"This is Exactly What the Community Needs": Evaluation of Home Visitor's Experience Facilitating a Postpartum Mental Health and Cash Supplement Program.

Abstract

Background: Significant racial inequities exist in perinatal mood disorders and diagnoses. Traditional postpartum care consists of a singular six-week visit, which leaves many individuals feeling unsupported. Postpartum home visiting programs have demonstrated effectiveness in reducing symptoms of perinatal depression. Preliminary evidence suggests that cash transfers can improve both mental health and maternal health.

Methods: This study uses the Birth Justice Collaborative Postpartum Support Pilot to evaluate how home visiting coupled with cash transfers supports maternal mental health. Two focus groups (Black, n = 3, American Indian, n = 3) with home visitors (HVs) were conducted in January 2025. Authors used a semi-structured guide focused on gleaning insights from the HVs' perspective. Then inductive coding and thematic analysis were used to elucidate learnings.

Results: Six themes were illuminated regarding the role of the HV and how they supported postpartum families. Overall HVs spoke highly of this pilot and deemed it successful. HVs reiterated that this program is necessary. The most notable limitations of the pilot were addressing the sustainability of the home visiting workforce and the lack of cultural alignment in the Family Spirit curriculum with Black participants.

Discussion: HV and cash transfers support perinatal mental health through a variety of ways. Insights from HVs reveal this care is needed and is well received, but it requires flexibility to tailor support and attentive leadership to facilitate the conditions for HVs to thrive. A well-supported perinatal workforce can, in turn, provide adequate care, leading to improved mental health for postpartum families.