About

Dorothy Cilenti, DrPH, is a clinical professor in the Department of Maternal and Child Health at the UNC Gillings School of Global Public Health and serves as the Associate Dean for Practice. She has over 20 years of experience working in local and state public health agencies in North Carolina, with a primary focus on strengthening public health systems for underserved populations. Dr. Cilenti directs the National Maternal and Child Health (MCH) Workforce Development Center, a cooperative agreement with the Health Resources Services Administration, Maternal and Child Health Bureau, Division of MCH Workforce Development. Her work involves overseeing training and technical assistance to state agencies implementing health transformation, with priority areas including quality improvement, population health management, evidence-informed decision-making, and systems integration. She has served as principal investigator for more than 40 grants and contracts totaling over $55 million, contributing significantly to public health workforce development and maternal and child health initiatives.

Research topics

• Political Science
• Medicine
• Medical education
• Social Science
• Psychology
• Sociology
• Computer Science
• Nursing
• Public relations
• Environmental health
• Knowledge management
• Engineering
• Business
• Pedagogy
• Economic growth
• Biology
• Marketing
• Management science
• Family medicine
• Public administration

Selected publications

• Operationalizing Implementation Coaching in a Maternal Health Setting: Lessons From the Field

  Journal of Public Health Management and Practice · 2025-12-17

  articleSenior author

  CONTEXT: The US is the only high-income country with increasing maternal mortality and severe maternal morbidity rates. The Maternal Health Learning & Innovation Center (MHLIC), funded in 2019 by the Health Resources and Services Administration (HRSA), builds the capacity of State Maternal Health Innovation (MHI) teams to address this crisis. OBJECTIVES: Describe the MHLIC coaching model and its role in supporting State MHI teams to strengthen capacity and implement maternal health initiatives. DESIGN: A mixed-methods study was conducted as part of a broader evaluation of the MHLIC to explore how coaching facilitated state-level capacity building, strategy development, and implementation of maternal health initiatives. SETTING: Quantitative data came from coaching logs completed in REDCap; qualitative data were gathered through semi-structured interviews with staff from the cohort 1 states (funded 2019-2024). PARTICIPANTS: Implementation coaches documented interactions from a total of 35 State MHI teams; interviews were conducted with one or more staff from all cohort 1 states. INTERVENTION: Implementation coaching is a structured approach to support innovation adoption and address barriers to evidence-informed maternal health practices. OUTCOME MEASURES: Coaching logs identified functions performed; interviews captured the most common outputs from coaching engagement. RESULTS: From 2019 to 2024, MHLIC conducted 1178 coaching interactions with 35 state teams. The common coaching functions involved building collaborative relationships with team members, brokering MHLIC resources, and facilitating external connections and resources. Capacity building focused on effective engagement, systems leadership, and health equity. Key outputs identified were strategic planning and maternal health taskforce development, fostering innovation through collaboration, and building data capacity for evidence-based decisions. CONCLUSION: The MHLIC coaching model demonstrates a promising strategy for advancing maternal health by equipping state teams with capacity, leadership, and resources. Findings highlight the role of implementation coaching in accelerating improvements and contributing to the broader effort to ensure equitable and high-quality maternal care.

  PublisherDOI

• Using a Learning Collaborative to Develop Implementation Guides to Address the Maternal Health Crisis in the US

  2025-04-21

  preprintOpen accessSenior author

  Background: Delay between generating evidence and integrating it into practice poses a significant barrier to improving population health, as the “know-do” gap prevents or postpones positive impacts of interventions. One strategy researchers, practitioners, and partners can utilize to increase the timeliness of intervention uptake is to create implementation guides. Implementation guides describe the “how” of implementation best practices while also promoting knowledge translation. To contribute to implementation guide development, organizations can participate in Learning Collaboratives. Learning Collaboratives offer peer-to-peer support and connection, group learning, and collective insight into quality improvement cycles. In the United States, co-designing implementation guides with users is one way to address the maternal health crisis.Methods: The Maternal Health Learning and Innovation Center (MHLIC) partnered with four national maternal health organizations in a virtual Learning Collaborative during 2024. Qualitative and quantitative evaluation with Learning Collaboration participants occurred via Qualtrics following each individual session. At the final session, a cumulative evaluation was distributed. Results: Four implementation guides were developed. Through the process, members of each MCH organization identified the best practices to develop their implementation guides. The flexible approach enabled each of the organizations to co-design their process to develop the implementation guides. Universally, using co-design strategies and the inclusion of people with lived expertise as well as other researchers, practitioners, and partners was critical to the development of the implementation guides. Conclusions: Using a Learning Collaborative to support organizations in co-creating and co-designing implementation guides - tailored to the needs of their communities and partners, and communities – presents an opportunity to accelerate the adoption of evidence-informed, emerging, and promising practices.

  PublisherDOI

• Consolidated Framework for Collaboration Research derived from a systematic review of theories, models, frameworks and principles for cross-sector collaboration

  UNC Libraries · 2025-02-06

  reviewOpen access

  Cross-sector collaboration is needed to address root causes of persistent public health challenges. We conducted a systematic literature review to identify studies describing theories, models, frameworks and principles for cross-sector collaboration and synthesized collaboration constructs into the Consolidated Framework for Collaboration Research (CFCR). Ninety-five articles were included in the review. Constructs were abstracted from articles and grouped into seven domains within the framework: community context; group composition; structure and internal processes; group dynamics; social capital; activities that influence or take place within the collaboration; activities that influence or take place within the broader community; and activities that influence or take place both in the collaboration and in the community. Community engagement strategies employed by collaborations are discussed, as well as recommendations for using systems science methods for testing specific mechanisms of how constructs identified in the review influence one another. Researchers, funders, and collaboration members can use the consolidated framework to articulate components of collaboration and test mechanisms explaining how collaborations function. By working from a consolidated framework of collaboration terms and using systems science methods, researchers can advance evidence for the efficacy of cross-sector collaborations.

  PublisherDOI

• Practical Approaches for Promoting Health Equity in Communities

  UNC Libraries · 2025-02-06

  articleOpen access
  PublisherDOI

• Building Maternal Health Capacity: Impact of the Maternal Health Learning and Innovation Center

  Journal of Public Health Management and Practice · 2025-08-08 · 2 citations

  articleSenior author

  CONTEXT: To address the maternal health crisis, Health Resources and Services Administration funded the Maternal Health Learning and Innovation Center (MHLIC) in 2019 to provide capacity-building assistance (CBA) to maternal health practitioners nationally. OBJECTIVE: To measure whether and how MHLIC's capacity-building efforts increased maternal health practitioners' confidence in their team's capacity to address maternal health. DESIGN: Mixed methods evaluation, including a retrospective post-test survey and semi-structured focus group interview among 9 state Maternal Health Innovation (MHI) awardee teams funded for 5 years. SETTING: MHLIC served 9 state MHI teams initially, growing to 35 states nationally by 2024. PARTICIPANTS: From May-June 2024, 23 staff from 9 teams participated in the survey and these same staff and other teammates (n = 32) participated in a focus group interview. INTERVENTION: MHLIC's CBA is multi-pronged, offering learning opportunities to help awardees gain and strengthen the skills, knowledge, and tools they need to implement innovations that reduce severe maternal morbidity and mortality. Learning opportunities included coaching, technical assistance, tailored consultation, training, peer learning, learning institutes, and national symposia. OUTCOME MEASURES: The survey outcome was confidence in their team's ability to address 22 maternal health, engagement, and policy items before and after engaging with MHLIC. The focus group's main outcomes were evidence of improved maternal health capacity and the contribution of MHLIC's CBA. RESULTS: There were statistically significant moderate increases in teams' reported confidence on every item from before to after engaging with MHLIC. All changes were roughly 0.5 points or higher on the 4-point scale. Interview evidence of improved capacity with support from MHLIC included equity, community engagement, implicit bias, data use and dissemination, strategic planning, and sustainability. CONCLUSIONS: MHLIC's CBA increased teams' maternal health capacity, enabling teams to achieve their MHI goals while laying a foundation for advancing maternal health beyond the scope of the program.

  PublisherDOI

• Exploring Local Health Departments’ Understanding of and Engagement in Cross-Sector Collaboration and Community Engagement for Systems Change

  Journal of Public Health Management and Practice · 2025-07-10 · 1 citations

  article

  CONTEXT: Iowa's local public health services (LPHS) contract funding required local health departments (LHDs) to shift toward population health work. In previous research, LHDs indicated interest in learning about cross-sector collaboration (CSC) and community engagement (CE) approaches to systems change to pursue health equity. CSC and CE approaches were on the menu of approved activities for this LPHS funding thereby creating a unique opportunity to explore practitioners' understanding of and engagement in CSC and CE for systems change. OBJECTIVES: To collect evidence about what is needed for LHDs to translate CSC and CE principles to practice and to develop skill and capacity-building initiatives for collaborative systems change. DESIGN: The multi-phase, qualitative methods study employed an action research design drawing LHDs from Iowa's local public health system. SETTING AND PARTICIPANTS: Practitioners from LHDs, the Iowa Department of Health and Human Services, the Midwestern Public Health Training Center, and the Iowa Public Health Association formed an action research team to review and validate thematic findings and develop recommendations. Seven LHDs (19 individuals) were selected as participants from Iowa's 99 LHDs. RESULTS: LHD practitioners described authentic, non-transactional, sustained relationships in the community and with cross-sector partners as foundational to collaborative systems change. Their experience demonstrated that system context (eg, community dynamics and priorities) heavily influences collaborative systems change. Key principles present in systems change frameworks are represented in practitioners' understanding of collaborative systems change. While participants described establishing processes and structures for collaboration as important, no universal best practices emerged; rather practices evolved as collaboratives engaged in shared learning. CONCLUSIONS: LHD practitioners characterize CSC and CE for systems change (ie, what it is, the processes for and successes of) thereby moving beyond high-level constructs to language that might better connect with public health practitioners (ie, words matter).

  PublisherDOI

• A Path Towards Reproductive Justice: Incorporating a RJ Framework into North Carolina’s Improving Community Outcomes for Maternal and Child Health Initiative

  UNC Libraries · 2025-04-26

  articleOpen access
  PublisherDOI

• The Maternal and Child Health Workforce: A Snapshot of Current and Future Needs From Public Health WINS 2021.

  UNC Libraries · 2025-09-13

  articleOpen access

  OBJECTIVE: To summarize and examine data collected from the first-ever Public Health Workforce Interests and Needs Survey Maternal and Child Health (MCH) module. DESIGN, SETTING, AND PARTICIPANTS: Responses from MCH governmental public health employees in 47 state health departments and 288 local health departments (LHDs) in the United States. MAIN OUTCOME MEASURE: Demographic characteristics; 4 measures from the MCH module: the importance of and skill level in 5 MCH competencies in daily work, growth and leadership development opportunities, and additional workforce development needs. RESULTS: The MCH workforce predominantly self-identified as women (91.2%) and as White, non-Hispanic (55.2%). At least 70% of respondents reported MCH competencies as important in their daily work, but only 44% to 57% reported being proficient in those competencies. The MCH workforce in LHDs were less likely than those in state health departments to report being proficient in MCH competencies (adjusted prevalence rate ratio range: 0.83-0.92) or have growth and leadership development opportunities (adjusted prevalence rate ratio range 0.76-0.90). CONCLUSION: The MCH module highlights a need to further prioritize workforce development efforts for governmental public health staff, especially in LHDs. There is an ongoing need to meet public health professionals where they are and to tailor training models and workforce development plans to account for new and ongoing stressors faced by the workforce.

  PublisherDOI

• Disparities in Maternal Health Visits Between Rural and Urban Communities in the United States, 2016–2018

  UNC Libraries · 2024-09-06

  articleOpen access

  OBJECTIVE: The objective was to estimate the rural-urban differences in the receipt of prepregnancy, prenatal, and postpartum services. METHODS: The authors conducted a cross-sectional data analysis using data from the Pregnancy Risk Assessment and Monitoring System from 2016 to 2018 to analyze rural-urban differences in the receipt of medical visits and care content delivery during the prepregnancy year, as well as the prenatal and postpartum periods among birthing people in the US, using survey-weighted multivariable logistic regression models. RESULTS: Rural-dwelling birthing people were significantly less likely to attend a medical visit in the prepregnancy year or postpartum period, even when controlled for sociodemographic and clinical characteristics. Compared to their urban counterparts, they were also less likely to receive comprehensive screening and counseling in the prepregnancy and postpartum maternity phases. CONCLUSION: Efforts to ameliorate rural-urban differences in maternal care access and quality should explicitly adopt multilevel, systemic approaches to policy and program implementation and evaluation. Policymakers and practitioners should consider telehealth as a potential complementary tool to minimize gaps in quality of care which disproportionately impact rural-dwelling birthing people.

  PublisherDOI

• Assessing Local Public Health Governance in North Carolina Across Organizational and Governance Configurations

  North Carolina Medical Journal · 2024-08-01

  articleOpen access

  Background: Every county in North Carolina must include a board of health (BOH) with specific prescribed duties and powers. It is unclear how BOHs in North Carolina are currently exercising their governance ability. In 2012, the North Carolina General Assembly provided coun-ties with additional flexibility to select among different configurations for their local health department (LHD). The impact of this flexibility on the governance and service delivery of LHDs is yet to be explored. Methods: We conducted semi-structured interviews with LHD directors and BOH members to assess the strengths and weaknesses of BOHs within different local public health configurations across North Carolina. We employed conventional content analysis to derive themes from the interview transcripts. Results: BOHs were largely described as an underutilized institution, with few BOHs noted to be active beyond satisfying their required legal duties. Strong BOHs were noted to fulfill three identities on behalf of the LHD: an advocate, a bridge, and an advisor. The majority of interviewees desired to work in a standalone county health department (as opposed to a consolidated human services agency) with an appointed (versus elected) board of health. This configuration was preferred because, according to participants, it is more likely to enable a structural focus on public health initiatives. Limitations: Our sample frame did not control for the length of time an interviewee had been in the office nor the professional background of each BOH member. Conclusions: Wide variations exist in the exercise of BOHs across the state, partially due to how different LHD configurations structurally focus resources and attention on public health.

  PublisherOA PDFDOI

Frequent coauthors

• Rebecca Wells

  St George's, University of London

  41 shared

• Hye‐Chung Kum

  39 shared

• Marianne M. Hillemeier

  Pennsylvania State University

  39 shared

• RK Goyal

  RTI Health Solutions

  39 shared

• J. Timothy Whitmire

  University of North Carolina at Chapel Hill

  38 shared

• Edward L. Baker

  Baker Engineering (United States)

  18 shared

• Glen P. Mays

  University of Colorado Anschutz Medical Campus

  16 shared

• Anjum Hajat

  University of Washington

  16 shared

Awards & honors

• Director's Award 2018, HRSA Maternal and Child Health Bureau