Designing the First Pregnancy Guaranteed Income Program in the United States: Qualitative Needs Assessment and Human-Centered Design to Develop the Abundant Birth Project
BackgroundRacial inequities in pregnancy outcomes persist despite investments in clinical, educational, and behavioral interventions, indicating that a new approach is needed to address the root causes of health disparities. Guaranteed income during pregnancy has the potentia...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-01-01
|
| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2025/1/e60829 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832584010866360320 |
|---|---|
| author | Deborah Karasek Jazzmin C Williams Michaela A Taylor Monica M De La Cruz Stephanie Arteaga Sabra Bell Esperanza Castillo Maile A Chand Anjeanette Coats Erin M Hubbard Latriece Love-Goodlett Breezy Powell Solaire Spellen Zea Malawa Anu Manchikanti Gomez |
| author_facet | Deborah Karasek Jazzmin C Williams Michaela A Taylor Monica M De La Cruz Stephanie Arteaga Sabra Bell Esperanza Castillo Maile A Chand Anjeanette Coats Erin M Hubbard Latriece Love-Goodlett Breezy Powell Solaire Spellen Zea Malawa Anu Manchikanti Gomez |
| author_sort | Deborah Karasek |
| collection | DOAJ |
| description |
BackgroundRacial inequities in pregnancy outcomes persist despite investments in clinical, educational, and behavioral interventions, indicating that a new approach is needed to address the root causes of health disparities. Guaranteed income during pregnancy has the potential to narrow racial health inequities for birthing people and infants by alleviating financial stress.
ObjectiveWe describe community-driven formative research to design the first pregnancy-guaranteed income program in the United States—the Abundant Birth Project (ABP). Informed by birth equity and social determinants of health perspectives, ABP targets upstream structural factors to improve racial disparities in maternal and infant health.
MethodsThe research team included community researchers, community members with lived experience as Black or Pacific Islander pregnant, and parenting people in the San Francisco Bay Area. The team conducted needs assessment interviews and facilitated focus groups with participants using human-centered design methods. Needs assessment participants later served as co-designers of the ABP program and research, sharing their experiences with financial hardships and government benefits programs and providing recommendations on key program elements, including fund disbursement, eligibility, and amount.
ResultsHousing affordability and the high cost of living in San Francisco emerged as significant sources of stress in pregnancy. Participants reported prohibitively low income eligibility thresholds and burdensome enrollment processes as challenges or barriers to existing social services. These insights guided the design of prototypes of ABP’s program components, which were used in a design sprint to determine the final components. Based on this design process, the ABP program offered US $1000/month for 12 months to pregnant Black and Pacific Islander people, selected through a lottery called an abundance drawing.
ConclusionsThe formative design process maximized community input and shared decision-making to co-design a guaranteed income program for Black and Pacific Islander women and people. Our upstream approach and community research model can inform the development of public health and social service programs. |
| format | Article |
| id | doaj-art-04fd9d7aff79466fb249dd3538b2bd2e |
| institution | Kabale University |
| issn | 2561-326X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Formative Research |
| spelling | doaj-art-04fd9d7aff79466fb249dd3538b2bd2e2025-01-27T21:30:32ZengJMIR PublicationsJMIR Formative Research2561-326X2025-01-019e6082910.2196/60829Designing the First Pregnancy Guaranteed Income Program in the United States: Qualitative Needs Assessment and Human-Centered Design to Develop the Abundant Birth ProjectDeborah Karasekhttps://orcid.org/0000-0002-5909-5441Jazzmin C Williamshttps://orcid.org/0000-0002-8678-5157Michaela A Taylorhttps://orcid.org/0000-0001-7281-3578Monica M De La Cruzhttps://orcid.org/0000-0003-3014-7305Stephanie Arteagahttps://orcid.org/0000-0002-7064-1642Sabra Bellhttps://orcid.org/0009-0009-3574-2825Esperanza Castillohttps://orcid.org/0000-0001-8915-007XMaile A Chandhttps://orcid.org/0009-0006-7520-072XAnjeanette Coatshttps://orcid.org/0009-0005-0229-6858Erin M Hubbardhttps://orcid.org/0000-0003-0923-7920Latriece Love-Goodletthttps://orcid.org/0009-0001-5517-9111Breezy Powellhttps://orcid.org/0009-0008-2010-1120Solaire Spellenhttps://orcid.org/0000-0002-5197-6949Zea Malawahttps://orcid.org/0000-0001-7323-6266Anu Manchikanti Gomezhttps://orcid.org/0000-0002-9461-4411 BackgroundRacial inequities in pregnancy outcomes persist despite investments in clinical, educational, and behavioral interventions, indicating that a new approach is needed to address the root causes of health disparities. Guaranteed income during pregnancy has the potential to narrow racial health inequities for birthing people and infants by alleviating financial stress. ObjectiveWe describe community-driven formative research to design the first pregnancy-guaranteed income program in the United States—the Abundant Birth Project (ABP). Informed by birth equity and social determinants of health perspectives, ABP targets upstream structural factors to improve racial disparities in maternal and infant health. MethodsThe research team included community researchers, community members with lived experience as Black or Pacific Islander pregnant, and parenting people in the San Francisco Bay Area. The team conducted needs assessment interviews and facilitated focus groups with participants using human-centered design methods. Needs assessment participants later served as co-designers of the ABP program and research, sharing their experiences with financial hardships and government benefits programs and providing recommendations on key program elements, including fund disbursement, eligibility, and amount. ResultsHousing affordability and the high cost of living in San Francisco emerged as significant sources of stress in pregnancy. Participants reported prohibitively low income eligibility thresholds and burdensome enrollment processes as challenges or barriers to existing social services. These insights guided the design of prototypes of ABP’s program components, which were used in a design sprint to determine the final components. Based on this design process, the ABP program offered US $1000/month for 12 months to pregnant Black and Pacific Islander people, selected through a lottery called an abundance drawing. ConclusionsThe formative design process maximized community input and shared decision-making to co-design a guaranteed income program for Black and Pacific Islander women and people. Our upstream approach and community research model can inform the development of public health and social service programs.https://formative.jmir.org/2025/1/e60829 |
| spellingShingle | Deborah Karasek Jazzmin C Williams Michaela A Taylor Monica M De La Cruz Stephanie Arteaga Sabra Bell Esperanza Castillo Maile A Chand Anjeanette Coats Erin M Hubbard Latriece Love-Goodlett Breezy Powell Solaire Spellen Zea Malawa Anu Manchikanti Gomez Designing the First Pregnancy Guaranteed Income Program in the United States: Qualitative Needs Assessment and Human-Centered Design to Develop the Abundant Birth Project JMIR Formative Research |
| title | Designing the First Pregnancy Guaranteed Income Program in the United States: Qualitative Needs Assessment and Human-Centered Design to Develop the Abundant Birth Project |
| title_full | Designing the First Pregnancy Guaranteed Income Program in the United States: Qualitative Needs Assessment and Human-Centered Design to Develop the Abundant Birth Project |
| title_fullStr | Designing the First Pregnancy Guaranteed Income Program in the United States: Qualitative Needs Assessment and Human-Centered Design to Develop the Abundant Birth Project |
| title_full_unstemmed | Designing the First Pregnancy Guaranteed Income Program in the United States: Qualitative Needs Assessment and Human-Centered Design to Develop the Abundant Birth Project |
| title_short | Designing the First Pregnancy Guaranteed Income Program in the United States: Qualitative Needs Assessment and Human-Centered Design to Develop the Abundant Birth Project |
| title_sort | designing the first pregnancy guaranteed income program in the united states qualitative needs assessment and human centered design to develop the abundant birth project |
| url | https://formative.jmir.org/2025/1/e60829 |
| work_keys_str_mv | AT deborahkarasek designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT jazzmincwilliams designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT michaelaataylor designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT monicamdelacruz designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT stephaniearteaga designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT sabrabell designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT esperanzacastillo designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT maileachand designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT anjeanettecoats designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT erinmhubbard designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT latriecelovegoodlett designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT breezypowell designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT solairespellen designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT zeamalawa designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject AT anumanchikantigomez designingthefirstpregnancyguaranteedincomeprogramintheunitedstatesqualitativeneedsassessmentandhumancentereddesigntodeveloptheabundantbirthproject |