Pathways to integrate maternal-child health and nutrition interventions to transform equity and human potential

整合母婴健康和营养干预措施以转变公平和人类潜力的途径

• 批准号: 10413591
• 负责人: Gabriela Buccini
• 金额: $ 111.26万
• 依托单位: UNIVERSITY OF NEVADA LAS VEGAS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-23 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10413591
• 关键词: 3 year old; Address; Adolescence; Age; Birth Weight; COVID-19; COVID-19 pandemic; Caring; Characteristics; Child; Child Mortality; Child Nutrition; Childhood; Collaborations; Color; Communities; Counseling; Data; Development; Dietary Intervention; Effectiveness of Interventions; Employment; Food; Generations; Goals; Health; Health Food; Health education; Household; Housing; Human; Hybrids; Immunization; Infant; Intervention; Life; Life Cycle Stages; Link; Literature; Maternal Mortality; Maternal and Child Health; Methods; Monitor; Neighborhoods; Nevada; Outcome; Pathway interactions; Perinatal; Phase; Poverty; Pregnant Women; Prevalence; Psyche structure; Racial Equity; Recovery; Research; Resources; Services; Site; Social Justice; Solid; Southwestern United States; Structural Racism; System; adverse outcome; base; care systems; child services; community intervention; coronavirus disease; design; effectiveness evaluation; effectiveness outcome; evidence base; food insecurity; food security; implementation outcomes; implementation science; improved; innovation; insight; lower income families; maternal risk; nutrition; prenatal; racial and ethnic; response; screening; service utilization; social; social determinants; social health determinants; social interventions; socioeconomics; success; therapy development

SUMMARY ABSTRACT Maternal and child health is critical to achieving the Healthy People 2030 Goals. Investing in integrated nurturing care interventions from preconception through childhood and adolescence defines one’s developmental trajectory with benefits that accumulate across the life course and promote social justice (i.e., taking equity one step further by fixing the systems for generations to come). COVID-19 pandemic has disrupted essential nurturing care services such as prenatal, perinatal, and pediatric services. As a result, over a million preventable child and maternal deaths globally are projected to occur due to extreme poverty and household food insecurity (HFI; lack of consistent access to enough healthful food for an active, healthy life due to limited financial resources). Amid the COVID-19, HFI in the US tripled among households with children (~19.5%), disproportionately burdening marginalized low income and families of color. HFI is strongly linked with racial/ethnic inequities and adverse maternal-child health and nutrition outcomes. Integrating effective food security interventions within nurturing care services as a COVID-19 response & recovery efforts is an achievable strategy to promote equity. The West Las Vegas Promise Neighborhood (WLVPN) is an intervention addressing social determinants of health to reduce structural racism amid COVID-19 in historically racial/ethnic marginalized communities in the Southwest US. The WLVPN is implemented by over 50 multi- sector partners in key life domains (health, education, employment, housing, and social justice) coordinated by Nevada Partners, Inc., with whom we have a solid and long-term collaboration. While WLVPN social intervention is a unique opportunity and platform to address endemic inequities in maternal-child mortality and food insecurity levels, it lacks focus on maternal-child health and nutrition. Therefore, our partnership with Nevada Partners, Inc. is well-placed for promoting the maternal-child component within WLVPN and advancing implementation and equity research. Our community-based participatory approach will use a racial equity framework to co-create WITH the community an intervention to integrate maternal-child health and nutrition consisted of a bundle of effective food security interventions retrieved from the literature (e.g., universal screening, community referral, monitoring system, and nutrition-focused counseling strategies) adapted and integrated into the nurturing care services within WLVPN communities. A Hybrid Type III quasi-experimental within-site will be designed to 1) develop and implement an equity-focused system-level intervention to integrate maternal-child health and nutrition and 2) assess the effectiveness of this intervention in decreasing levels of food insecurity and/or improve health outcomes of pregnant women and their young children under the age of 3, which will nurture their potentials, enabling them to thrive. This project is designed to inform how best multi-sectoral interventions (maternal-child health and food insecurity interventions) can be integrated to promote transformation on the maternal-child health and nutrition of historically marginalized communities.

摘要摘要 孕产妇健康对于实现健康人2030目标至关重要。投资综合 从祖先到儿童时期和青少年培养护理干预措施定义 发展轨迹具有在整个生活过程中积累并促进社会正义的利益（即 通过修复几代人的系统，将权益进一步迈出一步。 COVID-19大流行 破坏了产前，围产期和小儿服务等基本培养护理服务。结果， 全球一百万可预防的儿童和孕产妇死亡是由于极端贫困和 家庭粮食不安全（HFI；无法始终获得足够健康的食物来实现活跃，健康的生活 由于财务资源有限）。在与孩子的家庭中，在美国的Covid-19中，HFI三倍 （〜19.5％），不成比例地燃烧边缘化的低收入和有色人种。 HFI紧密联系 种族/族裔不平等以及不利的母子健康和营养成果。整合有效 培养护理服务中的粮食安全干预措施作为19日的回应和恢复工作是一种 促进公平的可实现策略。西拉斯维加斯诺言社区（WLVPN）是一个 在历史上与社会决定者有关健康的社会决定者以减少结构性种族主义的干预措施。 美国西南部的种族/种族边缘化社区。 WLVPN由50多个多人 由关键生命领域（健康，教育，就业，住房和社会正义）的部门合作伙伴协调 内华达州合作伙伴公司，我们与我们进行了坚实而长期的合作。而WLVPN社交 干预是一个独特的机会和平台，可解决母亲死亡率的内在不平等现象 粮食不安全水平，它缺乏专注于母子健康和营养。因此，我们与 内华达州合作伙伴公司（Nevada Partners，Inc。 实施和股权研究。我们基于社区的参与方法将使用种族平等 与社区共同创建的框架，以干预综合的母子健康和营养 由从文献中检索出的一堆有效的粮食安全干预措施（例如，普遍存在 筛查，社区推荐，监测系统和以营养为中心的咨询策略）适应和 集成到WLVPN社区内的培养护理服务中。杂交III类准实验 现场将设计为1）开发和实施以股票为中心的系统级干预措施 综合母子健康和营养以及2）评估这种干预措施减少的有效性 粮食不安全和/或改善孕妇及其幼儿的健康状况 3岁的年龄将培养其潜力，使他们能够蓬勃发展。该项目旨在告知如何 最佳的多部门干预措施（母子健康和粮食不安全干预措施）可以集成到 促进对历史上边缘化社区的母子健康和营养的转变。