To characterize optimal strategies for screening for social determinants of health (SDOH) among children, the authors performed a cross-sectional study of parents and adolescents ages ≥13 years in a community health center. Participants were queried about how they prefer to receive information about social needs resources and 2 screening instruments were compared: Well Child Care, Evaluation, Community Resources, Advocacy, Referral, Education (WE CARE) and Accountable Health Communities (AHC). In July 2019, 154 parents and 21 adolescents were surveyed. Surveys were administered via tablet and required 5.6 minutes (standard deviation [SD] 3.9 minutes) for parents and 3.9 minutes (SD 1.4 minutes) for adolescents to complete. Parents identified technology (text message, email) and informational printouts as preferred mechanisms for information receipt (58% and 32% of participants, respectively); adolescents preferred text message (57%) and printouts (19%). Few (<10% overall) preferred in-person consultation with a care coordinator. Adolescent/parent pairs (n = 19 pairs) agreed, on average across SDOH, 82% of the time for WE CARE and 85% for AHC. AHC elicited more positive screens than WE CARE for housing insecurity (12% of parents versus 7%) and food insecurity (47% versus 16%) but fewer positive screens than WE CARE for difficulties paying for utilities (27% versus 39%). Routine screening for SDOH in children requires 2–3 minutes per screening instrument. Screening can target parents of young children and either adolescents themselves or their parents. Families prefer to receive information about meeting social needs via technologically-based methods as opposed to in-person consultation with enabling services providers.

Food insecurity is widespread in the United States. The COVID-19 pandemic intensified the need for food assistance and created opportunities for collaboration among historically-siloed organizations. Research has demonstrated the importance of coalition building and community organizing in Policy, Systems, and Environmental (PSE) change and its potential to address equitable access to food, ultimately improving population health outcomes. In New Haven, community partners formed a coalition to address systems-level issues in the local food assistance system through the Greater New Haven Coordinated Food Assistance Network (CFAN). Organizing the development of CFAN within the framework of Collaborating for Equity and Justice (CEJ) reveals a new way of collaborating with communities for social change with an explicit focus on equity and justice. A document review exploring the initiation and growth of the network found that 165 individuals, representing 63 organizations, participated in CFAN since its inception and collaborated on 50 actions that promote food access and overall health. Eighty-one percent of these actions advanced equitable resource distribution across the food system, with forty-five percent focused on coordinating food programs to meet the needs of underserved communities. With the goal of improving access to food while addressing overall equity within the system, the authors describe CFAN as a potential community organizing model in food assistance systems.

Background. Food insecurity, affecting approximately 10% of the U.S. population, with up to 40% or higher in some communities, is associated with higher rates of chronic conditions and inversely associated with diet quality. Nutrition interventions implemented at food pantries are an effective strategy to increase healthy food choices and improve health outcomes for people experiencing food and nutrition insecurity. Supporting Wellness at Pantries (SWAP), a stoplight nutrition ranking system, can facilitate healthy food procurement and distribution at pantries. Purpose. Guided by the RE-AIM Framework, this study assesses the implementation and outcomes of SWAP as nutritional guidance and institutional policy intervention, to increase procurement and distribution of healthy foods in pantries. Method. Mixed-methods evaluation included observations, process forms, and in-depth interviews. Food inventory assessments were conducted at baseline and 2-year follow-up. Results. Two large pantries in New Haven, Connecticut, collectively reaching more than 12,200 individuals yearly, implemented SWAP in 2019. Implementation was consistent prepandemic at both pantries. Due to COVID-mandated distribution changes, pantries adapted SWAP implementation during the pandemic while still maintaining the “spirit of SWAP.” One pantry increased the percentage of Green foods offered. Challenges to healthy food distribution are considered. Discussion. This study has implications for policy, systems, and environmental changes. It shows the potential for SWAP adoption at pantries, which can serve as a guide for continued healthy food procurement and advocacy. Maintaining the “spirit of SWAP” shows promising results for food pantries looking to implement nutrition interventions when standard practice may not be possible.

Background: Despite effective communication being critical to providing person-centered care, little is known of effective communication in breastfeeding care from the perspective of Latina women in the United States (U.S.) who experience breastfeeding inequities. Our study identifies (a) what constitutes effective communication and (b) which provider practices promote or hinder effective communication in the context of breastfeeding care delivered within the pregnancy, delivery, and postpartum periods to Latina women in the U.S. Methods: We analyzed data from a community-engaged study that included semi-structured interviews in English or Spanish with Latina women from low-income households in Connecticut. Women were asked about communication experiences with healthcare providers during their breastfeeding care across the pregnancy, delivery, and postpartum periods. Reflexive thematic analysis was used to analyze the data and develop a framework depicting key themes. Results: Of the 21 women interviewed, approximately half were 25–31 years of age (48%), were born outside of the U.S. (52%), and most had prior children (86%). We identified two themes of what constitutes effective communication in breastfeeding care to Latina women: personalized breadth and depth of breastfeeding information (theme 1) and bidirectional exchange of information with providers (theme 2). Provider use of open-ended questions that explored women’s breastfeeding experiences, goals, and challenges asked across the breastfeeding care continuum promoted effective communication. Conversely, providers who asked about breastfeeding at a single visit and/or used rushed, checklist-style questioning left women with unmet information needs and hindered effective communication. While some women preferred communication aligned with their cultural and language preferences, others appreciated providers who engaged with non-fluent Spanish, seen as a supportive gesture. Our “Framework for Effective Communication in Breastfeeding Care” illustrates our findings. Conclusion: Our findings could inform provider and systems level efforts to promote more effective communication in breastfeeding care, ultimately enhancing care quality and person-centeredness.

Individuals who face the daily impact of health inequities and their social drivers have knowledge and invaluable insights about solutions that are feasible at the local level. Community organizing is a dynamic and proven approach for building power among residents to identify community priorities, advocate for change, and co-create solutions to community issues, which has been applied to advance community priorities in the public health field. To build on evidence and further cultivate a pathway to strengthen community power and capacity within a public health framework, the Community Alliance for Research and Engagement (CARE), a health equity-focused partnership among Southern Connecticut State University, Yale School of Public Health, and the New Haven community, developed and implemented a new initiative, the Community Health Leaders (CHL) Program. The CHL program provides a model for community-centered leadership development as a strategy for advancing health equity. By equipping residents with the skills and support needed to advocate for change, CHL contributes to strengthening community power. Ultimately, continued investment in programs like CHL has the potential to create responsive public health programs and policies, reduce health inequities, and improve health outcomes.