ArticleCommunity health equity research & policy2024
Activating Life Course Theory through a Whole System Prevention Framework to Address the Wicked Problem of Maternal and Infant Morbidity and Mortality.
Article in Community health equity research & policy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Methods to design, adapt and apply equity-focused implementation science theories, models and frameworks in healthcare systems: a scoping review.Implementation science communications · 2026Review
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Authors and funding
7 authors.
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Abstract
backgroundRacial/ethnic disparities in maternal and infant morbidity and mortality (MIM&M) is a wicked problem that is reinforced and perpetuated by our system[s] of care. Life Course Theory (LCT) helps to explain drivers of health disparities, but its application is challenged. An upstream approach that promotes systemic change requires the implementation of an expanded prevention framework that includes primordial and quaternary prevention. RESEARCH
designWe developed an innovative expanded Whole System Prevention Framework (WSPF) that incorporates LCT, prevention (including primordial and quaternary prevention) and systems thinking. STUDY SAMPLE: We implemented this new conceptual Framework with two Healthy Start community partnerships through training, service mapping, and strategic planning to address upstream drivers of MIM&M. DATA COLLECTION AND ANALYSIS: Service mapping revealed few Healthy Start upstream activities/services with the predominance being delivered downstream at the program (microsystem) level.
resultsService mapping provided a snapshot of the current service distribution of services across the systems. The preponderance were primary, secondary and tertiary prevention activities (75.5% and 65.6%) delivered at the program level (58.2% and 68%), revealing opportunities for upstream strategies to promote equity. The implementation process provided a new way to frame strategic planning and develop upstream strategies to promote health equity and reduce MIM&M.
conclusionThe Whole System Prevention Framework and its implementation methodology could be applied to address other wicked problems.
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