Roll-Out Implementation Optimization (ROIO) trial to develop and test the implementation of a food security screening...

Area of Science:

• Implementation Science
• Pediatric Health
• Public Health Nutrition

Background:

• Food insecurity (FI) negatively impacts children's health, psychosocial functioning, and academic achievement.
• Integrating nutrition support into healthcare is recommended but faces implementation challenges in clinical settings.
• Existing workflows for FI screening and referral are inconsistently implemented and difficult to sustain.

Purpose of the Study:

• To refine, adapt, and optimize a comprehensive FI screening and referral program (I-FRESH) for pediatric healthcare systems.
• To identify effective implementation strategies for successful adoption and long-term sustainability of FI programs.
• To generate a scalable, context-responsive implementation model for addressing FI in pediatric settings.

Main Methods:

• A RollOut Implementation and Optimization (ROIO) trial design will be used across 4 pediatric clinics.
• The I-FRESH program includes FI screening, needs assessment, referral/navigation support, and follow-up.
• The Pragmatic, Robust Implementation and Sustainability Model (PRISM) and RE-AIM framework will guide adaptation and evaluation.

Main Results:

• Preliminary effectiveness will be assessed on family-level food security and pediatric nutrition-related health outcomes.
• Implementation strategies will be identified to enhance the likelihood of successful program implementation and sustainability.
• Data will inform a future Type 2 Hybrid Effectiveness-Implementation Trial.

Conclusions:

• This study will yield a scalable, context-responsive model for addressing FI in pediatric healthcare.
• Findings will guide sustainable strategies to connect families with nutrition support and improve child health outcomes.
• The research integrates PRISM and RE-AIM within an iterative ROIO design for robust evaluation.