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Food insecurity is widespread in the United States. The COVID-19 pandemic intensified the need for food assistance and created opportunities for collaboration among historically-siloed organizations. Research has demonstrated the importance of coalition building and community organizing in Policy, Systems, and Environmental (PSE) change and its potential to address equitable access to food, ultimately improving population health outcomes. In New Haven, community partners formed a coalition to address systems-level issues in the local food assistance system through the Greater New Haven Coordinated Food Assistance Network (CFAN). Organizing the development of CFAN within the framework of Collaborating for Equity and Justice (CEJ) reveals a new way of collaborating with communities for social change with an explicit focus on equity and justice. A document review exploring the initiation and growth of the network found that 165 individuals, representing 63 organizations, participated in CFAN since its inception and collaborated on 50 actions that promote food access and overall health. Eighty-one percent of these actions advanced equitable resource distribution across the food system, with forty-five percent focused on coordinating food programs to meet the needs of underserved communities. With the goal of improving access to food while addressing overall equity within the system, the authors describe CFAN as a potential community organizing model in food assistance systems.

Background. Food insecurity, affecting approximately 10% of the U.S. population, with up to 40% or higher in some communities, is associated with higher rates of chronic conditions and inversely associated with diet quality. Nutrition interventions implemented at food pantries are an effective strategy to increase healthy food choices and improve health outcomes for people experiencing food and nutrition insecurity. Supporting Wellness at Pantries (SWAP), a stoplight nutrition ranking system, can facilitate healthy food procurement and distribution at pantries. Purpose. Guided by the RE-AIM Framework, this study assesses the implementation and outcomes of SWAP as nutritional guidance and institutional policy intervention, to increase procurement and distribution of healthy foods in pantries. Method. Mixed-methods evaluation included observations, process forms, and in-depth interviews. Food inventory assessments were conducted at baseline and 2-year follow-up. Results. Two large pantries in New Haven, Connecticut, collectively reaching more than 12,200 individuals yearly, implemented SWAP in 2019. Implementation was consistent prepandemic at both pantries. Due to COVID-mandated distribution changes, pantries adapted SWAP implementation during the pandemic while still maintaining the “spirit of SWAP.” One pantry increased the percentage of Green foods offered. Challenges to healthy food distribution are considered. Discussion. This study has implications for policy, systems, and environmental changes. It shows the potential for SWAP adoption at pantries, which can serve as a guide for continued healthy food procurement and advocacy. Maintaining the “spirit of SWAP” shows promising results for food pantries looking to implement nutrition interventions when standard practice may not be possible.

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Objectives Little is known about how to promote high-quality, person-centered breastfeeding care for women of color. We sought to understand breastfeeding care experiences among Latina women to inform the co-design of quality improvement interventions. Methods We conducted in-depth interviews with 21 Latina women with low incomes in Connecticut about their breastfeeding care experiences during prenatal, birth, and postpartum visits and ways to improve care experiences. We conducted a thematic analysis and mapped results to the WHO quality of care framework for maternal and newborn health. Results Most women received little or no breastfeeding information during prenatal visits and reported that providers rushed visits. Yet, women wanted to learn about breastfeeding before birth and valued spending quality time with providers, particularly when they asked open-ended questions about breastfeeding that promoted discussion. Women emphasized that respectful breastfeeding care requires providers be attentive to their needs and preferences, especially during birth care. While most women appreciated birth care nurses who answered breastfeeding questions and responded to requests (e.g., for breast pumps), a few felt disrespected when nurses ignored requests for their infants to be brought to them and pressured women to formula feed against their wishes. Women reported that lactation consultants (LCs) offered encouragement, though LCs were often unavailable when needed. After discharge, some women felt discouraged because providers did not follow up to offer breastfeeding support. Among women who had negative experiences, many still strove to meet their breastfeeding goals; a few chose to not use postpartum and primary care services as result of negative experiences. At the provider level, women recommended that providers build relationships and trust with women by engaging in breastfeeding conversations. They also recommended systems level changes, including longer prenatal visits, continuity of breastfeeding care, culturally responsive providers who speak Spanish and look like them, provision of breastfeeding peer counselors, and timely access to LCs. Conclusions Multi-level changes recommended by Latina women should be prioritized in efforts to improve breastfeeding care quality. Funding Sources NIH/NHLBI K12HL138037; CDC U48DP006380-02-00.

Two-part s-possessives such as the dad’s kid’s bike admit at least two distinct interpretations: the dad has a kid who has a bike, or the dad has a bike that is made for kids. We propose that the former interpretation derives from recursively embedding DP-possessives, and the latter from representing kid’s bike as a generic NP-possessive. Accordingly, in the right context, two-part s-possessives are fully ambiguous for adults between ‘recursive’ and ‘generic’ readings. These readings can be disambiguated syntactically. Consider the difference in meaning when we insert a relative clause and extract the constituent kid’s bike — the kid’s bike that is the dad’s — versus when we extract the head noun bike — the bike that is the dad’s kid’s. Our story-based experiment demonstrates that 4-7-year-olds (N=79) and adults (N=68) strongly favor (~80%) the generic interpretation of phrases like the kid’s bike that is the dad’s, as the A-over-A constraint blocks the extraction of a DP-possessive out of a recursive DP. Similarly, adults show a strong preference (~80%) for recursive interpretations of phrases like the bike that is the dad’s kid’s, as the A-over-A constraint blocks the extraction of the head noun bike out of the generic NP-possessive kid’s bike. However, 4-5-year-olds admit generic readings of these recursive phrases 54% of the time; it is not until 6 or 7 years that children show an adult-like preference for the recursive interpretation (~80%). These data support two complementary claims. First, that recursive possessives are acquired late on account of their syntax, and second that children, like adults, represent generic possessives under a different syntactic node than regular possessives.