Barriers and facilitators of implementing a community workshop series to mitigate maternal-child food insecurity: a mixed-methods RE-AIM evaluation

实施社区系列研讨会以缓解母婴粮食不安全问题的障碍和促进因素:一项混合方法 RE-AIM 评估

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Abstract

BACKGROUND: Community-led workshops offer promising health education models to advance maternal-child health equity by providing culturally congruent spaces for information sharing, resource access, and social support building. This study aimed to (1) document the participatory co-creation of a Community Workshop Series with topics across the Nurturing Care Framework domains (health, nutrition, early learning, security/safety, responsive caregiving) to mitigate maternal-child food insecurity, (2) evaluate CWS effectiveness in increasing participants' knowledge across the Nurturing Care Framework, and (3) identify CWS implementation barriers and facilitators. METHODS: The study employed two-phases: Phase One engaged members of a Community Advisory Board in participatory research to co-create Community Workshop Series topics based on Nurturing Care domains. Phase Two encompassed planning of Community Workshop Series implementation, training, outreach, and content development. Quantitative surveys assessed reach and effectiveness through food insecurity risk, demographics, knowledge change, and attendance barriers. Semi-structured interviews with workshop hosts underwent thematic analysis to identify barriers and facilitators across RE-AIM dimensions (Reach, Effectiveness, Adoption, Implementation, Maintenance). RESULTS: Eight workshop topics across Nurturing Care Framework domains were defined and 17 workshops were pilot. Workshops reached 87 adults and 39 children, with 46% reporting risk for food insecurity. Participants demonstrated significant changes in self-rated knowledge, with 95% indicating likely application of workshop content. Thematic analysis identified 14 sub-themes across RE-AIM dimensions, including 35 barriers (i.e., outreach limitations, attendance challenges, lack of direct services) and 34 facilitators (i.e., culturally appropriate content, on-site childcare, organizational mission alignment). CONCLUSION: AC ommunity Workshop Series with topics across the Nurturing Care Framework was successfully co-created and piloted. Participants showed significant knowledge increase after participation in the workshops. Despite implementation barriers, the community workshop series was found as a promising community level health education intervention to address maternal-child food insecurity within underserved communities.

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