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: 10831872
• 负责人: Gabriela Buccini
• 金额: $ 63.43万
• 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 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10831872
• 关键词: Pathways; integrate; maternal; child; health

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 妇幼保健是实现2030年健康人目标的关键。投资于集成 从先入为主到童年和青春期的养育干预定义了一个人的 在整个生命过程中积累并促进社会正义的利益的发展轨迹(即， 通过为子孙后代修复制度，使公平更进一步)。新冠肺炎大流行已经 中断基本的护理服务，如产前、围产期和儿科服务。因此，结束 预计全球将发生一百万可预防的儿童和孕产妇死亡，原因是极端贫困和 家庭粮食不安全(HFI；缺乏持续获得足够的健康食品以维持积极健康的生活 由于财政资源有限)。在新冠肺炎期间，美国有孩子的家庭高频I增加了两倍 (~19.5%)，对边缘化的低收入和有色人种家庭造成不成比例的负担。肾综合征出血热与 存在种族/族裔不平等和不利的母婴健康和营养结果。有效整合 作为新冠肺炎应对和恢复努力的养育护理服务中的粮食安全干预是一种 促进公平的可实现战略。西拉斯维加斯承诺社区(WLVPN)是一个 历史上解决健康社会决定因素的干预措施以减少新冠肺炎中的结构性种族主义 美国西南部的种族/民族边缘化社区。WLVPN由50多个关键生活领域(健康、教育、就业、住房和社会正义)的多部门合作伙伴实施，由 内华达合伙公司，我们与他们有着坚实和长期的合作关系。虽然WLVPN社交 干预措施是解决母婴死亡率和儿童死亡率不平等现象的独特机会和平台 鉴于粮食不安全的程度，它缺乏对母婴健康和营养的关注。因此，我们与 内华达合作伙伴公司在促进WLVPN内的母婴组成部分和推进 实施和公平性研究。我们以社区为基础的参与式方法将使用种族平等 与社区共同制定干预措施的框架，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，普遍的 筛查、社区转诊、监测系统和以营养为重点的咨询战略)适应和 整合到WLVPN社区内的养育护理服务中。一种III型混合动力车的准实验 现场内将设计为1)开发和实施以股权为重点的系统级别干预，以 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/或改善以下年龄以下孕妇及其幼儿的健康结果 3岁，这将培养他们的潜力，使他们能够茁壮成长。此项目旨在告知您如何 最佳的多部门干预措施(母婴健康和粮食不安全干预措施)可以整合到 促进历史上被边缘化社区的母婴保健和营养方面的变革。