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Addressing Food Insecurity in Pregnancy

3 de novembro de 2026 atualizado por: Women and Infants Hospital of Rhode Island

The goal of this observational study is to learn if providing meal kits during pregnancy is helpful for people experiencing food insecurity. The study will also learn about participants' experiences with receiving meal kits during pregnancy and after giving birth. The main questions it aims to answer are:

  • Does receiving meal kits affect pregnancy and health outcomes?
  • How do participants experience and use the meal kits?
  • What benefits or challenges do participants report when receiving the meal kits?

Participants who screen positive for food insecurity during routine prenatal care will be offered weekly meal kits through Meals on Wheels Rhode Island (MoWRI). Participants who accept the meal program will receive meal kits throughout pregnancy and through two weeks after giving birth. Participants who do not enroll in the meal program will continue to receive their usual prenatal care and referrals to food and nutrition resources.

Participants will:

  • Complete surveys about their health, food access, and experiences with the meal program.
  • Continue their regular prenatal care.
  • Some participants will be invited to complete an interview about their experiences.

Visão geral do estudo

Status

Ainda não está recrutando

Condições

Intervenção / Tratamento

Descrição detalhada

Food insecurity during pregnancy is associated with adverse maternal and perinatal outcomes and may be an important modifiable social determinant of health. This mixed-methods observational study will evaluate the feasibility, acceptability, and preliminary outcomes associated with providing meal support to pregnant persons experiencing food insecurity who receive prenatal care at the Women & Infants Hospital of Rhode Island Obstetrics and Gynecology Care Center (OGCC).

All pregnant persons receiving prenatal care at the OGCC are routinely screened for food insecurity as part of social determinants of health screening. Screening may be conducted using the clinic's standard screening language or the Hunger Vital Sign, a validated two-question screening tool derived from the U.S. Household Food Security Survey Module.

  1. "Within the past 12 months we worried whether our food would run out before we got money to buy more."
  2. "Within the past 12 months the food we bought just didn't last and we didn't have money to get more."

A response of "sometimes true" or "often true" to either or both questions is considered a positive screen for food insecurity.

Individuals who screen positive for food insecurity during a routine prenatal visit, including prenatal intake, new obstetric visits, new high-risk appointments, or other obstetric follow-up visits, will be offered enrollment in Meals on Wheels Rhode Island (MoWRI). Participants who agree to participate in the meal delivery program will comprise the intervention group. Their contact information will be provided to MoWRI, which will confirm individual and/or household meal needs and arrange delivery of weekly meal kits throughout pregnancy through two weeks postpartum.

Participants who decline or do not enroll in the MoWRI meal program for any reason will comprise the usual-care group. These participants will continue to receive standard prenatal care, including routine nutrition counseling and referrals to community resources such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Supplemental Nutrition Assistance Program (SNAP), and other resources available through the OGCC.

Assignment to the intervention or usual-care group will not be randomized. Group assignment will be determined by the participant's decision to accept or decline enrollment in the MoWRI meal program. Participants in both groups will otherwise receive the same routine prenatal medical care, with medical problems documented and managed according to standard clinical practice.

A mixed-methods approach will be used to evaluate participant outcomes and experiences. Quantitative data will be collected through participant surveys and abstraction of relevant information from the medical record. Qualitative data will be collected through participant interviews exploring experiences with food insecurity, the meal program, prenatal care, and perceived benefits or challenges associated with the intervention. Quantitative and qualitative findings will be analyzed in parallel and integrated to provide a comprehensive assessment of the intervention and participant experiences.

Tipo de estudo

Observacional

Inscrição (Estimado)

700

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Estude backup de contato

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos a 50 anos (Adulto)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Fêmea

Método de amostragem

Amostra Não Probabilística

População do estudo

All pregnant persons receiving prenatal care at the OGCC are screened for food insecurity using either the clinic's standard verbiage during the routine social determinants of health screening or the "Hunger Vital Sign" during their routine prenatal visits (including their prenatal intake visit, new OB visit, new High-Risk appointments, or other OB follow up visits). Those who screen positive during one of these visits will be offered enrollment into MoWRI's supplemental nutrition program and this study. Patient who choose to receive meals through MoWRI can opt out of participation in the study. Patients who elect not to receive meals through MoWRI are still eligible to participate in the study.

Descrição

Inclusion Criteria:

  • Pregnant persons aged 18-50 years.
  • Receiving prenatal care at the Women & Infants Hospital of Rhode Island (WIH) Obstetrics & Gynecology Care Center (OGCC).
  • Screen positive for food insecurity.
  • Able to give informed consent (interpreter services will be offered for non-English speakers).
  • Planning to continue care and deliver at WIH.

Exclusion Criteria:

  • Plans to relocate or transfer prenatal care outside OGCC before delivery.
  • Medical contraindications that would severely alter dietary intake (as assessed by clinician).

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Modelos de observação: COHORT
  • Perspectivas de Tempo: PROSPECTIVE

Coortes e Intervenções

Grupo / Coorte
Intervenção / Tratamento
Usual Care

Participants identified as food insecure and referred to Social Work for standard assistance.

Intervention with Meal Supplementation

Participants identified as food insecure and referred to meal supplementation program, based on program availability.

Weekly deliveries of supplemental meals to pregnant persons and their households from enrollment until two weeks postpartum.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Qualitative perceptions of nutritional support and dietary quality among program participants
Prazo: Within 12 months following completion of the nutritional intervention

Assessment of pregnant patients' experiences, program satisfaction, barriers to food access, and perceived changes in dietary quality resulting from the Meals on Wheels Rhode Island program. Data will be collected via semi-structured qualitative interviews or focus groups with the intervention group. Eligible participants include those who completed the nutritional intervention prior to the interview date. Text data will be transcribed and analyzed using thematic analysis.

Within 12 months following completion of the nutritional intervention
Proportion of participants experiencing any maternal medical complication
Prazo: From enrollment through delivery (up to 42 weeks of gestation)

A composite clinical endpoint evaluating overall maternal health complications. A participant will be counted once if they develop at least one of the following clinically diagnosed conditions: gestational diabetes, anemia, chronic hypertension, pulmonary hypertension, gestational hypertension, preeclampsia, or eclampsia. Rates will be compared between the intervention group (receiving meal delivery) and the control group (not receiving meals).

From enrollment through delivery (up to 42 weeks of gestation)

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Proportion of participants experiencing delivery-related complications
Prazo: At delivery (up to 42 weeks of gestation)

The percentage of participants who experience at least one of the following binary (yes/no) labor and delivery events: mode of delivery categorized as cesarean section (vs. vaginal delivery), placental complications (e.g., abruption or previa), clinically documented maternal infections during labor, precipitous labor and delivery (expulsion of the fetus within 3 hours of regular contractions), or an umbilical cord complication.

At delivery (up to 42 weeks of gestation)
Gestational age at delivery
Prazo: At delivery (up to 42 weeks of gestation)

Gestational age at delivery, measured in completed days.

At delivery (up to 42 weeks of gestation)
Proportion of neonates with breech or fetal malpresentation
Prazo: At delivery (up to 42 weeks of gestation)

The percentage of neonates presenting in a breech position or other non-vertex fetal malpresentation (yes/no) documented by the clinical team at the time of delivery.

At delivery (up to 42 weeks of gestation)
Change from baseline in maternal depression symptoms
Prazo: Baseline (Prenatal Intake or New OB visit, whichever comes first) to approximately 6 weeks postpartum

This outcome tracks maternal mental health metrics over time, comparing the intervention group to the control group. It measures depression symptoms using the Patient Health Questionnaire-9 (PHQ-9) total score (range 0-27, higher scores indicate worse symptoms).

Baseline (Prenatal Intake or New OB visit, whichever comes first) to approximately 6 weeks postpartum
Neonate birth weight
Prazo: At birth (up to 42 weeks of gestation)

Neonate birth weight, measured continuously in grams.

At birth (up to 42 weeks of gestation)
Apgar scores
Prazo: 1, 5, and 10 minutes after birth

Apgar scores assessed at 1, 5, and 10 minutes after birth. Each score is measured on a standardized scale from 0 to 10, with higher scores indicating better clinical transition.

1, 5, and 10 minutes after birth
Change in maternal weight from baseline
Prazo: Baseline (Prenatal Intake or New OB visit, whichever comes first) to approximately 6 weeks postpartum

This outcome tracks maternal gestational weight gain (measured in kilograms) over time, comparing the intervention group to the control group.

Baseline (Prenatal Intake or New OB visit, whichever comes first) to approximately 6 weeks postpartum
Proportion of participants with a preterm delivery
Prazo: At delivery (up to 42 weeks of gestation)

The percentage of participants who experience a live birth prior to 37 completed weeks of gestation (less than 259 days). Gestational age will be determined based on the first day of the last menstrual period and confirmed by early ultrasound dating. Rates will be compared between the intervention group (receiving MoWRI meal delivery) and the concurrent control group (not receiving meals).

At delivery (up to 42 weeks of gestation)

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Colaboradores

Investigadores

  • Investigador principal: Janet Lefkowitz, DO, Women & Infants Hospital

Publicações e links úteis

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Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

1 de novembro de 2026

Conclusão Primária (Estimado)

1 de janeiro de 2029

Conclusão do estudo (Estimado)

1 de janeiro de 2029

Datas de inscrição no estudo

Enviado pela primeira vez

19 de agosto de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

3 de novembro de 2026

Primeira postagem (Real)

5 de novembro de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

5 de novembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

3 de novembro de 2026

Última verificação

1 de agosto de 2026

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • WIH-1921808

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Descrição do plano IPD

Individual participant data will not be shared with researchers outside of the study team. Study data will include information obtained from medical records, participant-completed surveys, and qualitative interviews, including demographic, clinical, pregnancy, delivery, neonatal, and survey data. Interview transcripts will contain participants' open-ended responses to semi-structured interview questions. Data will be stored securely and access will be limited to authorized members of the research team. Because the study collects sensitive health and personal information, IPD will not be made available for sharing outside the institution. Any future data sharing or transfer outside the institution would require appropriate institutional and IRB approval and applicable data-sharing agreements and privacy protections.

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .