From Frameworks to Findings: A Literature Review of Theoretical Approaches in Black Maternal Health Research in The United States.

Black maternal health research is growing in response to the preventable and persistent health disparities Black women face throughout the perinatal period. Traditionally, public health research draws upon theoretical frameworks to inform the framing, design, analysis, and interpretation of studies. A literature review was conducted to examine how theoretical frameworks are integrated into Black maternal health research in the United States. Forty-one studies met inclusion criteria, 21 different theoretical frameworks were identified, and a synthesis of the findings yielded two analytical tiers and six themes. The first tier, theoretical operationalization, represents the point of theoretical integration and has three themes: (1) dual theoretical and framework approaches, (2) application of critical theories, and (3) innovative models for understanding Black maternal health disparities. The second tier, structural and community-based approaches to Black maternal health, representing a structural level of analysis, yielded three themes: (1) the redistribution of responsibility for health outcomes from individuals to institutions, (2) health strategies and interventions beyond clinical settings, and (3) dynamics of patient-provider relationships. Collectively, these findings highlight both the breadth and inconsistency of theoretical integration in the field. Future research should more explicitly consider at which phases of the research process theoretical frameworks are integrated and critically assess how specific theories are adapted and applied to historically underserved populations, including Black mothers and birthing people.