# Food for LifecOURse equity In maternal Security and Health

> **NIH NIH U54** · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · 2024 · $618,512

## Abstract

Project Summary / Abstract
The Food for LifecOURse equity In maternal Security and Health (FLOURISH) Study uses a cross-cutting
research design that is widely-applicable to the prevention and treatment of many chronic co-morbidities that
disproportionately affect Indigenous women of childbearing age. Through intentional engagement with
community stakeholders across all project years, diverse perspectives will be integrated into the research
strategy and aims to ensure study findings are relevant, actionable, and yield the greatest potential for reducing
health inequities. Broadly, FLOURISH will elucidate nutritional and non-nutritional behavioral risk pathways
linking food insecurity to severe maternal morbidity (SMM) and related outcomes among Indigenous women
during pregnancy and the immediate post-partum period. A primary focus will be the impact of trauma on food
insecurity and health risk, as well as the rigorous evaluation and manipulation of dietary intake as an influential
pathway, with a special focus on dietary quality, chronic inflammation and dysglycemia. The study will be
conducted in Oklahoma, which is home to 39 of the federally-recognized Tribes that comprise the Southern
Plains region, in collaborative partnership with the Southern Plains Tribal Health Board. It is comprised of three
aims. First, the team will test and refine a conceptual integrated framework of food insecurity and SMM to identify
significant structural, social, behavioral, and biological pathways as candidate intervention points. This aim will
be accomplished through an observational study (n=350) of pregnant Indigenous women followed to 3-months
postpartum. Structural equation modeling will be used to test the study’s overall conceptual multi-level framework
of food insecurity and SMM. The final model will be refined through input with community stakeholders. Second,
the community-academic research team will develop the FLOURISH intervention, to be adapted from perinatal
food is medicine models used in non-Indigenous populations, with an emphasis on whole person health,
including stress management and self-care. The FLOURISH intervention will strategically address key nutrition
disparities and other health risk behaviors identified as significant path contributors to various drivers of SMM in
this specific population. This adaptation will be informed by findings from the first aim, and further refined and
finalized through a series of interviews groups with primiparous and multiparous Indigenous women with history
of SMM and various community care providers for this population (n=36). A series of focus groups with intended
users will solicit final feedback before the intervention is launched. Third, the research team will use a randomized
parallel group design (n=150) involving an additional external control comparison group to test the FLOURISH
and FLOURISH PLUS (including community healthcare workers) interventions to assess for feasibility,
acceptability, an...

## Key facts

- **NIH application ID:** 10908629
- **Project number:** 5U54HD113173-02
- **Recipient organization:** UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
- **Principal Investigator:** Emily Jean Jones
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $618,512
- **Award type:** 5
- **Project period:** 2023-08-17 → 2030-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10908629

## Citation

> US National Institutes of Health, RePORTER application 10908629, Food for LifecOURse equity In maternal Security and Health (5U54HD113173-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10908629. Licensed CC0.

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