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1 in 7 women experience a maternal mental health disorder and there is a mental health professional shortage in 61% of U.S. rural areas.

Robeson Whole Together team members sharing their visionWhole Together Robeson’s mission is to promote health equity for rural mothers, children, and families starting in Robeson County with the goal of expanding to other rural communities in North Carolina. We must address maternal emotional health and wellbeing during pregnancy and early childhood to improve health and developmental outcomes for children and families. The perinatal period and early childhood are critical periods for maternal and child health and development. Both impact immediate and lifelong risks for negative health outcomes. Health and developmental inequities persist through the critical years of childhood and are intricately tied to health and emotional wellbeing across the life course. Many mothers and children experience negative early health and developmental outcomes associated with the fundamental causes of racial discrimination and poverty. Residing in a rural area increases the risk for experiencing these health inequities. This partnership and community based participatory research (CBPR) addresses gaps in services and support for rural mothers to improve maternal health and emotional wellbeing and address associated health disparities to promote health equity for rural families.

Support to address the needs of rural mothers, children, and families to improve health

Proposed Aims:

  • Develop culturally acceptable, feasible study methods and a support group intervention to increase maternal health and emotional wellbeing in pregnant mothers and mothers of infants and toddlers in Robeson County.
  • Test the feasibility of the support group methods including delivering the intervention to pregnant mothers and mothers of young children, recruitment and retention of mothers, and measurement of changes in maternal health and wellbeing, to ensure the support group is acceptable and addressing the needs of rural mothers.
  • Develop an implementation and sustainability plan for the intervention.

Since 2017, we have been actively partnered to support rural maternal emotional health and wellbeing during pregnancy and early childhood in Robeson County, NC. Having a clear understanding of the strengths and challenges of rural communities and the families residing in them is critical to developing and implementing interventions that will be culturally dynamic, acceptable, and sustainable. Robeson County is a rural county where the majority of residents identify as Black, Indigenous, Latine, or People of Color (BILPOC). While supported by a strong spiritual community and dedicated agencies, programs, and providers, residents continue to experience increased risks for negative health and wellbeing outcomes beginning at birth. These risks are fueled by inequities experienced during pregnancy and in early childhood. Our CBPR began with a small exploratory, qualitative study around experiences of pregnancy and motherhood in Robeson County: Mothers Improving Pregnancy and Postpartum Health Outcomes Through Story Sharing (MI-PHOTOS). Our Community Advisory Board (CAB) includes staff and administrators from Robeson County Health Care Corporation, Healthy Start, Health Department, Nurse Family Partnership, and mothers who participated in the MI-PHOTOS project, as well as university faculty and students from University of North Carolina at Chapel Hill. In our previous study, rural mothers in Robeson County indicated they wanted access to both peer and professional support in a group-based format. Therefore, informed by constructivist, critical race, and feminist theories, we will use CBPR methods in partnership with our CAB, local agencies, and providers to develop and test the feasibility of a support group protocol for pregnant mothers and mothers of infants and toddlers in Robeson County based on recommendations from our previous research, community expertise, and broader empirical evidence.


Community-Academic Partners

This project will be led by the following Robeson community members and UNC faculty or researchers:

April Oxendine
Robeson County Department of Public Health
Erica Little
Healthy Start Robeson at UNC Pembroke


Sarah E. (Betsy) Bledsoe
School of Social Work
Anna Fetter
Department of Psychology and Neuroscience


Brittany Gordon
Healthy Start
Nicole Huggins
Community Advisor


Whole Together Robeson Infographic

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