P1.236: Integrating Doulas into Longitudinal, Perinatal Research Studies: Early Efforts at an NIH ECHO Pregnancy Cohort Site

Background: Perinatal research is critical to improve maternal and infant health outcomes and reduce disparities. However, research participation is not uniform across populations, which may mean findings do not generalize to populations at greater risk of adverse outcomes. To overcome systemic barriers to research participation and retention, research teams need innovative strategies.

Project Description: Penn-CHOP ECHO is a new pregnancy cohort site for the National Institutes of Health (NIH)-funded study of Environmental influences on Child Health Outcomes (ECHO). Nationally, ECHO aims to enroll 30,000 pregnant participants, with 2500 enrolled at Penn-CHOP ECHO; 848 pregnant women have enrolled into Penn-CHOP ECHO since January 2024. The population enrolled at our site is largely Medicaid-insured and identifies as Black. Doulas are trained professionals who provide emotional, informational, and practical support throughout pregnancy, childbirth, and postpartum. We hypothesized that doulas would strengthen our study team in three ways: (1) improve participant experience through trauma-informed and culturally responsive support when pairing with clinical research coordinators to conduct home and NICU study visits; (2) address barriers to participation and offer referrals to community or healthcare resources; and (3) mentor research staff by participating in study meetings and leading by example.

ECHO infant visits begin at 0 to < 6 months and can occur at the research clinic, home, or NICU. Doulas often (~40%) attend home or NICU visits and are available to assist during research clinic visits, as needed. Doulas address participant concerns related to lactation and assist in navigating community resources for financial needs, such as infant supplies, food, and rent. To capture the impact of doulas during study visits, we developed a questionnaire that coordinators have been using after each visit since March 13, 2025 (n=29 visits). Participant health questions and needs came up during 4 (14%) visits and included infant feeding, infant health, return to work, and transportation.

Discussion: For researchers focused on retention of high-risk pregnant populations, doulas offer a responsive solution. When participants from marginalized communities remain enrolled through ongoing support, trust, and resource navigation provided by doulas, the data better reflects their experiences and outcomes. Additional potential benefits include improved trust in medical research and mentorship of research coordinator staff members. Many research coordinators are recent college graduates who plan to pursue careers as physician- or nurse-scientists. Exposure to doulas may shape the views of this workforce and have long-lasting, positive impacts on medical care and science.

Conclusion: The integration of doula care in research settings represents a significant innovation in participant engagement that strives to transform the experiences of both participants and researchers. Doulas may bridge the gap between lived experience and clinical research, creating a model that fosters an environment built on trust, respect, and meaningful connection.