Channeling the voice of underserved communities on nutritional insufficiency and unaddressed needs on maternal infant health.

传达服务不足社区关于营养不足和母婴健康需求未得到解决的声音。

• 批准号: 10395287
• 负责人: MARCIA Roxana CRUZ-CORREA
• 金额: $ 27.85万
• 依托单位: UNIVERSITY OF PUERTO RICO MED SCIENCES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-02 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10395287
• 关键词: Address; Age; Behavioral; COVID-19; COVID-19 pandemic; Caring; Certification; Child; Child Nutrition; Clinical; Clinical assessments; Collaborations; Colon; Communities; Confusion; Consumption; Data; Dimensions; Disease; Eating Behavior; Eligibility Determination; Emergency Situation; Ensure; Environment; Event; Family; Food; Foundations; Fright; Fruit; Funding; Goals; Government; Grant; Growth; Habits; Health; Health Benefit; Health Services Accessibility; Health Status; Health behavior; Health behavior change; Healthcare; Healthy Eating; Home; Household; Individual; Infant; Infant Development; Infant Health; Infection; Intercept; Intervention; Interview; Knowledge; Length; Life; Location; Longevity; Maternal Health; Measures; Methods; Modeling; Morbidity - disease rate; Mothers; Nature; Nutritional; Nutritional status; Obesity; Outcome; Overweight; Participant; Pattern; Persons; Plant Roots; Postpartum Period; Postpartum Women; Pregnancy; Prenatal care; Prevalence; Prevention; Procedures; Process; Public Health; Puerto Rico; Recovery; Recruitment Activity; Reporting; Research; Resources; Risk; Risk Factors; SARS-CoV-2 infection; Schools; Series; Service delivery model; Services; Special Supplemental Nutrition Program for Women, Infants, and Children; Surveys; Third Pregnancy Trimester; Time; Urban Hospitals; Vegetables; Voice; Weight; Woman; Women' s Health; base; care coordination; care outcomes; coronavirus disease; design; early childhood; economic cost; experience; food insecurity; food security; fruits and vegetables; improved; infant outcome; interest; intervention mapping; lifestyle intervention; mortality; motherhood; multimodality; nutrition; obesogenic; offspring; pandemic disease; postpartum care; primary outcome; programs; prospective; remote health care; reproductive; safety net; screening; social health determinants; societal costs; socioeconomics; standard of care; transmission process; underserved community; unintended pregnancy

Addressing the obesity pandemic has been a looming challenge before COVID 19 changed our daily lives. Evidence to date suggest that to achieve full prevention, we should intervene during the first 1000 days of life. This goal requires optimal health and access to essential services as early in pregnancy as possible. Alternatives to mitigate the sequelae of intrauterine exposures are critical as most pregnancies are unplanned. The baby act trial was designed to evaluate the effects of a community based multimodal lifestyle intervention to improve early growth outcomes among participants of the Puerto Rico Women, Infant and Children Special Nutrition Program (PRWIC). Reports on the rate of overweight/obesity in early childhood and women post-partum during 2017-18 fiscal year showed a significant increase with an extremely low percent of women reporting fruit and vegetable consumption. Poor health habits following the first of a series of catastrophic events to take place in our study location remain a major concern. Preliminary data from BAT showed a rate of overweight/obesity prior to pregnancy of 63.7% and reported levels of fruit and vegetable consumption during pregnancy that do not reach the minimal amount needed to achieve health benefits. As subsequent events ensued, the PRWIC standard of care (control condition), was adapted. BAT participants continued to receive the intervention as designed, but our assessment team provided additional support as needed to achieve access to essential services. Navigation for PRWIC registration and information on health and government services was made available. As study implementation have remained responsive to our partner's real-life conditions, it is the goal of this study to assess the impact of the living conditions during the COVID 19 pandemic on women who participated in the PRWIC program and delivered during this global emergency. We will implement intervention mapping strategies to explore differences in the lived experience of transition from pregnancy to motherhood as reported by women who participated in BAT in both conditions, and PRWIC participants who delivered at the San Juan City Hospital that where not enrolled in BAT. Data collected via surveys on healthcare, nutrition, social determinants of health, and clinical measures, will be integrated with qualitative analysis achieved through in-depth interviews with a random group of participants from each group. Our overarching goal is to explore the root cause for minimal compliance with healthy eating behaviors during pregnancy and beyond, the effects of BAT participation on the rate of at-risk weight in both mother and infant. Acceptability of strategies to address women's health screening and coordination of care will be explored. We will address the following aims: 1) Compare the effects of BAT participation on maternal/infant weight and nutritional status, 2) Define the influence of baseline and lockdown living conditions on pregnancy and postpartum/early care outcomes among PRWIC participants, 3) Explore the acceptability of implementing the Implicit Interception Care model to address the needs of women who participated in the PRWIC program.

在COVID 19改变我们的日常生活之前，应对肥胖流行病一直是一个迫在眉睫的挑战。 迄今为止的证据表明，要实现全面预防，我们应该在生命的前1000天进行干预。 这一目标要求尽可能在怀孕早期获得最佳健康和基本服务。替代品 由于大多数怀孕都是计划外的，因此减少宫内照射的后遗症至关重要。婴儿行为 一项试验旨在评估基于社区的多模式生活方式干预对改善早期 波多黎各妇女、婴儿和儿童特殊营养方案参与者的生长结果 （PRWIC）. 2017- 2018年幼儿和产后妇女超重/肥胖率报告 一个财政年度显示，报告水果和蔬菜的妇女比例极低， 消费在我们的研究中发生的一系列灾难性事件中， 位置仍然是一个主要问题。英美烟草公司的初步数据显示， 怀孕的63.7%，报告的怀孕期间水果和蔬菜的消费水平没有达到 达到健康益处所需的最低量。随着后续事件的发生， 护理（对照条件）。BAT参与者继续接受设计的干预，但 我们的评估小组根据需要提供了额外支助，以实现获得基本服务的目标。导航 为PRWIC注册提供了一个平台，并提供了有关卫生和政府服务的信息。为研究 实施仍然对我们合作伙伴的现实生活条件作出反应，本研究的目标是评估 COVID 19大流行期间的生活条件对参加PRWIC的妇女的影响 在这场全球性的紧急事件中，我们将实施干预规划战略， 探讨妇女报告的从怀孕到成为母亲的生活经历的差异 在两种情况下都参加BAT的参与者，以及在圣胡安市医院分娩的PRWIC参与者 在BAT中没有注册。通过对保健、营养、健康的社会决定因素、 和临床措施，将与定性分析相结合，通过深入访谈， 从每组中随机抽取一组参与者。我们的首要目标是探索最小的根本原因 怀孕期间及以后的健康饮食行为的遵守情况，BAT参与对 母亲和婴儿的危险体重率。妇女健康检查战略的可接受性 和护理的协调将被探索。我们将讨论以下目标：1）比较BAT的效果 参与对孕产妇/婴儿体重和营养状况的影响，2）确定基线和锁定的影响 PRWIC参与者的生活条件对妊娠和产后/早期护理结果的影响，3）探索 实施隐性拦截护理模式以满足下列妇女的需求的可接受性： 参加了PRWIC计划。