Strengthening community-based doula and clinician partnerships through implementation and dissemination science approaches: a mixed-methods pilot study

Abstract

Background

Collaboration between community-based doulas and clinical care teams improves birth outcomes, yet partnerships are hindered by operational, communication, and role clarity challenges. Evidence is lacking on scalable, low-burden strategies to strengthen these relationships outside of formal intervention settings.

Methods

Rapid deductive content analysis of focus groups and interviews with 12 perinatal clinicians and 11 community-based doulas was conducted. Findings informed a five-minute video vignette illustrating the role of community-based doulas and their hopes for partnerships with clinical care teams. The vignette was screened in two settings: with community-based participants (n = 72), and with clinical healthcare professionals (n = 21).

Results

In the first screening, 94% of participants indicated that the vignette honored doula voices either “completely” or “mostly” (n = 72). Participants reported that the vignette centered authentic voices and presented clear, relatable narratives. In the second screening (n = 21), the 13-item Interprofessional Collaboration Scale (ICS) assessed perceived interprofessional collaboration across three subscales (Communication, Accommodation, and Isolation). Mean total ICS scores increased from 2.63 to 2.90 (t(20) = 3.27, p = .004, Cohen’s dz = 0.71). Communication and Accommodation subscales also improved significantly (Communication: 2.70 to 3.09, p < .001, dz = 0.87; Accommodation: 2.75 to 3.08, p = .010, dz = 0.62).

Conclusions

Combining rapid qualitative analysis with vignette-based dissemination is a feasible approach to improve partnerships outside of intervention settings. The vignette’s strongest influence was on perceptions and willingness to collaborate. This approach represents a scalable, low-burden strategy that may be adapted across interprofessional collaborations.

Contributions to the literature.

• This study investigates how brief, narrative-based tools can enhance collaboration between clinical teams and community-based birth workers beyond formal interventions.

• It demonstrates a practical approach that combines rapid qualitative analysis, community validation, and dissemination strategies to address relational barriers in care delivery.

• This study adds evidence that storytelling tools can be used as low-burden implementation strategies to support interprofessional understanding and readiness for collaboration.

• Findings inform how implementation science can better incorporate community voices when designing tools to improve equity-focused partnerships in maternal health.

Background

Maternal morbidity and mortality rates in the United States remain among the highest of any high-income nation, despite greater per capita spending on maternity care [1, 2]. Black families experience disproportionately higher rates of adverse outcomes, with Black women four times more likely to die from pregnancy-related causes than White women [3–6]. These maternal health disparities persist regardless of income, education, geography, and other social factors, indicating that solutions must address structural and systemic factors that contribute to adverse pregnancy outcomes [7].

Community-based doulas are non-clinical birth workers who provide continuous, culturally informed support during pregnancy, childbirth, and the postpartum period, encompassing physical, emotional, and informational care [8]. Evidence demonstrates that doula support is associated with reductions in cesarean delivery, labor time, preterm birth, and postpartum depression [9–11]. Community-based doulas often assist with care navigation, health education, and social support [12, 13]. However, they encounter persistent barriers to integration in healthcare settings, including limited reimbursement options, high demand with low compensation, and experiences of bias and discrimination [14–17]. These challenges contribute to high turnover, with the average community-based doula career lasting only 2–3 years [18]. Despite evidence of the benefits of doula care, there are few evidence-based strategies for building sustainable partnerships between community-based doulas and clinical care teams outside of intervention settings. Implementation science offers tools to address this gap by systematically identifying barriers, facilitators, and strategies to enhance the adoption and sustainability of new practices [19, 20]. The Consolidated Framework for Implementation Research (CFIR) provides a structured approach to examining multilevel influence on implementation processes, and recent expansions incorporate adaptations to address disparities in health outcomes [21, 22].

In Wisconsin, the ASCEND WI Maternal Health Center of Excellence is actively testing innovative cross-sector strategies to improve maternal health equity, including an ongoing randomized controlled trial to improve patient trust in healthcare settings. This study builds authentic collaborative partnerships with community-based doulas and clinical maternity care teams to improve outcomes for Black birthing families. Early published findings from the ASCEND WI research team demonstrate persistent racial inequities in maternal health care delivery, including differential care and treatment patterns [23]. Video vignettes are increasingly recognized as effective implementation and education tools because they convey complex experiences in ways that written guidelines or didactic training cannot [24]. Narrative and story-based communication enhances audience engagement, information retention, and openness to behavioral change, particularly when it represents real people and community contexts [25, 26]. In clinical settings, video vignettes are used to challenge assumptions, build empathy, and strengthen interprofessional understanding, making them a promising strategy for improving collaborative care [27–30].

By pairing this clinical intervention work with narrative-based dissemination tools like video vignettes, ASCEND WI seeks to strengthen trust, clarify roles, and reduce implementation barriers that commonly hinder doula-clinician collaboration. Together, these complementary strategies represent a multilevel, equity-focused approach to transforming maternity care in Wisconsin and beyond. Here, we pilot implementation and dissemination science strategies to strengthen community-based doula and clinical care team collaboration. We conducted a rapid deductive content analysis of qualitative data from doulas and perinatal clinicians, developed a video vignette informed by these findings, and tested the vignette with both community and clinical collaborators.

Methods

Study design

We conducted a mixed-methods pilot within the ASCEND WI Maternal Health Center of Excellence to inform strategies for strengthening collaboration between community-based doulas and clinical care teams [31]. Guided by CFIR 2.0, we first applied rapid content analysis to existing interview and focus group transcripts to identify common perceptions and misconceptions about community-based doulas [22]. Findings from this qualitative phase informed the development of a brief video vignette, which was then screened with community and clinical audiences. The primary intended audience for the vignette was clinical healthcare professionals, with emphasis placed on highlighting points of connection and collaboration. This was selected as the primary audience in response to community-based doula feedback about the mixed reception they receive when present in delivery rooms, ranging from excitement to confusion to hostility, and requests for tools to help educate clinical care teams on their roles and willingness to collaborate. We assessed the vignette’s impact on perceived interprofessional collaboration among clinicians using pre- and post-surveys that incorporated the Interprofessional Collaboration Scale (ICS), with the intent of capturing short-term changes in perception of collaboration rather than observed interprofessional behaviors [32].

Study team

The project was led by the ASCEND WI Maternal Health Center of Excellence in partnership with community and clinical collaborators. The team included media experts, community-based doulas, perinatal clinicians, and academic researchers with expertise in maternal health, community engagement, and implementation science. Each group contributed distinct perspectives to guide visual storytelling and production quality, authentic representation of lived experiences, insight into clinical workflows and interprofessional dynamics, study design, data analysis, and alignment with implementation science frameworks.

Secondary data analysis of interviews and focus groups

This study utilized interview and focus group data collected as part of a larger study to examine implementation barriers to clinician and community-based doula partnerships [23]. Participants were recruited through purposive sampling to capture a range of perspectives from perinatal clinicians and community-based doulas, in collaboration with community-based organizations and affiliated health systems. The original dataset included transcripts from in-depth interviews with perinatal clinicians and focus groups with community-based doulas. We applied rapid deductive content analysis to the transcripts resulting from this study, using a CFIR-based template [33]. Two independent coders coded all statements referencing perceptions of community-based doulas, noting the CFIR domains relevant to each perception (e.g., local attitudes, partnerships, policies, communications, funding). Differences were reconciled through discussion. Summaries of perceptions were discussed with the study team to confirm the accuracy of statements, as well as their neutrality and contextual understanding. Results of the analysis informed the development of the vignette content, described below.

Vignette development

The vignette concept was refined through a series of collaborative study team meetings. Initial discussions explored the production of an extended, immersive portrayal of doula work to capture the breadth of services and experiences. As planning progressed, the team determined that a more concise format would better serve the project’s immediate goals, allowing for a focused narrative that could be readily integrated into community and clinical settings. The final concept illustrated the relationship between community-based doulas and their clients, as well as their hopes for partnerships in clinical environments. Filming took place in a community-based setting, with community-based doulas sharing their experiences on one panel and clients sharing their experiences on another, along with footage of community-based doula-client interactions. Media partners oversaw all aspects of production, including filming, sound, and editing, while the full study team participated in iterative reviews to ensure alignment with community priorities and the project’s implementation science objectives.

Clinician beta-testing

Before broader dissemination, the vignette was beta-tested with three perinatal clinicians. These clinicians viewed the vignette individually and provided structured feedback on clarity, tone, accuracy, and applicability in their practice settings. Their input informed refinements to sequencing and language to enhance impact.

Community screening to assess accuracy

The final vignette was first screened at a community symposium focused on birth outcomes in Black communities. This event included over 200 community members, birth workers, healthcare professionals, researchers, and collaborators in related fields, all of whom were invited to view the film. Of the 200 attendees, 72 viewed the vignette in a group setting, followed by a panel and facilitated discussion led by study team members to elicit reactions, perceived strengths, and suggestions for improvement. A survey was disseminated to determine whether the vignette accurately represented lived experiences.

Clinical screening to assess impact

Screening with clinicians was made available by embedding the vignette within a pre- and post-survey format. The pre-survey collected demographic information (including role, years in practice, and prior experience with community-based doulas), as well as perceptions of community-based doulas, and included the validated Interprofessional Collaboration Scale. This scale was used to assess perceptions of collaboration across communication, accommodation, and isolation domains, based on the hypothesis that exposure to a narrative vignette could shift clinicians’ understanding of roles, empathy, and openness to collaborate in the short term, using a four-point Likert scale [32]. Immediately following the vignette, participants completed the post-survey, which included the ICS a second time and questions about perceptions of community-based doulas. Open-ended questions solicited qualitative feedback on how the vignette could be used in interprofessional education, and influence future engagement with community-based doulas, and welcomed partnership with screening participants.

Survey data analysis

Survey data were analyzed using descriptive and inferential statistics. For community screening surveys, frequencies and proportions were calculated for categorical variables and means and standard deviations for continuous variables. For the clinical screening, perceived interprofessional collaboration was measured pre- and post-vignette using the 13-Item ICS. Each item was scored on a 4-point Likert Scale (1 = Strongly Disagree, 4 = Strongly Agree), with five negatively worded items reverse-coded prior to scoring. Consistent with established scoring procedures, we calculated total ICS scores and three subscales: Communication, Accommodation, and Isolation, by averaging item responses. Communication captured the extent to which members of different professions perceive open information exchange, shared understanding of responsibilities, and clarity in treatment planning. Accommodation reflected willingness to adapt schedules, coordinate workflows, and cooperate with other professionals’ practices to deliver care. Isolation reflected the degree of perceived professional distance, lack of inclusion, or barriers to collaboration [34]. Normality of pre-post change scores was assessed using Shapiro–Wilk tests. Paired t-tests were used for normally distributed outcomes, and Wilcoxon signed-rank tests were applied when distributional assumptions were not met. Effect sizes (Cohen’s dz) and 95% Confidence Intervals were reported for all paired comparisons. Analyses were conducted using R v.4.4.1 (R Foundation for Statistical Computing,Vienna, Austria). Open-ended responses from both community and clinical participants were analyzed to identify common themes related to the perceived strengths of the vignette, suggested improvements, and anticipated impacts on doula-clinician collaboration.

Results

Community screening demographics

Seventy-two participants representing 40 zip codes across Wisconsin completed the community screening survey, with a majority of the zip codes located in Milwaukee County. The 53206, 53209, and 53212 zip codes, which are predominantly Black communities, were the most represented in the population. A community-based screening of the vignette took place at the 2025 Black Birth Symposium, held in Milwaukee, WI, during the lunch hour. Of the 200 participants in the Symposium, approximately half were present in the auditorium during the screening, and 72 participated in the survey that followed. Demographic information was collected on professional roles, previous experience with community-based doulas, and race/ethnicity. Seventeen percent of the audience identified as a community-based doula, and eighty-one percent of the audience had worked with community-based doulas in clinical settings. Just over thirty percent of the audience identified as a clinically based birth worker, the intended audience of the film. Most of the audience identified as either Black/African American (65.3%) or White (40.3%) (The survey encouraged individuals to check all that apply, leading to totals over 100%). Attendees were able to select multiple options for each demographic question, resulting in percentage totals over 100% for each demographic question (Table 1).

Table 1.

Community screening participants (Check all that apply, n = 72)

Question	N (%)
Role
Community-Based Doula	16 (22.2%)
Clinical-Based Birth Worker	22 (30.6%)
Public Health or Policy Professional	15 (20.8%)
Researcher or Evaluator	4 (5.6%)
Community-Based Organization Staff	26 (36.1%)
Birthing Person or Parent	18 (25.0%)
Funder or Funding Decision-Maker	3 (4.2%)
Government-Based Organization Staff	7 (9.7%)
Academic Faculty, Student, or Staff	7 (9.7%)
Blank	2 (2.8%)
Have you worked with community-based doulas?
Yes – I am a community-based doula	12 (16.7%)
Yes – As a professional partner	38 (52.8%)
Yes – As a client	8 (11.1%)
No	28 (38.9%)
Blank	1 (1.4%)
Race/Ethnicity
Black or African American	47 (65.3%)
White	29 (40.3%)
Indigenous or Native	4 (5.6%)
Hispanic or Latinx	6 (8.3%)
Asian	0
Multiracial	1 (1.4%)
Other	1 (1.4%)
Blank	0

Community screening results

A total of 72 community members, birth workers, and supporters completed the post-screening survey. Nearly all respondents (94%) reported that the vignette honored community-based doula voices “completely” or mostly,” indicating strong perceived authenticity and narrative accuracy (Fig. 1) Participants most frequently endorsed that the vignette centered on real community-based doula experiences, clearly illustrated the emotional and practical support that community-based doulas provide, and communicated the importance of community-rooted maternal care. Suggested improvements focused on expanding clinical examples and strengthening connections to healthcare systems. Many respondents expressed interest in future partnership opportunities, including sharing the vignette, collaborating on events, and informing ongoing project development. Collectively, these findings suggest that the vignette was well-received, viewed as credible and respectful, and positioned as a useful tool for advancing community-clinical collaboration (Table 2).

Fig. 1.

Community screening participants report that the vignette honored community-based doula and client voices. Responses from community screening participants rated the extent to which the vignette honored community-based doula and client voices, with responses categorized as completely, mostly, somewhat, slightly, not at all or I don’t feel qualified to respond. (n = 72 participants)

Table 2.

Community-based vignette questions (n = 72)

Question	N (%)
Did this video make your perception of community-based doulas…(Check one)
- More Positive	42 (58.3%)
- Unchanged – Still Positive	27 (37.5%)
- Unchanged – Still Neutral	2 (2.8%)
- Unchanged – Still Negative	0
- More Negative	1 (1.4%)
- Blank	0
What did this video do well? (Check all that apply)
- Centered authentic voices of community-based doulas	51 (70.8%)
- Showed the emotional and practical support that doulas provide	61 (84.7%)
- Reflected cultural grounding and trust	36 (50.0%)
- Was visually compelling and well-produced	49 (68.1%)
- Communicated the importance of community-rooted care	47 (65.3%)
- Taught me something new about community-based doula work	22 (30.6%)
- Encouraged me to continue my work as a community-based doula and/or partner with a community-based doula	29 (40.3%)
- Blank	8 (11.1%)
What could be improved in this video? (Check all that apply)
- Add more perspectives	30 (41.7%)
- Include more concrete examples of support	23 (31.9%)
- Use a different medium – short form videos are not effective for this	0
- Clarify the connection to health systems or clinicians	29 (40.3%)
- Shorten or streamline	1 (1.4%)
- Lengthen or elaborate further	17 (23.6%)
- Nothing – it worked well as is	18 (25.0%)
- Blank	10 (13.9%)
Would you be interested in partnering with us in future initiatives? (Check one)
- Yes	36 (50.0%)
- Maybe	0
- No	7 (9.7%)
- Blank	29 (40.3%)
How would you like to partner? (Check all that apply)
- Share this video with my network	35 (48.6%)
- Co-host an event or conversation	23 (31.9%)
- Provide input on future projects	24 (33.3%)
- Participate in future projects	34 (47.2%)
- Support policy/advocacy efforts	35 (48.6%)
- Blank	36 (50.0%)

Clinical screening demographics

Twenty-one individuals who identified as clinical healthcare professionals participated in the pre- and post-vignette surveys. Although the screening was designed for maternal health professionals, the final sample included both maternal health-based clinical care providers and healthcare professionals in related roles (38.1%), including obstetrician-gynecologists, anesthesiologists, behavioral health professionals, and case managers whose workload includes support for individuals during the perinatal period. The clinical sample represented a range of professional experience: 19% had worked in healthcare for fewer than five years, while nearly half (48%) had ten or more years of experience. Twelve (57%) indicated prior professional collaboration with community-based doulas. The sample included Non-Hispanic Black and White clinical care providers, with no individuals identifying as mixed race, or any of the other options provided. No participants identified as community-based doulas themselves. Together, this sample represents a diverse cross-section of clinical care providers with varying degrees of familiarity and engagement with community-based doulas (Table 3).

Table 3.

Clinical screening participants (n = 21)

Question	N (%)
Age
20–29	1 (4.8%)
30–39	8 (38.1%)
40–49	4 (19.0%)
50–59	5 (23.8%)
60–69	1 (4.8%)
70–79	2 (9.5%)
Gender
Woman	21 (100%)
Race/Ethnicity
Black or African American	12 (57.1%)
White	9 (42.9%)
Hispanic	0
Primarily Maternal Health
Yes	13 (61.9%)
No (related field)	8 (38.1%)
Years in healthcare
0–4	4 (19.0%)
5–9	2 (9.5%)
10–14	6 (28.6%)
15–19	4 (19.0%)
20 +	5 (23.8%)
Have you worked with community-based doulas?
Yes – I work in this role	0
Yes – As a professional partner	12 (57.1%)
Yes – As a client	0
No	9 (42.9%)

Clinical screening results

Overall ICS scores increased from 2.63 at baseline to 2.90 post-vignette screening (p = 0.004, dz = 0.71). Communication improved from 2.30 to 2.69 post-vignette screening (p = 0.001, dz = 0.87), and Accommodation improved from 2.75 at baseline to 3.08 post-vignette screening (p = 0.010, dz = 0.062). Isolation did not change significantly (p = 0.74) (Fig. 2, Table 4).

Fig. 2.

In clinical screenings, willingness to collaborate with community-based doulas significantly increased. The Interprofessional Collaboration Scale assessed improvements across Communication, Accommodation, and Isolation subscales. Significant increases occurred in the total willingness to collaborate and in Communication and Accommodation. (N = 21 participants)

Table 4.

Pre- and post-vignette ICS scores among screening participants

Outcome	Pre-Test Mean (SD)	Post-Test Mean (SD)	Mean Difference	t(df)	p-value	Effect Size (dz)	95% CI
ICS Total	2.63 (0.24)	2.90 (0.37)	+ 0.27	3.27 (20)	0.004	0.71	[0.10, 0.43]
Communication	2.30 (0.22)	2.69 (0.42)	+ 0.39	3.98 (20)	0.001	0.87	[0.19, 0.60]
Accommodation	2.75 (0.38)	3.08 (0.46)	+ 0.32	2.86 (20)	0.010	0.62	[0.09, 0.56]
Isolation	3.00 (0.47)	2.95 (0.65)	-0.05	-0.33 (20)	0.745	-0.07	[-0.35, 0.25]

Bold font indicates a p-value of < 0.05

Discussion

This mixed-methods pilot demonstrates the feasibility of pairing rapid qualitative analysis with narrative-based dissemination to strengthen perceptions of collaboration between community-based doulas and clinical healthcare teams. Before implementing the vignette in clinical contexts, a community-based screening was conducted to ensure accuracy and appropriateness for sharing with clinically based healthcare professionals. Nearly all participants in the community-based screening reported that the vignette honored community-based doula voices, affirming that the story authentically represented their experiences and avoided reinforcing misconceptions about community-based doulas. This community validation step is critical in dissemination work to ensure that tools created do not misrepresent roles, minimize lived experiences, or inadvertently perpetuate bias. Findings from this phase indicated that the vignette met community expectations for accuracy and respectfulness, establishing a foundation for broader educational or practice-based use.

Our findings are consistent with calls to utilize storytelling work and narrative interventions to validate lived experiences and support community-based doula work and clinical healthcare partnerships. In a qualitative study of community-based doulas, one doula shared that: “It would be helpful if we brought the groups [clinicians and doulas] together more often to share stories to understand each other better. Hopefully, in doing that, they understand us better as well and start recognizing us as a team member and advocate, not an adversary” [35]. Similarly, an intervention that paired those experiencing grief with a “StoryListening Doula” revealed that narrative formats are feasible, acceptable, and can be integrated into care processes with minimal burden to improve patient outcomes and address clinician burnout [36]. Our study extends this literature by using doula- and client-centered narratives as an implementation tool aimed at shifting clinicians’ perceptions of collaboration.

Among clinically based healthcare professionals, the vignette was associated with statistically significant, short-term improvements in perceived interprofessional collaboration. Using the validated Interprofessional Collaboration Scale, we observed significant increases in total collaboration scores, driven by improvements in Communication and Accommodation. The ICS has demonstrated strong internal consistency and construct validity across multiple settings [32, 34, 37–39]. In one study, the ICS was used to examine collaboration among obstetricians, midwives, and nurses, and found that discrepancies were largest on the Isolation subscale, reflecting challenges in sharing opinions, discussing new practices, and feeling respected by other professions [40]. Other groups have applied the ICS before and after interprofessional training or quality improvement initiatives, generally finding modest but significant gains in Communication, with more mixed results for Isolation [41–43]. Our pre-post design aligns with this body of work. To our knowledge, it is the first study to apply the ICS in examining the collaboration between clinical care professionals and community-based doulas. By demonstrating that a brief video vignette can shift ICS scores in the expected direction immediately following exposure, this study supports the scale’s utility for capturing early relational impacts of community-based doula and clinician partnership efforts.

Isolation did not change significantly; however, the mean score was higher pre-test than the other scores, indicating that the professional distance between community-based doula and clinical healthcare professions may not be a primary issue to address. This aligns with prior work from our research team, which involved interviewing clinical healthcare providers and community-based doulas. A common theme emerged: the acknowledgement that both doulas and clinical care providers are “on the same team,” working together to improve maternal health outcomes [23].

Our approach also sits within a broader literature on video-based and narrative educational interventions for health professionals. Multiple studies have shown that patient case video vignettes and video interviews can improve cross-cultural communication skills, empathy, and outcomes among trainees [28, 44, 45]. Systematic reviews of digital and mobile health educational interventions for health professionals similarly conclude that well-designed digital content is at least as effective as traditional teaching for communication skills and is more scalable [29, 46, 47]. In a study on cancer-related knowledge, attitudes, beliefs, and intentions, fictional narrative films produced larger improvements in outcomes than non-narrative films, indicating that format for information delivery is an essential consideration in film production [26]. Our vignette intentionally leveraged narrative mechanisms, including emotional engagement and concrete scenarios, to help clinicians understand how community-based doulas and clients experience collaborative care.

At the same time, our findings underscore that video vignettes are not a stand-alone solution for structural issues in community-based doula and clinical care team relationships. Toolkits and implementation guides are increasingly emphasizing that collaboration with community-based doulas in clinical settings requires clear policies, referral pathways, and shared protocols [18, 48, 49]. Our vignette may serve as a relational tool that helps prompt and facilitate the subsequent adoption of concrete partnership tools, such as standardized community-based doula partnership documentation protocols, participation in team meetings, and shared birth planning processes.

We note several limitations of this pilot study. First, the sample size of the clinical screening was small (n = 21), limiting statistical power and precision of estimates. Second, the immediate pre-post design captures short-term perceptual changes and does not assess sustained effects, changes in clinical behavior, or patient outcomes. Third, the Interprofessional Collaboration Scale reflects self-reported perceptions of collaboration, which may not correspond to observed interprofessional practices and may be particularly sensitive to short-term perceptual shifts immediately following exposure to narrative content. Fourth, participants in the community screening were largely individuals already engaged in or supportive of community-based birth work, which may limit generalizability. Finally, this study was conducted within a single geographic context, and findings may not generalize to other settings or health systems. These limitations are consistent with the exploratory aims and inform the design of future studies evaluating sustained and practice-level outcomes.

A possible next step would be the design of a paired video vignette that examines the perspectives of clinical care teams, co-created with community-based doulas. Prior work in obstetric teams shows that perceptions of collaboration are often misaligned across professional groups, with obstetricians perceiving collaboration more positively than nurses or midwives [40]. A reciprocal storytelling approach could help surface discrepancies, build mutual empathy, and support bidirectional understanding of constraints, pressures, and shared goals. Evaluating paired vignettes with the ICS could provide a more complete picture of how narrative tools influence interprofessional collaboration across all sides of the partnership. The current vignette is available for viewing on the ASCEND WI Maternal Health Center of Excellence website, with the capability to continue data collection on its reach and impact [31].

Conclusion

This pilot adds to a small but growing field of study on implementation strategies that include community-based doulas as integral partners in maternity care. By combining rapid qualitative analysis, community validation, and a brief narrative vignette evaluated using a validated measure of interprofessional collaboration, we demonstrate a feasible and low-burden approach that may influence clinicians’ perceptions regarding collaboration with community-based doulas. Future research should evaluate repeated or embedded use of such vignettes in medical or residency curricula, continuing education, and system-level doula collaboration initiatives, including assessment of sustained effects, behavioral outcomes, and implementation across diverse settings. As health systems and community organizations seek scalable strategies to build equitable, team-based maternity care, these narrative tools represent a promising strategy to support implementation.

Abbreviations

ICS

Interprofessional Collaboration Scale

CFIR

Consolidated Framework for Implementation Research

Authors’ contributions

JO led the conceptualization, methodology, validation, formal analysis, investigation, data curation, writing of the original draft, and funding acquisition of this project. AC led project administration. EM and KQ contributed to the data curation and validation of this study. GB, MP, TW, JPG, CV, CJ, XJ, and DB contributed to the investigation and validation of this study. JW and AP contributed to the funding acquisition and visualization of this study. All authors reviewed, edited, and approved the manuscript drafts.

Funding

This work was supported in full by the National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development through AMETHIST@Penn: Achieving Maternal Empowerment and Transforming Health through Implementation Science and Training (U24HD113146) and Addressing Key Social-Structural Risk Factors for Racial Disparities in Maternal Morbidity in Southeastern Wisconsin (U54HD113408).

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

This study was reviewed and waived for approval by the Medical College of Wisconsin’s Institutional Review Board (PRO #00054214).

Consent for publication

This manuscript contains no individual person’s data in any form, therefore, no consent for publication is needed.

Competing interests

The authors declare no competing interests.