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 妇幼健康对于实现“2030 年健康人民”目标至关重要。 从孕前到童年和青春期的养育护理干预措施定义了一个人的 发展轨迹，其效益在整个生命过程中积累并促进社会正义（即 通过为子孙后代修复系统，让公平更进一步）。 导致产前、围产期和儿科服务等基本护理服务中断。 预计全球将有 100 万可预防的儿童和孕产妇死亡因极端贫困和 家庭粮食不安全（HFI；无法持续获得足够的健康食品以维持积极、健康的生活 在 COVID-19 疫情期间，美国有孩子的家庭的 HFI 增加了两倍 (~19.5%)，低收入家庭和有色人种家庭的负担过重，与此密切相关。 种族/民族不平等以及不良的母婴健康和营养结果。 作为 COVID-19 应对和恢复工作的一项重要内容，培育护理服务中的粮食安全干预措施 促进公平的可实现战略 西拉斯维加斯承诺社区 (WLVPN) 是一项可实现的战略。 历史性的针对健康社会决定因素的干预措施，以减少 COVID-19 期间的结构性种族主义 WLVPN 由 50 多个多部门合作伙伴在关键生活领域（健康、教育、就业、住房和社会正义）协调实施。 Nevada Partners, Inc.，我们与他们有着稳固且长期的合作。 干预是解决孕产妇死亡率和儿童死亡率方面普遍存在的不平等问题的独特机会和平台 粮食不安全水平，缺乏对孕产妇健康和营养的关注，因此，我们与的伙伴关系。 Nevada Partners, Inc. 在促进 WLVPN 中的母婴部分和推进 我们基于社区的参与方法将采用种族平等。 与社区共同制定整合母婴健康和营养干预措施的框架 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中心的咨询策略）经过调整和 融入 WLVPN 社区内的培育护理服务 混合型 III 准实验。 现场的设计目的是 1) 制定和实施以公平为中心的系统级干预措施 整合母婴健康和营养，并 2) 评估该干预措施在减少母婴健康方面的有效性 粮食不安全程度和/或改善孕妇及其幼儿的健康状况 3 岁，这将培养他们的潜力，使他们能够茁壮成长。 最好的多部门干预措施（妇幼健康和粮食不安全干预措施）可以整合到 促进历史社区的母婴健康和营养转型。