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To describe the feasibility, acceptability and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention. Pilot randomised controlled trial. Participants received six visits with a community health worker trained in motivational interviewing (three home visits, three phone calls); an in-home cooking or reading activity; personalised feedback on a recorded family meal or reading activity; text messages and tailored printed materials. Parents and their 2-5-year-old child were randomised into intervention (responsive food parenting practices/nutrition) or control (reading readiness) groups. Parents ( 63) were mostly mothers (90 %), Hispanic/Latinx (87 %), born outside the USA (62 %), with household incomes <$25 k (54 %). Despite delivery during COVID-19, 63 % of dyads were retained at 6 months. The intervention was delivered with high fidelity. All parents in the intervention group ( 24) expressed high levels of satisfaction with the intervention, which produced positive treatment effects for whole and total fruit component Healthy Eating Index-2015 scores (point estimate (PE) = 2·14, 95 % CI (0·17, 1·48); PE = 1·71, 95 % CI (0·16, 1·47), respectively) and negative treatment effects for sodium (PE = -2·09, 95 % CI (-1·35, -0·04)). Positive treatment effects also resulted for the following food parenting practices: regular timing of meals and snacks (PE = 1·08, 95 % CI (0·61, 2·00)), reducing distractions during mealtimes (PE = -0·79, 95 % CI (-1·52, -0·19)), using food as a reward (PE = -0·54, 95 % CI (-1·35, -0·04)) and providing a supportive meal environment (PE = 0·73, 95 % CI (0·18, 1·51)). Given the continued disparities in diet quality among low-income and diverse families, continued efforts to improve child diet quality in fully powered intervention trials are needed.

Background Food insecurity is common in the United States, especially in Rhode Island, where it affects up to 33% of residents. Food insecurity is associated with adverse health outcomes and disproportionally affects people from minoritized backgrounds. Produce prescription programs, in which healthcare providers write “prescriptions” for free or reduced cost vegetables, have been used to address food insecurity and diet-related chronic disease. Although there is growing evidence for the effectiveness of produce prescription programs in improving food security and diet quality, there have been few efforts to use implementation science methods to improve the adoption of these programs. Methods This two-phase pilot study will examine determinants and preliminary implementation and effectiveness outcomes for an existing produce prescription program. The existing program is funded by an Accountable Care Organization in Rhode Island and delivered in primary care practices. For the first phase, we conducted a formative evaluation, guided by the Consolidated Framework for Implementation Research 2.0, to assess barriers, facilitators, and existing implementation strategies for the produce prescription program. Responses from the formative evaluation were analyzed using a rapid qualitative analytic approach to yield a summary of existing barriers and facilitators. In the second phase, we presented our formative evaluation findings to a community advisory board consisting of primary care staff, Accountable Care Organization staff, and staff who source and deliver the vegetables. The community advisory board used this information to identify and refine a set of implementation strategies to support the adoption of the program via an implementation blueprint. Guided by the implementation blueprint, we will conduct a single-arm pilot study to assess implementation antecedents (i.e., feasibility, acceptability, appropriateness, implementation climate, implementation readiness), implementation outcomes (i.e., adoption), and preliminary program effectiveness (i.e., food and nutrition security). The first phase is complete, and the second phase is ongoing. Discussion This study will advance the existing literature on produce prescription programs by formally assessing implementation determinants and developing a tailored set of implementation strategies to address identified barriers. Results from this study will inform a future fully powered hybrid type 3 study that will use the tailored implementation strategies and assess implementation and effectiveness outcomes for a produce prescription program. Trial registration Clinical trials: NCT05941403 , Registered June 9, 2023.

Children in the United States have poor diet quality, increasing their risk for chronic disease burden later in life. Caregivers' feeding behaviors are a critical factor in shaping lifelong dietary habits. The Strong Families Start at Home/Familias Fuertes Comienzan en Casa (SFSH) was a 6-month, home-based, pilot randomized-controlled feasibility trial that aimed to improve the diet quality of 2-5-year-old children and promote positive parental feeding practices among a predominantly Hispanic/Latine sample. The pilot saw significant improvements in children's Healthy Eating Index-2015 total and whole fruit scores, as well as multiple food parenting practices, and it was received well by participants. Building on the success of the pilot study, this protocol paper describes the modifications, study design, and procedures for a fully powered randomized controlled trial. Caregiver-child dyads are randomized to a \"healthy eating\" intervention group or a \"reading readiness\" attention control group. In the intervention group, a trained community health worker conducts monthly home visits or phone calls for 6 months that focus on age-appropriate nutrition recommendations and food parenting practices. There are three home visits that include tailored nutrition education materials that address their child's appetitive traits and eating habits, an interactive cooking activity, and a review of a family meal video with feedback. Community health workers use motivational interviewing and goal setting, which are key components of the program. The control group is similarly structured, with content focusing on reading and language development. Caregivers complete in-person and over-the-phone baseline and 6-month follow-up measurements to capture diet quality (primary outcomes: Healthy Eating Index-2015 scores via two 24-h dietary recalls and dermal carotenoids) and selected parental feeding practices and availability of healthy foods in the home (secondary outcomes). This protocol was approved by the Brown University institutional review board (protocol number 2022003389). As of March 2025, a total of 81 participants were randomized. Of these, 29 participants completed the study, and 8 participants withdrew. Recruitment will continue until 257 participants have been randomized. Data analysis is expected to conclude in 2028. Findings will determine the efficacy of the intervention to improve child diet quality and parental feeding practices, which will ultimately inform future effectiveness and the real-world of home-based food parenting programs. ClinicalTrials.gov NCT06099288; https://clinicaltrials.gov/study/NCT06099288. DERR1-10.2196/73923.

Complementary feeding practices promote healthy eating habits and food preferences later in life. Little is known about how US pediatricians communicate infant feeding practices to caregivers or how caregivers respond to this information. The purpose of this study is to explore mothers’ experiences and perceptions of the complementary feeding recommendations they receive in primary care settings. English- and Spanish-speaking mothers of infants were recruited from Special Supplemental Nutrition for Women, Infants, and Children offices in Rhode Island, US, and snowball sampling. Semi-structured telephone interviews were conducted to investigate mothers’ discussions with pediatricians about complementary feeding and their overall impressions of wellness visits. Thematic analysis was informed by the Fundamentals of Care theoretical framework. The mean age of the sample (n = 13) was 30.5 years and 62% self-identified as Latina. Four themes emerged from the analysis: (1) wellness visits are mostly positive experiences, (2) not all infant feeding recommendations are easy to follow, (3) alternative sources of infant feeding recommendations can be just as helpful, and (4) there is room for improvement at wellness visits. Improving the content, delivery, and cultural relevance of infant feeding recommendations in primary care settings with more specific and tailored information may promote adherence to evidence-based practices.

Objective: To explore mothers’ experiences and perceptions of the complementary feeding recommendations they receive in the primary care setting.Methods: English- and Spanish-speaking mothers of infants were recruited from WIC offices in Rhode Island and through snowball sampling. Semi-structured telephone interviews were conducted to investigate mothers’ discussions with pediatricians about complementary feeding and their overall impressions of wellness visits. Thematic analysis was informed by the Fundamentals of Care theoretical framework.Results: The mean age of the sample (n = 13) was 30.5 years and 62% were Latina. Overall, mothers reported being satisfied with wellness visits and that they trusted pediatricians (theme 1). However, most also felt that pediatricians’ feeding recommendations are vague or incompatible with their child’s behaviors or their own cultural preferences (theme 2), and that they are comfortable relying on alternative sources for advice (theme 3). Mothers described ways to improve wellness visits, most notably through additional take-home materials (theme 4).Conclusion: This sample of mothers did not always perceive pediatricians’ infant feeding recommendations as comprehensive enough to meet their needs.Practice Implications: Improving the content, delivery, and cultural relevance of infant feeding recommendations in primary care settings with more specific and tailored information may promote adherence to evidence-based practices.

Lee Urban, Portland's former economic development director, latched onto the diner rescue effort as part of the city's plan to revitalize the Bayside neighborhood.

[Esther M. Dyer] May Dyer, 92, a longtime Cliff Island resident who recently moved to State Street, died June 15, 2000, at the Barron Center. She was married to John F. Dyer Sr., a herring fisherman, for 53 years. The couple lived in Portland for several years early in their marriage before moving to Cliff Island, where Mr. Dyer grew up. He died in 1977. Surviving are two sons, John F. Jr. of Casco and Bruce E. Dyer of Cliff Island; three daughters, Gloria A. DePalma of Portland, Sally E. Wellsman of Holliston, Mass., and Delores L. Dyer of Windham; 13 grandchildren and 16 great-grandchildren. A son, Alfred V. Dyer, died in 1988.

A traditional reception, catered by the city-owned Barron Center, will be held after the council inauguration ceremony at noon on Dec. 6 at City Hall. The cost of the inauguration and reception, including flowers and photographs, will be covered by $4,500 allocated by the council.