Nourishing Beginnings: Addressing Food Insecurity During Pregnancy

Better Health Partnership, Greater Cleveland Food Bank, Pregnancy with Possibilities Resource Center, Village of Healing Center, United Way of Greater Cleveland, MetroHealth Medical Center

This is a pilot project designed to test the feasibility of implementing a community health worker (CHW)-led intervention to improve nutritious food access and consumption among pregnant people and to evaluate the effectiveness of this approach. The project will be conducted in partnership with the Greater Cleveland Food Bank and the Better Health Partnership Community Health Worker HUB

The Nourishing Beginnings pilot study will enroll 160 pregnant individuals (<22 weeks gestation) who are eligible to use the Partnership Community HUB (i.e., Medicaid eligible). Participants will be randomly assigned into one of two intervention arms - either direct food delivery (n=80) or small financial resources and individualized navigation support for accessing local healthy foods (n=80). The pilot will (1) assess the feasibility and allow protocol refinement; (2) assess the preliminary impact of CHW-led intervention; and (3) conduct a rigorous process evaluation of the implementation of the intervention using an effectiveness-implementation hybrid type 1 design. Dietary behavior, psychosocial health, health care utilization, and health outcomes and birth outcomes will be tracked at baseline, mid-pregnancy, and at delivery, derived from both primary and secondary data sources (i.e., Hub and claims data). Critical implementation points (referral, CHW touch points, and food delivery) will be assessed. Intervention arms will be compared to a matched comparison group derived from local claims data for the same time period.

Food Insecurity, Community Health Workers, Food Delivery, Prenatal Nutrition, Social Determinants of Health

$30 provide on gift card every two weeks until 6 weeks post delivery + neighborhood food retail navigation support.

Food box with food to feed a family of four, delivered by the Greater Cleveland Food Bank every two weeks. Based on participant preferences, includes recipes.

Provides supplemental funds to purchase healthy foods; provides choice. Includes recipes for limited budgets and assistance locating healthy food options in their specific neighborhood.

From date of NICU admission to date of discharge from NICU or death, which ever comes first, up to 100 months

From date of delivery to date of baby discharge from hospital or death, which ever comes first, up to 100 months

Inclusion Criteria: Medicaid eligible Enrolls in the CHW Hub Able to read and understand English Exclusion Criteria: -