Education for pregnant women, caregivers and parents of young children is important for both the adults and children. Health and Human Services reported that in 2022, the percentage of child maltreatment in Kentucky was approximately 60% higher than the national rate. The “Prevent Child Abuse Kentucky” website states that the most common child maltreatment type reported to Child Protective Services in 2021 was neglect (74% of cases). Child maltreatment can be the result of family isolation, inadequate housing, substance use disorder or lack of community support. In addition to preventing child abuse and neglect, education for pregnant women, caregivers and parents can provide up-to-date information, resources, skills, increased confidence and support.

In 2021, the University of Kentucky Cooperative Extension Nutrition Education Program (NEP) began formative research into developing a new curriculum for pregnant women, parents and caregivers of infants and toddlers. Although current lessons existed, many instructors reported challenges engaging with this audience. The initial phase of inquiry involved three focus groups held with NEP Assistants and Family and Consumer Science (FCS) Agents. The discussion involved defining who should receive this curriculum, the content, the method of program delivery, recruitment of participants, program retention, and community partner collaborations. In 2022, the second phase involved online or phone interviews with sixteen community partners identified by NEP Assistants and FCS Agents. These partners from Eastern, Central and Western Kentucky worked in public health, pregnancy centers, public schools, and substance use recovery centers.  Partners identified services for expectant families and caregivers, client recruitment and referrals, needs for nutrition education in their communities and lessons learned working with this audience. In 2023 and early 2024, the third and final phase involved conducting six online and in-person focus groups with pre- and postnatal women and caregivers in various settings, including two groups at a substance use recovery center and one at a high school program for pregnant teens. Topics included breastfeeding, formula feeding, nutrition during and after pregnancy, infant and toddler nutrition, favorite sources of parenting information, and what an ideal nutrition education class would include.  

All the responses collected from these three phases were recorded and transcribed. Coding and analyses were done by independent coders using the constant comparison method using NVivo 10 and 11 Pro® qualitative analysis software. Participants agreed to have their responses recorded with the understanding that all comments and quotes would remain anonymous in reports and publications. In addition to class content, topics synthesized from results included promoters and barriers to class attendance; suggested facilities and location for classes; ideal format, duration, frequency, number of classes and resources for this audience.

Many of the findings reflected the time-constraints and busy lives of parents and caregivers of infants and toddlers, indicating that an in-person hour-long lecture-style class held the same day and time every week would not be practical for this audience. Some of the findings included:

• a need for classes that would include infants/children or provide childcare at the class location
• an accessible and centralized location due to transportation issues
• shorter class duration (20 to 30 minutes)
• flexible scheduling
• options for online or hybrid class format

These results are currently being used by NEP and FCS Specialists in the development of this new curriculum. Once the curriculum has been written and approved, it will piloted by NEP assistants and FCS agents.