Improving social determinants of health, such as access to nutritious food, is crucial for achieving health equity. Nutrition insecurity, especially during pregnancy and postpartum, can lead to poor maternal and birth outcomes. Food is Medicine (FIM) programs, which integrate food into the health care system to prevent or manage disease, have the potential to improve nutrition insecurity, but research about perinatal FIM programs is limited. The purpose of this study was to explore perceptions of public health impacts of perinatal FIM programs from the perspectives of both program implementers and program supporters and implementation strategies used to enhance program adoption, implementation, and maintenance. Qualitative data were collected through semi-structured interviews. The interview guide was based on the Reach, Effectiveness, Adoption, Implementation, Maintenance framework. Program implementers (n = 16) and program supporters (n = 20) were recruited across the United States through purposive sampling in 2022 and 2023. Data were analyzed using deductive thematic analysis and an iterative feedback loop with the project partner. Interviews were completed with program implementers and program supporters and generated meaning units (n = 1,942), which were coded into themes aligned with each Reach, Effectiveness, Adoption, Implementation, Maintenance dimension. Perinatal FIM programs reached multiple priority populations who were mainly recruited through health care systems. Effectiveness measures typically included nutrition patterns and practices, as well as return on investment. Motivations for adopting programs primarily included partnerships and connections, financing, and policies and laws. Program components varied and were adapted to meet participants and setting needs. Policy, evidence, funding, and partnerships could lead to program maintenance. Implementation strategies applied by the program supporters included financial strategies and infrastructure changes. There is a need to identify the core functions and adaptable forms of perinatal FIM programs, which could lead to identification of standard evaluation metrics. This could result in greater uptake by potential delivery agents, increased funding and policy support, and enhanced benefits for perinatal population experiencing health disparities.

中文翻译：

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围产期“食物即药物”计划的实施和影响：定性研究

改善健康的社会决定因素，例如获得营养食品的机会，对于实现健康公平至关重要。营养不安全，特别是在怀孕和产后期间，可能导致孕产妇和分娩结果不佳。食品即药物 (FIM) 计划将食品纳入医疗保健系统以预防或管理疾病，有可能改善营养不安全状况，但有关围产期 FIM 计划的研究有限。本研究的目的是从项目实施者和项目支持者的角度探讨围产期 FIM 项目对公共卫生影响的看法，以及用于加强项目采用、实施和维护的实施策略。通过半结构化访谈收集定性数据。访谈指南基于覆盖范围、有效性、采用、实施、维护框架。2022 年和 2023 年通过有目的抽样在美国招募了项目实施者 (n = 16) 和项目支持者 (n = 20)。使用演绎主题分析和与项目合作伙伴的迭代反馈循环对数据进行了分析。对计划实施者和计划支持者进行了访谈，并生成了意义单元 (n = 1,942)，这些意义单元被编码为与每个覆盖范围、有效性、采用、实施、维护维度相一致的主题。围产期 FIM 计划覆盖了多个重点人群，这些人群主要是通过卫生保健系统招募的。有效性衡量标准通常包括营养模式和实践以及投资回报。采用计划的动机主要包括伙伴关系和联系、融资以及政策和法律。计划的组成部分多种多样，并进行了调整，以满足参与者和环境的需求。政策、证据、资金和伙伴关系可以促进项目的维持。计划支持者采用的实施策略包括财务策略和基础设施变革。需要确定围产期 FIM 计划的核心功能和适应性形式，这可能会导致标准评估指标的确定。这可能会导致潜在的分娩机构更多地采用这种方法，增加资金和政策支持，并提高经历健康差异的围产期人口的福利。