Background: Healthy lifestyle behaviors during pregnancy strongly influence maternal and neonatal outcomes. The UCSD/SDSU General Preventive Medicine Residency (PMR) program partnered with San Diego Family Care, a Federally Qualified Health Center (FQHC) to identify patients’ understandings, barriers, and needs to meet the recommendations for healthy lifestyle behaviors during pregnancy.

Methods: The needs assessment followed the PRECEDE-PROCEED model, and the first three phases used a mixed-method design consisting of social, educational, and ecological assessments. PMR residents and students conducted interviews and focus groups with key stakeholders of the FQHC including maternal health patients, clinicians, and clinic staff and leadership. An environmental survey of the clinic’s catchment area was also performed by PMR residents guided by experts in urban design to assess walkability, safety, and available amenities.

Results: Findings suggest that improved nutrition resources during pregnancy are needed but solutions differed between patients and staff. Clinic staff and leadership were interested in more workers to provide education, while patients requested more information directly from providers. The ecological assessment identified areas of greater walkability and access to healthy food. Overall, the microenvironments discouraged a healthy lifestyle in the local community surrounding the FQHC.

Conclusions: The preliminary results solidify the need to improve resources for maternal nutrition during pregnancy at SDFC. Themes and results from the assessments will be used to inform and design a future intervention. The methods can be used by other sites and FQHCs for ongoing quality improvement and research projects.