Date of Award
Spring 5-10-2025
Level of Access Assigned by Author
Open-Access Thesis
Degree Name
Doctor of Philosophy (PhD)
Department
Food and Nutrition Sciences
First Committee Advisor
Jade McNamara
Second Committee Member
Kate Yerxa
Third Committee Member
Kayla Parsons
Additional Committee Members
Angela Daley
Noereem Mena
Abstract
Problem: Rural, low-income perinatal individuals face challenges regarding diet quality (DQ), food security status (FSS), and mental health, which lead to poor maternal and infant outcomes. Barriers to maintaining health include time constraints, lack of resources, and lack of social support. Community-based participatory research (CBPR) fosters community collaboration to create relevant and acceptable programming to support perinatal well-being.
Methods: In 2022, a community advisory board (CAB) developed a web-based program (GLOW) to improve DQ, FSS, and mental health among rural, low-income, perinatal individuals in Maine. CAB members completed one-on-one interviews regarding their experiences. In 2024, perinatal individuals were recruited to participate in GLOW, completing a pre-survey measuring; (1) demographics, (2) DQ via the Short Healthy Eating Index (sHEI), (3) FSS via the USDA Household Food Security Screener, (3) and mental health via the PROMIS Emotional Support-Short Form 8a, and the Warwick-Edinburgh Mental Well-Being Scale. Due to an inability to recruit a sufficient sample, the pilot program was not implemented. Instead, a formative evaluation via cognitive walkthroughs (CW), assessed content acceptability, barriers to use, and cognitive load associated with each component of GLOW.
Results: Five themes emerged from the CAB interviews: collaboration, learning, community, addressing a need, and CAB expansion. Among pre-survey respondents (N=38), mean scores for DQ, emotional support, and mental well-being were 49.9 (±9.0) out of a possible 100, 33.2 (±6.7) out of a possible 40, and 47.6 (±8.5) out of a possible 70, respectively. All participants were food insecure, with 64.9% experiencing very low food security. Emotional support was the only significant predictor of mental well-being (p< 0.001). CW participants discussed their perinatal experiences, and identified strengths and weaknesses of the GLOW intervention.
Conclusions: CBPR proved effective for creating relevant and acceptable perinatal health programming, and provided many benefits to participants. Pre-survey results highlight a need for interventions addressing perinatal DQ, FSS, and mental health, with a particular emphasis on emotional support. CW participants identified; (1) notable highlights of GLOW, (2) logistical opportunities for improvement, and (3) strategies to promote engagement.
Recommended Citation
Neptune, Leigh, "GLOW (Guiding Lifemakers on Wellness): A Community-Based Participatory Approach to Perinatal Wellness" (2025). Electronic Theses and Dissertations. 4146.
https://digitalcommons.library.umaine.edu/etd/4146