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Background Perinatal quality improvement lacks valid tools to measure adverse hospital experiences disproportionately impacting Black mothers and birthing people. Measuring and mitigating harm requires using a framework that centers the lived experiences of Black birthing people in evaluating inequitable care, namely, obstetric racism. We sought to develop a valid patient‐reported experience measure (PREM) of Obstetric Racism© in hospital‐based intrapartum care designed for, by, and with Black women as patient, community, and content experts. Methods PROMIS© instrument development standards adapted with cultural rigor methodology. Phase 1 included item pool generation, modified Delphi method, and cognitive interviews. Phase 2 evaluated the item pool using factor analysis and item response theory. Results Items were identified or written to cover 7 previously identified theoretical domains. 806 Black mothers and birthing people completed the pilot test. Factor analysis concluded a 3 factor structure with good fit indices (CFI = 0.931‐0.977, RMSEA = 0.087‐0.10, R2 > .3, residual correlation < 0.15). All items in each factor fit the IRT model and were able to be calibrated. Factor 1, “Humanity,” had 31 items measuring experiences of safety and accountability, autonomy, communication, and empathy. A 12‐item short form was created to ease respondent burden. Factor 2, “Racism,” had 12 items measuring experiences of neglect and mistreatment. Factor 3, “Kinship,” had 7 items measuring hospital denial and disruption of relationships between Black mothers and their child or support system. Conclusions The PREM‐OB Scale™ suite is a valid tool to characterize and quantify obstetric racism for use in perinatal improvement initiatives.

Objective: The objective of this study was to explore clinician perceptions of how racism affects Black women's pregnancy experiences, perinatal care, and birth outcomes. Materials and Methods: We conducted 25 semi-structured interviews with perinatal care clinicians practicing in the San Francisco Bay Area (January to March 2019) who serve racially diverse women. Participants were primarily recruited through “Dear Perinatal Care Provider” email correspondences sent through department listservs. Culturally concordant, qualitatively trained research assistants conducted all interviews in person. The interviews ranged from 30 to 60 minutes and were audio-recorded and professionally transcribed verbatim. We used the constant comparative method consistent with grounded theory to analyze data. Results: Most participants were obstetrician/gynecologists ( n = 11, 44%) or certified nurse midwives ( n = 8, 32%), had worked in their current role for 1 to 5 years ( n = 10, 40%), and identified as white ( n = 16, 64%). Three themes emerged from the interviews: provision of inequitable care ( e.g. , I had a woman who had a massive complication during her labor course and felt like she wasn't being treated seriously ); surveillance of Black women and families ( e.g. , A urine tox screen on the Black baby even though it was not indicated, and they didn't do it on the white baby when, in fact, it was indicated ); and structural care issues ( e.g. , the history of medical racial experimentation ). Conclusion: Clinicians' views about how racism is currently operating and negatively impacting Black women's care experiences, health outcomes, and well-being in medical institutions will be used to develop a racial equity training for perinatal care clinicians in collaboration with Black women and clinicians.

Cytauxzoonosis is caused by Cytauxzoon felis (C. felis), a tick-borne parasite that causes severe disease in domestic cats in the United States. Currently, there is no vaccine to prevent this fatal disease, as traditional vaccine development strategies have been limited by the inability to culture this parasite in vitro. Here, we used a replication-defective human adenoviral vector (AdHu5) to deliver C. felis-specific immunogenic antigens and induce a cell-mediated and humoral immune response in cats. Cats (n = 6 per group) received either the vaccine or placebo in two doses, 4 weeks apart, followed by experimental challenge with C. felis at 5 weeks post-second dose. While the vaccine induced significant cell-mediated and humoral immune responses in immunized cats, it did not ultimately prevent infection with C. felis. However, immunization significantly delayed the onset of clinical signs and reduced febrility during C. felis infection. This AdHu5 vaccine platform shows promising results as a vaccination strategy against cytauxzoonosis.

INTRODUCTION: To explore providers’ perceptions of the need for a racial equity training and recommendations on strategies that can be used to improve black women’s reproductive health outcomes. METHODS: January-March 2019 we conducted 25 semi-structured interviews (30-60 minutes) with a diverse group of prenatal care providers practicing in the San Francisco Bay Area. Providers were recruited through email correspondences and department meetings. Culturally concordant qualitatively trained researcher assistants conducted all interviews. Interviews were audio-recorded and transcribed. We used the constant comparative method to analyze data. This study was approved by the University of California, San Francisco Institutional Review Board. RESULTS: Most providers were CNM (n=8, 32%) or OB/GYN (n=7, 28%), worked in their current role for 1-5 years (n=10, 40%), and identified as white (n=16, 64%). All providers expressed a need and importance to address racial inequities to improve the care experiences and reproductive health outcomes of black women. Most providers agreed that the proposed components of the racial equity training were important topics to cover: Racism in the US (n=20, 80%), Racial Disparities in Maternal and Neonatal Outcomes (n=23, 92%), Women’s Experiences, (n=24, 96%), Providers’ Experiences (n=16, 64%), and Reflection and Discussion (n=18, 72%). Providers stressed that there is need for an action-oriented racial equity training where they learn how to address racism as well as implement system-level accountabilities (e.g., metrics on patients’ perceptions of care). CONCLUSION: Providers desire an action-oriented racial equity training that will provide ongoing skills and practice, and system-level accountabilities to better serve black women.