Abstract for: A Group Model Building Process to Address the Rise in Cardiovascular Severe Maternal Morbidity Among Black Women in NorthTexas

The aim of this paper is to share the lessons learned from an ongoing System Dynamics Group Model Building (SD GMB) process, serving as the initial phase of a multi-year project focused on addressing cardiovascular severe maternal morbidity (CSMM) among non-Hispanic Black women (NHBW) in North Texas. CSMM is rising in high-income countries and has become the leading cause of maternal mortality, with NHBW bearing a disproportionate burden of CSMM impact. In this study we used System Dynamics Group Model Building (SD GMB) to identify and map key mechanisms underlying disproportionally high and increasing rates in CSMM prevalence among NHBW. SD GMB activities took place during an in-person workshop across one and a half days with thirteen community experts attending day one and eleven participants attending day two. The SD GMB workshop applied multiple systems thinking exercises to elicit hopes and concerns, key variables (5 R’s), behavior‐over‐time graphs (BOTGs), and causal loop diagrams. Two causal loop diagrams were developed by two different groups to explain CSMM rates among NHBW in North Texas: One mainly focused on the mechanisms underlying healthcare availability, accessibility, quality, and affordability, while the other focused on neighborhood wealth and built environment factors relevant to CSMM.