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Breastfeeding is a key nutritional behavior for infants during their first years of life. While prenatal breastfeeding intentions do not differ significantly between non-Hispanic Black and White mothers, the ability to meet those intentions decreases over time, and to a greater extent among Black mothers. This is partially due to environments inadequately supportive of individuals’ breastfeeding needs (i.e., not breastfeeding-friendly). The Community Readiness Assessment is a powerful tool to assess a community’s readiness to take action on pressing health issues. While it is frequently used to understand readiness to prevent negative health outcomes, this study explores how it can be used to understand readiness to promote breastfeeding friendliness and subsequently identify appropriate intervention strategies. Between November 2020 and June 2021, we conducted interviews with 23 key respondents in New Haven, Connecticut, representing five community sectors. Respondents scored five dimensions of readiness on a 9-point scale (1 = no awareness, 9 = community ownership). The overall community readiness score was 4.2, denoting the “preplanning” stage of readiness. The highest-scoring readiness dimension was “community knowledge about the issue” (mean score: 4.5), and the lowest-scoring dimension was “resources related to the issue” (mean score: 3.3). Small business owners reported the highest readiness score by sector (mean score: 5.0), while large employers reported the lowest (mean score: 3.1). Scores stratified by both sector and dimension revealed specific areas within the community where readiness-level-appropriate interventions could be implemented. This study highlights the benefit of assessing community readiness prior to intervention to identify tailored, equitable, and effective intervention strategies. © 2025 The Author(s). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
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Background. Food insecurity, affecting approximately 10% of the U.S. population, with up to 40% or higher in some communities, is associated with higher rates of chronic conditions and inversely associated with diet quality. Nutrition interventions implemented at food pantries are an effective strategy to increase healthy food choices and improve health outcomes for people experiencing food and nutrition insecurity. Supporting Wellness at Pantries (SWAP), a stoplight nutrition ranking system, can facilitate healthy food procurement and distribution at pantries. Purpose. Guided by the RE-AIM Framework, this study assesses the implementation and outcomes of SWAP as nutritional guidance and institutional policy intervention, to increase procurement and distribution of healthy foods in pantries. Method. Mixed-methods evaluation included observations, process forms, and in-depth interviews. Food inventory assessments were conducted at baseline and 2-year follow-up. Results. Two large pantries in New Haven, Connecticut, collectively reaching more than 12,200 individuals yearly, implemented SWAP in 2019. Implementation was consistent prepandemic at both pantries. Due to COVID-mandated distribution changes, pantries adapted SWAP implementation during the pandemic while still maintaining the ?spirit of SWAP.? One pantry increased the percentage of Green foods offered. Challenges to healthy food distribution are considered. Discussion. This study has implications for policy, systems, and environmental changes. It shows the potential for SWAP adoption at pantries, which can serve as a guide for continued healthy food procurement and advocacy. Maintaining the ?spirit of SWAP? shows promising results for food pantries looking to implement nutrition interventions when standard practice may not be possible.
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