Rural Health Care Services Outreach Grant Program - Track: Special track Special track focus: Maternal Health Target population: The Healthy Foods Healthy Births project will serve pregnant and postpartum people and their infants in rural communities in Orange and Windsor Counties, VT and Grafton and Sullivan Counties, NH. This project focuses on low-income and underserved people who experience disproportionately worse food insecurity and maternal and child health outcomes, including racial/ethnic minorities, Medicaid patients, and those in our most rural communities. Goal and objectives: The goal of this project is to improve food and nutrition security and maternal, neonatal, and infant health outcomes through a coordinated Food is Medicine (FIM) service and breastfeeding support for rural perinatal patients. Our objectives are to: 1. Create shared referral pathways and provide medically tailored meals to at least 320 pregnant and postpartum patients experiencing food insecurity and other health and social needs across consortium member sites by Apr 30, 2029. 2. Provide at least 400 pregnant and postpartum patients with shared, standardized and culturally and linguistically appropriate nutrition education resources (healthy eating info, breastfeeding support, culinary skill building, etc.) and referrals to community-based services (food pantries, WIC) by Apr 30, 2029. 3. Provide supported in-home lactation counseling in the patient’s preferred language to 40 pregnant and postpartum patients per year through a shared services model across our consortium members. Approach: We will implement an evidence-informed Food is Medicine (FIM) model adapted for the perinatal period. FIM approaches provide food-based nutrition services integrated into health care. There is growing interest at state and federal levels for the use FIM to improve health and increasing evidence for adapting these approaches to address food insecurity and poor nutrition for pregnant and postpartum patients. We will create a coordinated system with shared workflows and referral processes to more consistently and equitably provide FIM services across our care continuum. Our FIM approach will include medically tailored meals, nutrition education, food and nutrition resources, and breastfeeding support during the perinatal period. Outcomes: Our expected outcomes among pregnant and postpartum people and their infants in rural target communities include: reduced food insecurity, improved diet quality, improved pregnancy outcomes (depression, healthy weight gain, gestational diabetes, anemia), improved birth outcomes (term birth and birth weight), reduced postpartum depression, and increased breastfeeding initiation and duration. Capacity: Our consortium members have longstanding relationships and have collaborated to improve food security and maternal health. Our members include: Mary Hitchcock Memorial Hospital, Little Rivers Health Care, and New London Hospital/Newport Health Center, all of which serve rural underserved pregnant and postpartum patients. Our project team members have led the development of food support programs at all consortium member sites. Our project leadership team has formed and participated in several healthcare-community consortiums including the HRSA-funded North Country Maternity Network, and the NH Perinatal Quality Collaborative. Together, our consortium members have substantial expertise and experience implementing programs and collaborating to meet the needs of underserved pregnant and postpartum patients in our rural region. MHMH qualifies for the HPSA, MUC, and the Focus on Primary Care and Wellness and Prevention Strategies funding preferences because 1) all Consortium Members are in designated HPSAs, 2) Consortium Members serve designated Medically Underserved Areas, and 3) the project focuses on perinatal care as de facto primary care and on food and nutrition strategies.
