Temporal trajectory and predictors of hemiplegic shoulder pain after stroke: a 12-month longitudinal clinical-ultrasound study.

According to the USDA, food insecurity is defined as limited or uncertain access to adequate food due to economic and household-level social conditions. Food insecurity can compromise the physical and emotional health of a pregnant person and the development of their fetus. In 2023, the national prevalence of food insecurity in the USA was 13·5 %. Research shows that inadequate nutrition during pregnancy can lead to increased antenatal anxiety, gestational diabetes, pregnancy-induced hypertension and overall reduced quality of life for the pregnant person. Infants born to a food-insecure mother have a higher risk for low birth weight, preterm births and developmental delays. Food insecurity is associated with poor early childhood and cognitive development and academic delays that persist into adulthood. The perinatal period – from pregnancy through postpartum – presents a critical window for both community-based (e.g. doulas, lactation consultants and social workers) and clinical (e.g. paediatricians and nurses) providers to identify and address the risks of adverse health outcomes associated with food insecurity. Providing equitable care for food-insecure pregnant people and infants can be done through the timely identification of needs, expanding opportunities to access services and coordinating care to address their needs. The Centers for Medicare and Medicaid Services (CMS) recommends the implementation of food insecurity programmes aiming at establishing screening, referrals and follow-up strategies to promote equitable care. However, the strategies outlined for addressing food insecurity are not routinely implemented in either community or clinical perinatal settings. Barriers to implementing strategies to screen, refer and follow up for food insecurity include limited provider knowledge, organisational constraints, limited time, stigma and limited funding. While many of these barriers have been identified within healthcare settings, little is known about the unique challenges faced by community-based and clinical perinatal providers. Fostering a deeper understanding of these implementation barriers is essential for improving perinatal health outcomes and advancing health equity. Therefore, this study aimed to explore the perceived barriers that community and clinical perinatal providers encounter when addressing food insecurity among the populations they serve.