also informed policy development. RESULTS: A workgroup formulated policies for B'more Fit staff and participants. Policies involved technical assistance, staff consultation, and gender-sensitive counseling sessions. These activities gained the attention of the Baltimore City Health Department's leadership, and department-wide trainings were conducted. Highly publicized violence in Baltimore led to expanded trauma-informed care training and policy development in all local government agencies through a partnership between the Baltimore City Health Department and Behavioral Health Systems Baltimore, Inc. CONCLUSIONS: The development and monitoring of trauma-informed interventions and policies within governmental and human service agencies can counterbalance social and environmental exposures. Applying a gender-based and trauma-informed program provided B'more Fit participants with strategies for weight loss, improved nutrition, and better parenting. Coordinated policies and interventions are underway in city institutions to address residents' behavioral health needs and improve citywide services.

Building effective partnerships to improve birth outcomes by reducing obesity: The B'more Fit for healthy babies coalition of Baltimore.

Obesity affects a large percentage of Baltimore City's population with repercussions on maternal health and birth outcomes. Approaches to ameliorate its impact must be comprehensive and include stakeholder involvement at all levels of influence including policy makers, service providers, and community residents. In this article, we examine the evolution of the B'more Fit for Healthy Babies Coalition in Baltimore, Maryland, with a specific focus on how the public health alliance was formed, the strategies employed, and how partners continually evaluated themselves. This study offers the opportunity to understand the extent and complexity undergirding the collaborative processes of community coalitions as they strive to find innovative solutions to major public health concerns.