Maternal Child Health Equity Fellowship

Associate Professor and Macy Scholar Dr. Jessica Devido is helping undergraduate nursing students promote maternal child health equity by preparing the future health care workforce to understand and address systemic inequities.

According to Devido, the most important clinical skills in nursing are active listening and a commitment to authentic communication. And as an associate professor at the Duquesne University School of Nursing and one of just five interdisciplinary faculty across the country to have been selected as a 2021 Macy Faculty Scholar, Devido is excited to share the importance of this outlook with future generations of Duquesne nurses through a new educational innovation project – the Maternal Child Health Equity Fellowship.

As part of her Macy Scholars selection, Devido has developed the Maternal Child Health Equity Fellowship, a program designed for undergraduate pre-licensure nursing students to promote equity, cross-cultural sensitivity and collaboration with community stakeholders.

“The goal is to help build a better working relationship between nurses, interdisciplinary colleagues and new mothers in communities of color. We want patients to feel as though their needs are being met, and they are truly being heard and understood,” explains Devido, the first Duquesne nursing faculty to be recognized as a Macy Scholar.

Devido, who spent months planning her project as part of the Macy Faculty Scholars application process, says being among such a small number of selected educators has left her genuinely humbled. “I feel so honored to have this amazing opportunity,” Devido says. “I feel blessed to be at a university with a true mission to serve others, and I have felt that in every capacity here. Our university and our faculty and staff serve not only God, but we serve our students, the community and each other.”

Devido explains that as a nurse educator, she is preparing nurses to be nurse generalists. When they graduate and pass the NCLEX-RN exam, they are licensed to practice in multiple specialty areas. “This program provides a more intentional, deliberate education for those who have expressed a desire to work in maternal child care,” says Devido. “It goes beyond what they would typically receive in a standard nursing education and creates a focus on issues of equity.” And, according to Devido, this type of intervention is needed – particularly in the maternity unit because the country is currently in the throes of a “maternal child health care crisis,” with women of color bearing the brunt of the burden. Devido has been influenced by the deep and imperative work of community members and researchers to reach this conclusion.

Devido’s claims are mirrored by extensive literature, including a recent report from the Centers for Disease Control, which found that Black women are three times more likely to die from pregnancy or childbirth-related causes than white women – an alarming phenomenon the organization attributes to structural racism, as well as variation in the quality of health care, underlying chronic conditions and implicit bias.

“Sometimes, there are cases of a woman saying she is in pain or feels there is an unrecognized problem and getting brushed off. Or a provider may say, ‘OK, we are going to do this procedure,’ without consulting with the patient and providing a choice, even if other options are available,” Devido says. “Patients may not realize it is their right to ask questions about their treatment. They must be recognized as a full partner in their care. This is where there is room for change in maternal child health care.”

Devido hopes to help facilitate change through her inaugural Maternal Child Health Equity Fellowship program. Open to senior-level nursing students interested in pursuing their nursing careers in maternal child health, the fellowship spans nine months or two academic semesters and combines traditional teaching and hands-on learning to enhance students’ knowledge of equity and their focus on accountability and individual response. Twelve Duquesne nursing students were selected as inaugural Fellows in the fall of 2022. A committed professional and teacher-scholar, Devido’s curiosity and drive foster her research and creativity and have made her classroom a valuable learning environment for her students.

The overall idea, explains Devido, is to engage nurses in working to proactively eliminate race-related inequities through a collective approach to the concept of safe womanhood. “There are amazing people doing this work in our community. I am committed to teaching our students the importance of learning from and working alongside those leaders. We want to educate students to invest in clinical solutions that will serve people who may have been underserved or marginalized in health care. In this case, we are talking about solutions specifically for maternal child health equity,” says Devido. “That means immersing students in the communities in which they will be serving. Having them work for and learn from community leaders, birth workers and community activists.”

It also means taking a more holistic approach when helping women prepare for the transition they will undergo as new mothers – and, perhaps most critically, showing future nurses how to actively listen to all patients. “Nurses truly are the first point of contact and the first point of care in a hospital setting,” Devido says. “We are at the front lines and widely regarded as members of the most trusted profession. We must use that power to advocate for our patients and help amplify their voices so they can be heard and receive equitable care.”

To develop the program, Devido turned to the birthwork community for partnership and recruited several doulas who are women of color to help shape the curriculum. Together, they created a program advisory board and staffed it with leaders from across the Pittsburgh area. This includes the position of community advisor, who serves as a cultural advisor and community navigator for the board. The board is rounded out by three additional Duquesne faculty members, representing experts in sociology, history and clinical affairs. The multidisciplinary approach helps ensure that these aspects of the issue are not discounted. “I am very excited for the possibilities of how we might be able to impact some of the disparities that are occurring related to maternal child health here in the Pittsburgh area, hopefully changing the experience and the viewpoints of our students to better serve their patients,” says Devido.

The Macy Faculty Scholars Program required Devido to identify a project mentor and also paired Devido with a national advisory committee mentor, both to help assist and guide her through the development and execution of the program. Devido selected Dr. Joan Rosen Bloch as her project mentor. As a clinical and translational nurse scientist with expertise in vulnerable populations, public health and maternal child health (MCH), Bloch has experience mentoring faculty in nursing and public health. She is engaged in MCH initiatives, both regionally and nationally, and has provided valuable connections. Devido says she was thrilled that the role of national advisory committee mentor was filled by Dr. Afaf Meleis, a former professor of nursing and sociology and Dean Emerita at the University of Pennsylvania whose Transition Theory Devido says underpins much of the framework of her project.

“I feel so honored to be able to have had this once-ina- lifetime opportunity, to be able to do the work that I am doing through the Macy Faculty Scholarship, and to be connected to a national cohort of multidisciplinary scholars doing similar work,” Devido says. “It is very inspiring. And that I have had the chance to get direct input from Meleis on how I have utilized her theory to guide this work – many researchers never get that opportunity – it is incredible.”

Still, much of the inspiration to create the program came from Devido’s own years of hard work and experience. She spent the first part of her career as a labor and delivery nurse before moving on to pediatrics, becoming a nurse practitioner, and eventually going back to school for her doctorate. There, partially guided by what she saw during all those years in maternal child care, she pursued certificates in women and gender studies and focused on health equity.

“I have made it my life’s work to seek out safe womanhood – a right that all women so deeply deserve,” Devido says. “And this has been such an enriching experience for me. I have learned so much from this advisory board, and I have gained so much from working with them. They are experts in this field and this community, and that is so much of what we want to address with this program – that our experiences are all different, but when we work together toward a common goal they can make us stronger.”

She hopes the same ethos of creating strength and better understanding through unity will help her program become a permanent offering at Duquesne, even after the year-long trial period is up.

“I do not have all the answers and I certainly do not know how to fix everything. I am still learning myself,” Devido says. “And our goal is to foster our students’ commitment to lifelong learning. This team wants to promote an intentional and open approach to partnering with our patients and families at the point of care, and of collaborating with our colleagues, whether they be community activists, scholars, doulas or providers. That kind of meaningful alliance, where the needs of the patient drive decision-making, is what will create lasting change.”