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: 10912278
• 负责人: Gabriela Buccini
• 金额: $ 15.86万
• 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/10912278
• 关键词: Address; COVID-19; COVID-19 pandemic; Caring; Child; Child Mortality; Child Nutrition; Childhood; Collaborations; Color; Communities; Conceptions; Development; Dietary Intervention; Education; Employment; Equity; Ethnic Origin; Family; Food; Generations; Goals; Grant; Health; Household; Housing; Human; Hybrids; Inequity; Intervention; Investments; Life; Life Cycle Stages; Link; Low income; Maternal Mortality; Maternal and Child Health; Methods; Neighborhoods; Nevada; Outcome; Pathway interactions; Perinatal; Persons; Phase; Poverty; Race; Racial Equity; Recovery; Research; Resources; Social Justice; Solid; Structural Racism; System; care coordination; care systems; child services; design; effectiveness outcome; ethnic disparity; food insecurity; food security; implementation evaluation; implementation outcomes; implementation science; implementation strategy; implementation study; marginalization; marginalized community; nutrition; prenatal; response; screening; social health determinants; social interventions; socioeconomics

Admin Supplement Grant Number: 8 U01 HD115256-02, (previous FAIN: U01OD033239) Abstract Summary Strengthening maternal and child health and nutrition is critical to achieving the Healthy People 2030 Goals. Investing in integrated nurturing care interventions from preconception through childhood 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). The 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 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 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 effort 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 in historically racial/ethnic marginalized communities in Las Vegas, Nevada. 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 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. This implementation science project is utilizing a community-based participatory approach along with a racial equity framework to co-create WITH the community the Early Responsive Nurturing Care for Food Security (EARN-FS) intervention to integrate maternal-child health and nutrition. The EARN-FS is a system-level intervention consisting of a bundle of equity-focused implementation strategies to adapt and integrate effective food security interventions – (i) universal screening for HFI, (ii) referrals to access existing health-nutrition & other nurturing care resources within WLVPN communities, and (iii) care coordination to achieve pathways for food security. This project is designed to inform how best multi-sectoral interventions (maternal-child health and food insecurity interventions) can be integrated to promote transformation in the maternal-child health and nutrition of historically marginalized communities. A three-phase mixed-methods approach will be used to achieve the major goals of this project: Phase 1 will consist of a detailed analysis of (i) contextual barriers and facilitators to integrating effective food security interventions into maternal-child nurturing care services and (ii) baseline assessment of maternal-child socioeconomic, demographic, and health needs. Phase 2 will consist of the co-creation WITH the community of a bundle of equity-focused implementation strategies to adapt and integrate the EARN-FS intervention within maternal-child nurturing care services Phase 3 will consist of assessing implementation feasibility (phases 3A & 3B) and a hybrid type III implementation study to evaluate equity-focused implementation and effectiveness outcomes, i.e., changes in levels of food insecurity of maternal-child dyads (phase 3C).

行政补充 批准号：8 U 01 HD 115256 -02，（先前FAIN：U 01 OD 033239） 抽象概括 加强孕产妇和儿童健康和营养对于实现2030年健康人目标至关重要。 投资于从孕前到童年的综合养育护理干预措施， 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 预计将有100万可预防的儿童和孕产妇死亡是由于极端贫困和家庭暴力造成的。 粮食不安全（HFI）;由于有限的食物供应， 财政资源）。在COVID-19期间，美国有孩子的家庭的HFI增加了两倍（~19.5%）， 不成比例地加重了边缘化的低收入和有色人种家庭的负担。HFI与 种族/族裔不平等以及不利的母婴健康和营养结果。整合有效食物 作为COVID-19应对和恢复工作的养育护理服务中的安全干预是一项 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 针对健康问题社会决定因素的干预措施，以减少历史上种族/族裔 内华达州拉斯维加斯的边缘化社区。WLVPN由50多个多部门合作伙伴实施 由内华达州协调的关键生活领域（健康、教育、就业、住房和社会正义） Partners，Inc.我们与他们有着坚实的合作。虽然WLVPN社会干预是一种独特的 为解决母婴死亡率和粮食不安全水平方面普遍存在的不公平现象提供了机会和平台， 缺乏对母婴健康和营养的关注。因此，我们与内华达州合作伙伴公司的合作关系。是 有利于促进妇女和儿童保健方案内的母婴组成部分，并推动执行工作， 股权研究这一科学项目的实施采用了以社区为基础的参与式方法 沿着种族平等框架，与社区共同创建早期反应养育护理， 粮食安全（EARN-FS）干预措施，以整合母婴健康和营养。EARN-FS是一个 系统一级的干预措施，包括一套注重公平的执行战略， 综合有效的粮食安全干预措施-㈠对HFI进行普遍筛查，㈡转介获得现有的 在WLVPN社区内提供保健营养和其他养育护理资源，以及（iii）护理协调， 实现粮食安全的途径。该项目旨在告知如何最好地采取多部门干预措施 （妇幼保健和粮食不安全干预措施），以促进 母婴健康和营养问题。三相混合法 方法将用于实现本项目的主要目标： 第一阶段将包括对（i）整合有效食物的背景障碍和促进因素的详细分析 安全干预纳入母婴养育保健服务，以及（二）母婴养育保健服务的基线评估 社会经济、人口和健康需求。 第二阶段将包括与社区共同创建一系列以公平为重点的实施方案， 调整和整合EARN-FS干预措施的战略 第3阶段将包括评估实施可行性（第3A和3B阶段）和混合型III 执行情况研究，以评价注重公平的执行情况和成效成果，即，变化 母亲-子女二人组的粮食不安全程度（阶段3C）。