Overview and Rationale
Food insecurity remains a pressing health-related social need in the United States, disproportionately affecting households with children. In 2023, household food insecurity stood at 17.9% for families with children, underscoring gaps toward Healthy People 2030 goals. Maternal-child food insecurity is linked to maternal mental health challenges, developmental delays in children, and the double burden of malnutrition. The West Las Vegas Promise Neighborhood (WLVPN) area in Clark County, Nevada, embodies these disparities due to historical redlining and ongoing structural barriers. In response, a Community Workshop Series (CWS) was co-created with a Community Advisory Board (CAB) to address maternal-child food insecurity through a multisectoral, socio-ecological lens.
Frameworks Guiding Design and Evaluation
The project leveraged several frameworks: the Nurturing Care Framework (NCF), the Freire Model of Education (FME), and the Consolidated Framework for Implementation Research (CFIR) alongside RE-AIM. The NCF domains (good health, adequate nutrition, early learning, security and safety, responsive caregiving) guided content; FME provided a participatory, culturally congruent pedagogy; CFIR informed implementation planning; and RE-AIM structured the mixed-methods evaluation across reach, effectiveness, adoption, implementation, and maintenance.
Co-Creation at the Core
Between late 2022 and 2024, a CAB of 19 partners helped identify 22 strategies spanning individual, service, and community levels. Phase 1 defined CAB hosts and topics; Phase 2 produced implementation tools, including a workshop planner and a critical pedagogy training. The CWS delivered 17 planned sessions, with on-site childcare and meals as added incentives to remove barriers to participation.
Methodology and Data Sources
The evaluation used a convergent mixed-methods design, with quantitative data from participant feedback surveys (n approx. 68 completed) and attendance barriers surveys (n 28), and qualitative data from host interviews (n=7) and on-site observation (n=15 workshops). The RE-AIM framework guided analysis, enabling a holistic view of what helped or hindered implementation and potential sustainability.
Key Findings by RE-AIM Dimensions
Reach
About half of survey respondents resided in WLVPN zip codes, and roughly 46% were at risk for food insecurity. Attendance barriers included personal time conflicts, work obligations, and broader life circumstances. Outreach relied heavily on social media and word-of-mouth, yet attendees were frequently outside the WLVPN, underscoring reach gaps. Hosts highlighted transportation, childcare, and time constraints as structural barriers, compounded by pandemic-era declines in community participation. Consistency of workshop locations within the target zip codes emerged as a facilitator for reach.
Effectiveness
Participants reported significant gains in self-rated knowledge from pre- to post-workshop assessments (p < 0.001). The typical trajectory was from not/slightly knowledgeable to very/extremely knowledgeable, with about 96% indicating they would apply learned concepts. Qualitative feedback highlighted engaging, comprehensible content for both parents and children. A minority noted outdated information, pointing to the need for ongoing content updates in rapidly evolving health guidance.
Adoption
Adoption benefited from alignment between CAB missions and project values, emphasizing a people-centered approach. While virtual and in-person communication modalities were effective, some hosts preferred more direct contacts with organizational teams. The CAP’s collaborative ethos strengthened inter-organizational relationships, though there was a call for broader CAB engagement and more new partnerships to diversify topics and attendees.
Implementation
Fidelity to the Freire Model was high across workshops, with 40% addressing all five dimensions and most others addressing several. Critical Consciousness was frequently partially addressed, suggesting areas for refinement in facilitator prompts and participant-led problem solving. Real-time planning flexibility was valued, but hosts requested standardized opening/closing protocols and contingency plans. Training uptake varied; refresher materials and broader inclusion of co-facilitators could strengthen future cycles.
Maintenance
Hosts expressed strong commitment to continuing the CWS, with recommendations for Spanish-language offerings and translation support to broaden reach. There is interest in embedding direct services (e.g., resource bags or groceries) alongside education, and in leveraging quarterly CAB meetings to foster new partnerships beyond current hosts. The study notes that sustainability will require ongoing relationship-building, consistent funding, and strategies to ensure continued alignment with community needs.
Implications for Practice and Policy
The CWS demonstrates that community-led health education, grounded in nurturing care and Freirean pedagogy, can increase knowledge about maternal-child health and food security among participants. However, reach remains constrained by structural barriers—transportation, childcare, and competing priorities. To maximize impact, programs should incorporate direct services, intensify in-person community engagement, expand Spanish-language offerings, and standardize training while preserving flexible, culturally responsive content. The RE-AIM-informed evaluation offers a replicable blueprint for assessing similar initiatives in other underserved communities.
Conclusion
The CWS in WLVPN shows promise as a scalable, community-centered strategy to mitigate maternal-child food insecurity. Through participatory co-creation, knowledge gains, and strong alignment with community missions, the intervention lays groundwork for broader reach, refined implementation, and sustained impact on families facing food insecurity.
