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Karen Scott, MD, MPH

Title(s)Associate Professor, Ob/Gyn, Reproductive Sciences
SchoolSchool of Medicine
Address550 16th. Street
San Francisco CA 94158
Phone--
ORCID ORCID Icon0000-0002-6237-664X Additional info
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    Collapse Biography 
    Collapse Education and Training
    Emory University Rollins School of Public Health, Atlanta, GAMPH08/2018Applied Epidemiology
    Mercy Hospital and Medical Center, Chicago, ILInternship and Residency 06/2006Obstetrics & Gynecology
    Case Western Reserve University School of Medicine, Cleveland, OHMD05/2002Medicine
    Kenyon College, Gambier, OHBA05/1998Molecular Biology
    Collapse Awards and Honors
    Robert Wood Johnson Foundation2019Voted Best Snapshot of Innovation: Mothers Voices Driving Birth Equity
    Department of Obstetrics and Gynecology, Mercy Hospital and Medical Center, Chicago, IL2014CREOG Faculty Education, Excellence in Resident Education Award
    Illinois Caucus for Adolescent Health, Chicago, IL2013Healthcare Network Champion
    Institute of Women Today, Chicago, Illinois2012The Sister Margaret Traxler, SSND Award
    Joliet Chapter of the National Hook-Up of Black Women, Joliet, Illinois2007SHERO Award
    Berlex Laboratories, Department of Ob/Gyn Residency Program, Mercy Hospital & Medical Center2003Berlex Laboratories Best Teaching Award

    Collapse Overview 
    Collapse Overview
    At the University of California, San Francisco, Karen A. Scott, MD, MPH, FACOG is an Associate Professor and OBGYN Hospitalist in the Department of Obstetrics and Gynecology. As a sexual, reproductive, and perinatal (SRP) epidemiologist and obstetric hospitalist, the ethics and science of her research, clinical practice, and teaching exists at the intersections of critical, interpretative, cultural, and biomedical anthropology and crunk public health, with a foundation rooted in Cultural Rigor, Black Feminism, and Reproductive Justice (RJ).

    As a "dissident, disruptive, and recovering" board certified OBGYN and critical public health scholar, her work examines interventions to eliminate and reduce disparities and inequities in SRP health services provision, through the integration of a Black Feminist and Reproductive Justice (RJ) Praxis , in the afterlife of slavery and passage of the Congressional Act of 1807 (which took effect in 1808, prohibiting further participation of the United States in the slave trade.). A Black Feminist-RJ Praxis informs the ethical considerations, theoretical concepts, methods, and methodologies in her participatory research, practice, pedagogy, and policy analysis. She examines health service provision in antepartum, intrapartum, and postpartum units as sites through which racism (structural, gendered, and obstetric) can be understood, described, measured, and modified within patient-clinician, patient-system, and community-system interactions, across time, place, and levels of power in the following continuum of care: clinical cognition, assessment, diagnosis, service provision, and decision-making processes. Her research also examines the role of gendered racism, power, and economics in the authentic, coerced, and regulated formations and expressions of Blackness, Black womanhood, Black motherhood, Black births, and Black women's scholarship within hospital and health systems culture, organizational structures, and operating mechanisms.

    Inspired by Marshall, Pronovost, and Woods 2013 critical paper on the Promotion of Improvement as a Science and Deming’s System of Profound Knowledge (epistemology, variation, systems, and psychology), her participatory equity and justice based QI research aims to interrogate and dismantle traditional QI projects that rely on “contemporaneous, non-standardized unverified data to make judgments about their effectiveness” using atheoretical methods, at the exclusion and erasure of the wisdom and voices of the most impacted, marginalized, and minoritized patients, practitioners, and scholars. Her secondary research aim is to describe and amplify local wisdom and transferable knowledge with robust participatory research methods grounded in Cultural Rigor, Black Feminism, and Reproductive Justice, in order to facilitate local improvement in health systems and construct knowledge with external validity for, by, and with Black mothers, birthing, women-led/serving community-based organizations, and women scholars. The implications of her program of participatory QI research are three fold: 1) formation of authentic, affirming, and autonomous partnerships among community partners, patients, academic scholars, practitioners, payers, and policy makers; 2) theory of change development and clarification representing epistemological diversity from health services research, clinical epidemiology, medicine, nursing, public health, social sciences, humanities, bioethics, and legal studies; and 3) translation of participatory QI science into SRP health care services provision, interprofessional education, and policy at the local and national level.

    As an educator, she examines the approachability, acceptability, availability and accommodation, affordability, and appropriateness of individuals, institutions, and systems in public health and health care that have traditionally rendered marginalized voices and communities invisible or invaluable as decision-makers, generative thinkers, achievers, and connectors. As a clinician scientist, she works to build individual and system capacity to challenge the hierarchy of knowledge production and dissemination as well as the decision making that sustains the medical industrial complex and perpetuates social and health inequities.

    As the Principal Investigator of the SACRED Birth Study, she has defined three theoretical frameworks with the foal of redesigning perinatal QI through community driven measures, meanings, and methods: 1) sacred birth; 2) participatory QI research (QIR); and 3) participatory patient reported experience measure (PREM) of obstetric racism in partnership with Black birthing mothers and birthing people, Black women-led community based organizations, Black women scholars, and other scholar allies and accomplices, recently published in a public platform for greater accountability and dissemination to the public we serve.

    She has also examined the role of philanthropy in advancing cultural arrogance, philanthropic redlining, and community harm in addressing the perinatal health crisis in the United States. In response to the crisis, she has described four modalities of cultural rigor and offered recommendations on the operationalization of cultural rigor, reproductive justice, and Black feminism for funders, grantees, research teams, and QI experts.

    Collapse Research 
    Collapse Research Activities and Funding
    The SACRED Birth Study: Advancing a Culture of Dignity, Racial Justice, and Equity in Hospital Based Perinatal Care and Experiences
    California Health Care Foundation, The Grove Foundation Apr 1, 2020 - Mar 31, 2021
    Role: Principal Investigator
    Role Description: The purpose of the SACRED Birth Study, led by Dr. Karen A. Scott, MD, MPH, FACOG at UCSF and a team of patient, community, and content experts, is to develop and validate a participatory patient-reported experience measure (PREM) of obstetric racism that shifts the power of knowledge construction, in the evaluation and transformation of hospital based perinatal care, from Quality Improvement (QI) experts to a community of Black mothers and birthing people, in established equitable and dignified partnerships with Black women scholars, across disciplinary and geographic borders. To date, there are no community driven patient-reported experience measures of racism, bias, discrimination, or mistreatment by, for, and with impacted Black birthing communities, in partnerships with Black women scholars, about labor, birth, and immediate postpartum in hospital settings in California or the United States. Thus, the current QI clinical outcomes, measures, processes, and research activities in perinatal health lack the necessary scientific and cultural rigor, integrity, and validity to achieve and sustain equity, dignity, and accountability in birth care, experiences, and outcomes of Black mothers and birthing people. The study objectives include the following: 1) to develop a theoretical framework that describes the bias, discrimination, gendered racism, mistreatment, and violence of birthing in hospitals; 2) to operationalize Cultural Rigor, Black Feminism, Reproductive Justice, and the formative theoretical framework of birthing while Black in hospitals to develop a new racial equity and justice centered program of participatory quality improvement (QI) research; 3) to prioritize community voices, leadership, and expertise by facilitating authentic, autonomous, and affirming communications and collaborations; and 4) to foster critical participation of Black mothers, Black birthing people and Black women scholars in the design of community-based hospital strategies to prevent and/or mitigate the harm of obstetric racism, utilizing the accounts of Black mothers’ lived hospital birth experiences in their own words as opposed to relying exclusively on pre-existing theoretical frameworks.”
    California Birth Equity Collaborative Pilot
    California Maternal Quality Care Collaborative (CMQCC)/Stanford University, California Health Care Foundation Jan 1, 2019 - Sep 30, 2019
    Role: Director
    Role Description: The aim of the California Birth Equity Collaborative is to improve birth care, experiences, and outcomes for and with Black mothers and Black birthing people in California in three hospitals in Berkeley/Oakland, Long Beach, and Riverside. The goals will be achieved by: building a community informed knowledge on what constitutes respectful and dignified care in relationships, interactions, communication, counseling and shared decision making between patients and hospitals as well as communities and hospitals, and informing the development of a patient reported experience metric (PREM) of respect and dignity for use in community-hospital partnerships, quality improvement, systems accountability, interprofessional education, maternal data center, and patient advocacy. Our partners include hospitals, Black women led community-based organizations, Black women state and national mentors, and local community-hospital advisors from various disciplines in private and public sector. As Director, I created pilot goals, strategic vision, theory of change, organizational structure and work group goals, membership and strategies, and content on webpage about the pilot. I also cultivated relationships with Black women led community based organizations (CBOs) and leading Black women scholars in California and across the nation, and invited scholars and community leaders to join our team. As a public health scholar and clinician scientist, I led the patient reported experience measure (PREM) work group in the design of the interview guide, facilitation of focus group discussions/listening sessions, innovative and disruptive literature review, coding and analysis, and instrument development. I also provided expertise in content development and implementation of effective teaching and training practices for small and large group to increase engagement, learning, uptake, and utilization of information. In my administrative role, I developed scope of work and honorarium agreements, budgets, and multi-color coded pilot big picture and month to month timeline with deliverables across the Coordinating Body and six work groups: PREM, community partners, interprofessional education (IPE), quality improvement (QI) Task Force, research, evaluation, and measures (REM), and communications and social media.
    Mothers Voices Driving Birth Equity
    National Birth Equity Collaborative, Robert Wood Johnson Foundation Dec 15, 2018 - Sep 30, 2019
    Role: Director, California Birth Equity Collaborative, California Maternal Quality Care Collaborative
    Role Description: The National Birth Equity Collaborative (NBEC), CMQCC, and the American College of Obstetricians and Gynecologists Alliance for Innovation of Maternal Health California Maternal Quality Care Collaborative (CMQCC) will partner together to listen, learn and build a community informed knowledge base on what constitutes care that leads to trusted relationships with health care providers, shared decision making and respectful and dignified communications from a patient perspective. This knowledge base will inform the development of a patient reported experience measure for use in community engagement, quality improvement, systems accountability, provider education, and patient advocacy. The ethical principles and guidelines that inform how we prioritize Black women-led CBOs, Black mothers, Black birthing people, and Black women scholars in the research and evaluations are informed by Reproductive Justice, Cultural Humility and Rigor, and Research Justice. As Director, I co-developed the aims, research questions, theories of change, and methods. I also cultivated relationships and provided technical assistance with Black women led CBOs in California, Oklahoma, Texas, Illinois, Maryland, and Georgia. I also provided subject matter expertise and technical assistance in coding, analysis, and development of the patient reported experience measure (PREM), with regional/state specific measures.
    Racial Equity Pilot Planning Project
    California Maternal Quality Care Collaborative (CMQCC, Stanford University, California Health Care Foundation May 1, 2018 - Dec 31, 2018
    Role: Co-Director
    Role Description: CMQCC successfully reduced maternal mortality by 50% in California. However, the four-fold death gap between Black and white women still persists. Based on the impact of structural gendered racism on Black women’s birth care and experiences in hospitals, CMQCC engaged hospital and community leaders about their insights and experiences on the gap in fatal complications, deaths, and first cesareans births between Black and white women. Data collected from phone and in person interviews and a full day stakeholder meeting will inform the proposal for the pilot implementation project with three local hospitals from January 2019 – December 2020. A co-Director, I provided content expertise in community participation and racial equity and planned and facilitated the full day stakeholder meeting. I also co-developed interview guide for the key informant interviews and the brief report and provided technical assistance in the development of the two-year proposal goals, activities, partnerships, measures of success, and budget.
    Partnering with Adolescents to Ready The Newest Engaged Researchers (PARTNER)
    Eugene Washington Patient Centered Outcomes Research Institute (PCORI) Engagement Award Sep 1, 2016 - Jul 31, 2018
    Role: Evaluator
    Role Description: PARTNER is a Continuous Quality Improvement (CQI) project to center youth voices and experiences in patient-centered outcomes research and comparative effectiveness research (PCOR/CER) and to evaluate the necessary and appropriate context, people, and processes for curriculum design, that will occur in concert with curriculum implementation and evaluation. Key population included youth and adults in community health center in Northern California and school-based health center in Central California. As the evaluator, I provided expertise and technical assistance in development of theories of change and process measures for the CQI project. I described and evaluated project activities and impact of the processes on the experience of the involved youth, adults, site directors, project facilitators, and project leadership. I conducted key informant interviews at both sites and provided early feedback as to whether the CQI project was being implemented as intended and identified barriers and successes, and recommended real time changes based on feedback.

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    Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help. to make corrections and additions.
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    Altmetrics Details PMC Citations indicate the number of times the publication was cited by articles in PubMed Central, and the Altmetric score represents citations in news articles and social media. (Note that publications are often cited in additional ways that are not shown here.) Fields are based on how the National Library of Medicine (NLM) classifies the publication's journal and might not represent the specific topic of the publication. Translation tags are based on the publication type and the MeSH terms NLM assigns to the publication. Some publications (especially newer ones and publications not in PubMed) might not yet be assigned Field or Translation tags.) Click a Field or Translation tag to filter the publications.
    1. Racial and Ethnic Disparities in Hospital-Based Care Associated with Postpartum Depression. J Racial Ethn Health Disparities. 2020 May 30. Chan AL, Guo N, Popat R, Robakis T, Blumenfeld YY, Main E, Scott KA, Butwick AJ. PMID: 32474833.
      View in: PubMed   Mentions:    Fields:    
    2. First, Do No Harm: Why Philanthropy Needs to Re-Examine Its Role in Reproductive Equity and Racial Justice. Health Equity. 2020; 4(1):17-22. Scott KA, Bray S, McLemore MR. PMID: 32219193.
      View in: PubMed   Mentions:
    3. Redesigning Perinatal Quality Improvement Initiative: Community Driven Measures, Meanings, and Methods. 2019. View Publication.
    4. Race, Research, and Women's Health: Best Practice Guidelines for Investigators. Obstet Gynecol. 2019 08; 134(2):422-423. McLemore MR, Asiodu I, Crear-Perry J, Davis DA, Drew M, Hardeman RR, Mendez DD, Roberts L, Scott KA. PMID: 31348216.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    5. The Ethics of Perinatal Care for Black Women: Dismantling the Structural Racism in "Mother Blame" Narratives. J Perinat Neonatal Nurs. 2019 Apr/Jun; 33(2):108-115. Scott KA, Britton L, McLemore MR. PMID: 31021935.
      View in: PubMed   Mentions: 1     Fields:    Translation:Humans
    6. Racial and ethnic disparities in severe maternal morbidity prevalence and trends. Ann Epidemiol. 2019 05; 33:30-36. Leonard SA, Main EK, Scott KA, Profit J, Carmichael SL. PMID: 30928320.
      View in: PubMed   Mentions: 3     Fields:    Translation:Humans
    7. An inconvenient truth: You have no answer that Black women don’t already possess. An open letter to, birth workers, clinicians, funders, perinatal and systems re-designers and policy makers. Black Women Birthing Justice Blog. 2018. View Publication.
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