Healthcare-based interventions to address food insecurity during pregnancy: a systematic review

Merchant, Tazim; Roytman, Maya V.; DiTosto, Julia D.; Beestrum, Molly; Niznik, Charlotte M.; Yee, Lynn M.

doi:10.1016/j.ajogmf.2023.100884

Cited by 4 publications

(7 citation statements)

References 29 publications

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“…51 The consolidated reporting criteria for qualitative studies were used to design and report this study. 52 Ethics approval was granted by Royal Women's Hospital (RWH) Hospital HREC (02773/ [22][23][24][25][26][27][28][29][30][31][32][33] and Deakin University HREC (2023-016).…”

Section: Methodsmentioning

confidence: 99%

“…24 There are also few interventions that address food insecurity during pregnancy within healthcare settings, beyond the screening process. [25][26][27] Government-level food assistance programmes have been established in some high-income countries, to improve dietary quality of priority groups such as pregnant and postpartum women. The Special Supplemental Nutrition Program for women, infants and children (WIC) in the United States 28 and the Healthy Start program in the United Kingdom 29 provide access to nutritious foods and micronutrient supplements to low-income pregnant women who have been deemed to be at nutritional risk.…”

Section: Introductionmentioning

confidence: 99%

“…A recent systematic review found seven published studies investigating screening procedures within the antenatal healthcare setting, comprising four screening tools, with varying methods of implementation and minimal evaluation of effectiveness 24 . There are also few interventions that address food insecurity during pregnancy within healthcare settings, beyond the screening process 25–27 …”

Section: Introductionmentioning

confidence: 99%

“…37 Interventions that are 'internally' based in a healthcare setting are considered a viable option to screen and address food insecurity, to complement a referral to these established 'external' food assistance programmes. 27 Healthcare-based interventions are considered valuable by clinicians as well as patients, based on research in general, nonpregnancy healthcare settings. 25,[38][39][40][41] However, the acceptability and preferences of pregnant women regarding food insecurity screening and support within antenatal healthcare are poorly understood.…”

Section: Introductionmentioning

confidence: 99%

“…Interventions that are ‘internally’ based in a healthcare setting are considered a viable option to screen and address food insecurity, to complement a referral to these established ‘external’ food assistance programmes 27 . Healthcare‐based interventions are considered valuable by clinicians as well as patients, based on research in general, nonpregnancy healthcare settings 25,38–41 .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Views and preferences of food‐insecure pregnant women regarding food insecurity screening and support within routine antenatal care

Zinga,

van der Pligt,

McKay

2024

Health Expectations

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BackgroundFood insecurity is a public health concern that has profound impact on physical and mental health, and on social well‐being. Pregnancy is a period in which food insecurity is likely to be particularly deleterious, due to the serious impact on both mother and child. Food insecurity is not routinely screened in antenatal healthcare settings, and the preferences of pregnant women regarding food insecurity screening and support are poorly understood. This study aimed to determine the views and preferences of food‐insecure pregnant women regarding food insecurity screening and support within antenatal healthcare.MethodsThis qualitative descriptive study used face‐to‐face semi‐structured interviews, conducted in February and March 2023, to gain the views of purposively sampled food‐insecure, pregnant women in Melbourne, Australia. Food insecurity was evidenced by an affirmative response to at least one of three assessment items in a screening questionnaire. Qualitative content analysis was conducted to summarise the views and preferences of women.ResultsNineteen food‐insecure pregnant women were interviewed. Three themes were identified: (1) acceptability of being screened for food insecurity, (2) concerns about the consequences of disclosure and (3) preferences regarding food insecurity screening and supportive strategies that could be offered within an antenatal healthcare setting.ConclusionWomen were accepting of food insecurity screening being conducted within routine healthcare. Women identified potential benefits of routine screening, such as feeling supported by their clinician to have a healthy pregnancy and less pressure to voluntarily ask for food assistance. Women gave suggestions for the implementation of food insecurity screening to optimise their healthcare experience, maintain their dignity and feel able to disclose within a safe and caring environment. These results indicate that food insecurity screening in the antenatal setting is likely to have support from pregnant women and is urgently needed in the interest of promoting optimal nutrition for women and children.Patient ContributionPregnant women with lived experience of food insecurity were purposively sampled to obtain their insights regarding screening and support within a pregnancy healthcare setting. Member‐checking occurred following data collection, whereby all participants were offered the opportunity to review their interview transcript to ensure trustworthiness of the data.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Views and preferences of food‐insecure pregnant women regarding food insecurity screening and support within routine antenatal care

Zinga,

van der Pligt,

McKay

2024

Health Expectations

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Trends, Prevalence, and Risk Factors of Food Insecurity Among Pregnant and Postpartum Women in the United States: Findings from the 2019–2021 National Health Interview Survey

Ujah,

Olaore,

Ogbu

et al. 2023

Journal of Women's Health

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Food security status and cardiometabolic health among pregnant women in the United States

Murkey,

Gaston,

Payne

et al. 2024

Front. Glob. Womens Health

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IntroductionPregnant women and their offspring are particularly vulnerable to food insecurity and its adverse effects during critical periods of fetal development. Racially/ethnically minoritized women in the United States (US) who are pregnant are additionally burdened by food insecurity, which may exacerbate cardiovascular health (CVH) disparities. Despite heightened social vulnerability, few studies have employed an intersectional framework, including race and gender, to assess the food insecurity and CVH relationship.MethodsWe used 2012–2018 and 2020 National Health Interview Survey data among US pregnant women aged 18–49 years old (N = 1,999) to assess the prevalence of food insecurity status by race/ethnicity and to investigate household food security status in relation to ideal CVH, using a modified ideal CVH (mICVH) metric. We categorized food security status as “very low/low”, “marginal”, or “high”. To assess mICVH, a summary score of 7 clinical characteristics and health behaviors was dichotomized as yes [(7)] vs. no [<7]. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of associations between food security status and mICVH were estimated using Poisson regression with robust variance. Models were adjusted for age, household income, educational attainment, geographic region, marital status, alcohol consumption, survey year, and race/ethnicity (in overall model).ResultsThe mean age ± standard error was 29.0 ± 0.2 years. Among pregnant women, 12.7% reported “very low/low”, 10.6% reported “marginal”, and 76.7% reported “high” food security. “Very low/low” food security prevalence was higher among NH-Black (16.2%) and Hispanic/Latina (15.2%) pregnant women compared to NH-White (10.3%) and NH-Asian (3.2%) pregnant women. The mICVH prevalence was 11.6% overall and 14.5% for NH-White, 4.1% for NH-Black, 5.0% for Hispanic/Latina, and 26.7% for NH-Asian pregnant women. Among all pregnant women, “very low/low” and “marginal” vs. “high” food security status was associated with a lower prevalence of mICVH {[PRvery low/low = 0.26 (95% CI: 0.08–0.75)]; [PRmarginal = 0.47 (95% CI: 0.23 −0.96)]}.ConclusionHousehold food insecurity was higher among pregnant women in minoritized racial/ethnic groups and was associated with lower mICVH prevalence. Given the higher burden of food insecurity among minoritized racial/ethnic groups, food security may be an important intervention target to help address disparities in poor CVH among pregnant women.

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Healthcare-based interventions to address food insecurity during pregnancy: a systematic review

Cited by 4 publications

References 29 publications

Views and preferences of food‐insecure pregnant women regarding food insecurity screening and support within routine antenatal care

Views and preferences of food‐insecure pregnant women regarding food insecurity screening and support within routine antenatal care

Trends, Prevalence, and Risk Factors of Food Insecurity Among Pregnant and Postpartum Women in the United States: Findings from the 2019–2021 National Health Interview Survey

Food security status and cardiometabolic health among pregnant women in the United States

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