# Building TrUst and UNiting Teams Through DouLa partnErship-BUNDLE

> **NIH NIH U54** · MEDICAL COLLEGE OF WISCONSIN · 2024 · $456,871

## Abstract

PROJECT SUMMARY/ABSTRACT: BUNDLE
Black/African American (Black/AA) birthing people experience disproportionately higher rates of mortality and
morbidity associated with pregnancy. Nationwide, Black women are three times more likely to die from
pregnancy-related causes than non-Hispanic white women, but in Wisconsin, they are five times more likely to
die. 70% of the Black population of Wisconsin resides in Milwaukee County, which is in Southeastern
Wisconsin. One of the key factors contributing to these disparities is medical mistrust, a defensive reaction
against prevailing structural inequities that leads to suboptimal access to healthcare resources. In our
healthcare system, we found high rates of medical mistrust among Black/AA pregnant people. Moreover, a
2021 Community Health Needs Assessment conducted in Milwaukee County, relying on residents’ survey,
stakeholders’ interviews and focus groups with community leaders, found that trust in the health care system
was identified as key concern for maternal and infant health in Milwaukee County. To address the critical need
to build trust between our healthcare system and Black/AA birthing communities in Southeastern Wisconsin,
our team has partnered with a community-based doula organization, the African American Breastfeeding
Network (AABN). Community-based doulas are integral in addressing the maternal health crisis by diversifying
the prenatal workforce and serving as advocates and emotional supporters for mothers as they navigate the
health system. Numerous studies demonstrate that community-based doulas are associated with lower odds of
cesarean, preterm birth, and postpartum depression. However, currently, AABN doulas and any other
community-based doulas operate separately from healthcare professionals in Wisconsin. This leads to mixed
attitudes on acceptance of doulas on labor and delivery by hospital staff. To date, no effort has been attempted
to merge the strengths of these groups to improve maternal health across the region. Our central hypothesis is
that earlier integration of community-based doulas in prenatal care reduces medical mistrust by uniting and
diversifying the perinatal workforce and improves maternal health outcomes. We plan to test this hypothesis
with a mixed methods study, titled Building TrUst and UNiting Teams Through DouLa partnErship (BUNDLE),
using three specific aims: Aim 1: Develop an integrated prenatal care model of medical providers and
community-based doulas in Southeastern Wisconsin, Aim 2: Compare the effectiveness of the integrated
prenatal care model to standard prenatal care in improving healthcare engagement and trust, and reducing
adverse outcomes, and Aim 3: Disseminate findings to scholarly and community-based forums and actively
pursue opportunities for systems- and policy-level change. After the proposed research is completed, we
expect to identify drivers of medical mistrust for Black birthing people and the establish a sustainable
integrated dou...

## Key facts

- **NIH application ID:** 10908689
- **Project number:** 5U54HD113408-02
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Jessica M Olson
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $456,871
- **Award type:** 5
- **Project period:** 2023-08-17 → 2030-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10908689

## Citation

> US National Institutes of Health, RePORTER application 10908689, Building TrUst and UNiting Teams Through DouLa partnErship-BUNDLE (5U54HD113408-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10908689. Licensed CC0.

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