OBJECTIVE:Food insecurity is prevalent among underserved communities and contributes to maternal-child health disparities. The perinatal period - from pregnancy through 1 year postpartum - provides a critical window of opportunity to identify and address food insecurity. However, perinatal providers face barriers that prevent them from providing screening, referrals and follow-up services. The study aimed to understand barriers perceived by perinatal providers to implement strategies to screen, refer and follow up for food-insecure pregnant people and children living in underserved areas. DESIGN:This qualitative phenomenological study explored multi-level barriers perceived by perinatal providers when implementing strategies for screening, referral and follow-up for food insecurity guided by the socio-ecological model. SETTING:This study was conducted within five zip codes of Southern Nevada (89101, 89106, 89030, 89031 and 89032) selected for their prevalence of food insecurity and health disparities. PARTICIPANTS:Semi-structured interviews were conducted with fifteen perinatal providers. RESULTS:Barriers at the individual provider level included lack of knowledge and education on food insecurity; at the interpersonal level included patient hesitancy to reveal sensitive information to providers; at the institutional level included lack of standard procedures to conduct screening, referrals and follow-up services; and at the community and policy levels identified organisational capacity and historical distrust of healthcare systems as obstacles to offering equitable care for food insecurity in perinatal settings. CONCLUSION:Addressing these multi-level barriers is essential to implementing effective food insecurity mitigation strategies within perinatal care settings. Utilising the created recommendations may promote equitable care for food insecurity within clinical and community perinatal settings.
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