Using concept mapping to co‐create implementation strategies to address maternal–child food insecurity during the first 1000 days of life.

Food insecurity (FI) has short‐ and long‐term effects on maternal and child health, with persistent inequities within under‐resourced communities of colour (e.g., Hispanic and Non‐Hispanic Black). Interventions to mitigate maternal–child FI must engage the voices of under‐resourced communities of colour to improve implementation and tackle socio‐ecological drivers of inequities, leading to positive maternal–child outcomes. This exploratory sequential mixed‐methods study aimed to co‐create implementation strategies to tailor a culturally sensitive intervention to address FI during the first 1000 days of life in under‐resourced communities of colour in Las Vegas. A Community Advisory Board (CAB) engaged in a two‐step participatory process. First, through the concept mapping, hierarchical cluster analysis organized 125 strategies into seven thematic areas: policy and advocacy, access to food and resources, built environment, education across systems, social and peer support, cultural congruency and trust, and wellness and mental health. Second, through consensus‐building, strategies were combined by similarity (n = 94) and excluded if unrelated to health and nutrition (n = 9). The CAB reached a consensus on 22 strategies classified across three socio‐ecological levels. Examples of strategies at the community level (n = 16) included increasing utilization of federal nutrition assistance programmes; at the service level (n = 4), integrating FI screenings and referral coordination systems across services; and at the individual level (n = 2), providing mentorship, education, and support for families and moms. The co‐creation of a culturally sensitive intervention to reduce inequities in maternal‐child FI during the first 1000 days of life requires multi‐level strategies across three socio‐ecological levels in under‐resourced communities of colour in Las Vegas. Key messages: Implementation co‐creation can increase interventions' feasibility, acceptability, and ownership, ultimately reducing structural barriers and inequities.Using a concept mapping activity, the community advisory board (CAB) identified seven thematic areas for addressing maternal‐child food insecurity: policy and advocacy, access to food and resources, built environment, education across systems, social and peer support, cultural congruency and trust, and wellness and mental health.Using a consensus‐building process, the CAB reached a consensus on 22 strategies across three socio‐ecological levels. Examples of strategies at the community level (n = 16) included the reach and utilization of federal nutrition assistance programmes; at the service level (n = 4), integrating FI screenings and referral and coordination systems across services; and at the individual level (n = 2), developing groups that provide support for moms.The co‐creation of a culturally sensitive intervention to address maternal‐child food insecurity during the first 1000 days requires multi‐level strategies across three socio‐ecological levels. [ABSTRACT FROM AUTHOR]