Introduction
Maternal-child food insecurity remains a pressing public health challenge in the United States, linked to maternal mental health issues and child development risks. In West Las Vegas, Nevada, historically redlined neighborhoods face persistent gaps in access to nutritious food and supportive services. A Community Workshop Series (CWS) was co-created with local stakeholders to address these gaps through education, resources, and culturally attuned outreach, grounded in the Nurturing Care Framework (NCF) domains. This article presents a mixed-methods, RE-AIM–based evaluation of the CWS implementation, focusing on barriers and facilitators across reach, effectiveness, adoption, implementation, and maintenance.
Methods at a Glance
The study used mixed methods (quantitative and qualitative) guided by RE-AIM and the Freire Model of Education for delivery. The West Las Vegas Promise Neighborhood (WLVPN) zip codes served as the setting. A Community Advisory Board (CAB) guided co-creation, with 7 hosts delivering 17 workshops in 2024. Data sources included participant feedback surveys (n≈68) assessing knowledge gain, an attendance barriers survey (n=28), observation checklists for fidelity, semi-structured CAB host interviews (n=7), and project documents. The analysis integrated qualitative themes with quantitative findings to map barriers and facilitators to RE-AIM dimensions.
Key Findings by RE-AIM Dimension
Reach
Reach was a central challenge. About 45.7% of respondents resided in WLVPN zip codes, with roughly half at risk for food insecurity. Attendance barriers included personal time conflicts, work obligations, and broader systemic issues. Hosts noted that outreach primarily via social media and Eventbrite extended reach beyond the target area, yet did not efficiently engage WLVPN residents. They recommended in-person canvassing and printed flyers to improve local penetration, stressing that participants often prioritize immediate needs over education unless workshops are paired with tangible benefits such as childcare or food provisions.
Effectiveness
Participants reported a statistically significant increase in self-rated knowledge after each CWS (p<0.001). Most attendees indicated they would apply what they learned, and around 96% expected to use the information. Positive qualitative feedback highlighted accessible, relatable content that could be understood by both mothers and their children. A single critique noted some content as not up-to-date, underscoring the need for ongoing content updates in rapidly evolving fields like nutrition and child health.
Adoption
Adoption was strong at the organizational level. Alignment between hosts’ missions and the CWS goals fostered a people-centered, culturally congruent approach. The EARN-FS team’s flexibility in communication styles (email, Zoom, phone) was a facilitator, though some hosts desired more direct contact with their organization’s communications teams and more regular in-person debriefs. While CAB collaboration strengthened during planning, there was less momentum for new partnerships during implementation, revealing opportunities to broaden network participation to sustain momentum.
Implementation
Implementation fidelity to the Freire Model of Education was generally high: 40% of workshops fully addressed all five dimensions, and most addressed four. The most consistently covered dimension was Critical Consciousness, with Conscientization occasionally under-addressed. Hosts valued the Critical Pedagogy Training, though some found it less memorable or applicable to partners outside the core team. Practical barriers included the need for standardized planning prompts, contingency plans, and linguistic adaptations to serve Spanish-speaking residents. In-session flexibility was embraced to tailor content to local needs, which enhanced relevance but occasionally challenged protocol adherence.
Maintenance
Maintaining the intervention hinges on sustaining CAB networks and expanding language access. Hosts expressed desire for ongoing cross-organizational relationships, more Spanish-language offerings, and potential direct-service components (e.g., resource bags, groceries, or stipends). Quarterly CAB meetings were cited as a key facilitator for sustaining partnerships, while the lack of ongoing new CAB members limited breadth of future reach. Overall, maintenance appears viable with deliberate expansion of language access and deeper cross-CAB collaboration.
Discussion and Implications
The CWS demonstrates that community-driven, POP (participatory) education can elevate knowledge about nurturing care domains among mothers and families in high-need urban neighborhoods. The experience highlights that reach benefits from targeted, door-to-door and on-site outreach, integrated with tangible supports (childcare, food). The NCF-guided content showed promise as a framework for addressing maternal-child food insecurity through multi-sector collaboration. However, reach remains a bottleneck, amplified by transportation, time constraints, and competing priorities. Direct-service components and Spanish-language expansion emerge as concrete steps to enhance equity and participation.
Recommendations for Next Steps
- Increase in-person community engagement in targeted zip codes with clear outreach messages about childcare and food supports.
- Expand Spanish-language offerings and live translation to broaden access among non-English speakers.
- Consider direct service add-ons (e.g., resource bags or fresh groceries) to address Maslow’s hierarchy of needs alongside education.
- Strengthen cross-CAB relationships with quarterly non-research meetings to foster broader collaboration and sustainability.
- Provide refresher training and concise, standardized planning materials to ensure consistent fidelity across workshops.
Conclusion
Though challenges in reach persist, the Community Workshop Series shows clear potential to mitigate maternal-child food insecurity through knowledge-building and community empowerment. The co-created, framework-guided approach coordinated by CAB hosts, researchers, and community partners yielded meaningful knowledge gains and highlighted tangible paths toward more inclusive, sustainable community health education.
