BCHS PhD student, Erricka Hager will be defending her dissertation; The HERitage Study: A Mixed Methods Examination of Intergenerational Communication and Pregnancy Health History in Black Families.

Abstract

Sexual and reproductive health literacy (SRHL) is often framed as an individual‑level capacity to access, process, and understand health information. Increasingly, however, research underscores that SRHL is socially produced through relationships, cultural practices, and intergenerational communication, shaping pregnancy‑related decision‑making and outcomes. This perspective is particularly relevant for Black women, who experience persistent maternal health inequities alongside limited access to pregnancy‑specific health information and pregnancy‑specific family health history (PSFHH).

This dissertation examined how sexual and reproductive health (SRH) knowledge—specifically pregnancy health knowledge and PSFHH—is transmitted, interpreted, and trusted across generations within Black families. Using a sequential, theory‑building mixed‑methods design, the study pursued three aims: (1) to synthesize existing evidence on intergenerational SRH communication among Black female family members; (2) to examine whether relational and communicative factors within mother–adult daughter relationships are associated with Black women’s intentions to seek pregnancy‑related health information during the interconception period; and (3) to characterize how pregnancy health knowledge circulates within multigenerational matrilineal family networks and identify mechanisms shaping credibility and trust.

The first analysis demonstrated that intergenerational SRH communication within Black families is relationally grounded and culturally situated, frequently mediated through maternal storytelling and silence, while pregnancy‑specific health knowledge remains largely absent from existing models. The second analysis showed that stronger mother–adult daughter relationship cohesion and greater comfort communicating about pregnancy health were positively associated with intentions to seek pregnancy‑related health information, suggesting that PSFHH engagement is embedded within relational processes. The third analysis revealed that pregnancy health informant identification was associated with lived pregnancy experience, sharing peripartum facts, and reciprocal pregnancy‑related communication, independent of kinship role or generational position.

Collectively, these findings indicate that pregnancy health literacy within Black families is an intergenerational, relational process grounded in lived experience and narrative exchange. This dissertation advances the Relational‑Narrative Framework of Intergenerational Pregnancy Knowledge and refines the concept of maternal epistemic trust, offering implications for family‑centered, culturally grounded approaches to advancing maternal health equity across the life course.

Erricka's Committee consists of:

Jason Deakings, PhD

Ashley Hill, DrPH

Alison Hipwell, PhD

Michael Levine, PhD

For more information on this event, please reach out to Paul Markgraf at pjm111@pitt.edu.