Providers at Penn Medicine are seeking to improve maternal health through a program that helps pregnant women experiencing food insecurity gain access to the food they need.
The program, dubbed Food for Health, pairs nursing school students with community health workers to assess patients for food insecurity and connect them to programs that provide healthy foods. Food for Health aims to improve maternal health outcomes among high-risk Black, Indigenous and People of Color patients who have diabetes.
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Carreno and Jessie Reich, Penn Medicine's director of patient experience, started the project in January 2022 with the help of a grant from Penn's Nursing Innovation Accelerator. Last week, it was one of four programs selected to receive an IBX clinical care innovation grant, which are awarded to projects that improve the quality and delivery of health care in the Philadelphia region.
The latest grant will help expand the community health worker side of the program, Carreno said.
"Having this relationship-based care with community health workers sometimes can help to support patients in a way that providers can't," said Sofia Carreno, a registered nurse and community engagement specialist who co-leads the Food for Health program. "They're more trusted among patients, oftentimes, and often have some shared lived experiences."
Food insecurity, which impacts nearly 1 in 4 Americans, can lead to anemia, low birth weight and death. Pregnant women who have diabetes are at higher risk of preeclampsia, fetal growth disturbances and preterm delivery. And Black people are more likely to be diagnosed with diabetes and die from the chronic condition.
There also are wide racial disparities in maternal health. According to a maternal mortality report released by the Philadelphia Dept. of Public Health in 2020, Black women made up 43% of births in the city between 2013 and 2018, but accounted for 73% of pregnancy-related deaths.
Improving maternal health outcomes requires a multifaceted solution, Carreno said, like providing access to healthy foods in addition to medications and doctor's visits.
"There are a lot of factors that can prevent successful pregnancy and we want to be able to address it before anything is exacerbated during the postpartum period," Carreno said.
As part of the Food for Health program, nursing students help determine the specific food needs of patients, like low-sodium or low-sugar diets. The community health workers then connect the patients to food access programs in their neighborhoods. Patients also can receive referrals to HUP Harvest, the food pantry at the Hospital of the University of Pennsylvania, which they can visit before or after prenatal appointments.
Through these connections, Food for Health aims to increase food access and thereby improve the city's mortality and morbidity rates. The program began through HUP Harvest, which provides food staples to HUP patients experiencing food insecurity. Through the success of that program, Carreno said, she wanted to build relationships with patients to keep them healthy outside of the hospital.
Carreno said Food for Health helps nursing students by teaching them how to ask patients about food access, housing and other non-medical needs – training that many providers don't offer. But these issues can play a large role in shaping health outcomes.
"This is a program very much rooted in looking upstream at how we prepare our health care providers, the future generations, and looking at not just nursing, but looking at how our providers are in even interacting with each other," Carreno said.
The other three programs to receive IBX clinical care innovation grants include a Jefferson Health project to improve access to opioid use disorder medications via telemedicine, a Penn Medicine project to help people with recurrent urinary tract infections reduce the use of antibiotics, and a Temple Health project that integrates clinical care and social resources for cancer patients in North Philly.