Food insecurity; lack of regular access to nutritionally adequate food; during pregnancy is linked to premature births and poorer health for low-income mothers and their babies, contributing to staggering infant mortality rates in Cleveland and Cuyahoga County.
To address this critical need, a partnership between Case Western Reserve University School of Medicine (CWRU), Greater Cleveland Food Bank (GCFB), and the Community Pathways HUB (HUB) of the Better Health Partnership created a pilot program called Nourishing Beginnings (NB). The program was launched in 2022 with funding from the Vitamix and Bruening Foundations and the CWRU Clinical and Translational Science Collaboration.
Now, thanks to a $500,000 grant from the Systems for Action program of the Robert Wood Johnson Foundation (RWJF), the partnership will expand the program and study its delivery and effectiveness. At stake is one of the highest infant mortality rates in the nation, according to First Year Cleveland, a CWRU-based nonprofit dedicated to reversing that trend.
“We want to better understand not only how access to healthy foods might improve pregnancy outcomes, but also the barriers that low-income pregnant women face and the system failures that contribute to these barriers,” said Elaine Borawski, professor and vice chair of applied research in the School of Medicine’s Department of Nutrition.
Borawski, who is leading the study, said the partners also wanted to know how the program that combines a community health worker (CHW) with direct food access interventions can impact related issues such as prenatal visits, diet quality, stress, depression and reports of discrimination. , “all of which are also linked to prematurity and other health problems”.
NB connects low-income pregnant women in Cuyahoga County receiving support from a CHW through the HUB with direct access to healthy food in one of two ways: a custom-made GCFB food box delivered to their homes every two weeks or cash for groceries with personalized navigation to outlets offering healthy foods in their neighborhoods, developed by the CWRU Prevention Research Center for Healthy Neighborhoods. Participants also receive help with necessary kitchen items, easy-to-understand recipes, and nutritional information during and after pregnancy.
The use of a CHW has been shown to be an effective approach to improving health outcomes in at-risk populations in previous studies. The NB program leverages the strength of this relationship by having a CHW not only respond directly to a client’s food security and other social needs, but also serve as a trusted ally and ingenious for clients as they navigate their prenatal experiences. »
Christopher Mundorf, HUB Chief Analytics Officer, Program Co-Lead
“If this proves effective, it’s the hope that funding food-as-medicine initiatives like Nourishing Beginnings will be reimbursed by the healthcare system,” Borawski said. “With this support, the program could be distributed throughout the region and state, utilizing the rich network of Pathway HUBS and Ohio food banks.”
The grant was one of only two RWJF awarded nationally this year as part of its 2022 Systems for Action: Systems and Services Research to Build a Culture of Health call for proposals.
Investigators hypothesize that alignment of the referral and delivery system, support from a caring community health worker, and direct access to healthy foods will lead to healthier mothers and babies.
“Healthy eating during pregnancy is essential,” said Alissa Glenn, one of the program leaders and GCFB Community Nutrition Director. “And yet, many low-income pregnant women not only struggle to afford healthy, nutritious food, but often live in neighborhoods with limited healthy food options, making it difficult to obtain nutritious food. affordable, high quality and necessary during pregnancy.”
Referrals to supportive federal programs like the Supplemental Nutrition Assistance Program and Women, Infants and Children or even the food bank are helpful, Glenn said, but often don’t adequately address barriers to access to healthy food.
“What’s needed,” she said, “is a strategy that directly connects pregnant women to resources without placing an additional burden on them.”
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