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 孕产妇和儿童健康对于实现2030年健康人目标至关重要。投资于综合 从孕前到童年和青春期的养育护理干预定义了一个人的 发展轨迹，在整个生命过程中积累利益，促进社会正义（即， 通过为子孙后代修复系统，进一步实现公平）。COVID-19疫情 产前、围产期和儿科服务等基本护理服务中断。因此，在 预计全球将有100万可预防的儿童和孕产妇死亡是由于极端贫困， 家庭粮食不安全（HFI;缺乏持续获得足够的健康食物以维持积极健康的生活 由于财政资源有限）。在COVID-19期间，美国有孩子的家庭的HFI增加了两倍 （~19.5%），不成比例地负担边缘化的低收入和有色人种家庭。HFI与 种族/民族不平等和不利的母婴健康和营养结果。整合有效 作为COVID-19应对和恢复工作的养育护理服务中的粮食安全干预措施是一项 可实现的战略，以促进公平。西拉斯维加斯承诺社区（WLVPN）是一个 针对健康的社会决定因素的干预措施，以减少历史上COVID-19期间的结构性种族主义 美国西南部的种族/民族边缘化社区。WLVPN由50多个多- 主要生活领域（卫生、教育、就业、住房和社会正义）的部门伙伴，由 内华达州合伙人公司，我们与他们有着长期而稳固的合作关系。虽然WLVPN社交 干预是解决母婴死亡率普遍不平等问题的独特机会和平台， 由于粮食不安全程度高，它缺乏对母婴健康和营养的关注。因此，我们与 内华达州合伙人公司在WLVPN中推广母婴组件并推进 执行和公平研究。我们以社区为基础的参与式方法将使用种族平等 与社区共同创建一个框架，将母婴健康和营养结合起来 包括从文献中检索到的一系列有效的粮食安全干预措施（例如，普遍 筛查、社区转诊、监测系统和以营养为重点的咨询战略）， 纳入WLVPN社区内的养育护理服务。混合III型准实验 现场内部的设计将：1）制定和实施以公平为重点的系统级干预措施， 将母婴健康和营养结合起来; 2）评估这一干预措施在减少 粮食不安全程度和/或改善孕妇及其未满18岁幼儿的健康状况 3岁，这将培养他们的潜力，使他们茁壮成长。该项目旨在告知如何 最好的多部门干预措施（母婴健康和粮食不安全干预措施）可以被整合， 促进历史上被边缘化社区的母婴健康和营养转型。