Date of Graduation

Fall 12-15-2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Psychiatric Mental Health Nurse Practitioner

First Advisor

Dr. Jo Loomis

Second Advisor

Dr. Trinette Radasa



Those who have been affected by any adverse childhood experience (ACE) have an increased likelihood of poor birth outcomes. These include low infant birth weight, preterm delivery and can even lead to pregnancy loss.


Latina women have been identified by the Centers for Disease Control (CDC) as those most affected by ACEs. Further evidence supports those affected by 2 or more ACEs have poor birth outcomes.


For this project, The Save the Children organization in partnership with the University of San Francisco Doctorate of Nursing Practice (USF DNP) students and Community Health Workers (CHWs) of the Central Valley of California came together with the goal to positively impact the birth outcomes of future generations.


CHWs were provided training developed by an advanced practice nurse. Educational sessions were online and in person and included topics of adverse childhood experiences, trauma informed care, perinatal mood and anxiety disorders, encouraging healthy habits along with various resources available to CHWs and those within their communities. Educational sessions included lecture type presentations in addition to robust discussions. The education and subsequent implementation of CHWs working with pregnant Latina’s facilitated a decrease in health care costs, adoption of healthier choices for mother and child, and providing support and connection within a community.


This quality improvement project assessed the education and motivation levels of CHWs. Pre and post assessments were given for each module taught. Three modules were taught over four to five hours of nurse led training and education over a three month time period.


Post assessment data revealed that CHWs had increased their knowledge of the educational topics taught. Additionally, CHWs showed an increased motivation by having the educational program and support from the advanced practice nurse.


Latinas are more at risk for poor birth outcomes in Central California due to the amount of ACEs experienced. Evidence based research supported the intervention of implementing a nurse led training program for CHWs. With increased knowledge and motivation of the CHWs, validation was further given that CHWs will greatly impact their communities by having the education necessary to decrease low birth weight (LBW) infants, preterm births (PTB), and pregnancy loss or miscarriage.

Keywords: community health worker, promotora, birth outcomes, pregnancy loss, low birth infant, improved outcomes, Latina