Research and Outcome Priorities for the Canada Prenatal Nutrition Program in Ontario: A Community-Engaged Modified Delphi Study.

The Canada Prenatal Nutrition Program (CPNP) is a federal initiative that addresses the critical impact of early nutrition and perinatal care on health outcomes by providing community-based perinatal health and nutrition services to socially and economically vulnerable women and their infants. Using a flexible, locally adaptable community programming model, the CPNP aims to improve the health of women and their babies by promoting healthy birth weights and supporting breastfeeding; fostering community partnerships; and providing culturally sensitive support. To identify priorities for future research and outcome measurement within the program's monitoring and evaluation framework, we engaged CPNP personnel from 26 sites across the province of Ontario as expert knowledge holders in a Modified Delphi study. Among participating sites, 57% were hosted within a community-based agency, 23% within an Indigenous-led agency, and 20% within a public health unit. Participants ranked priorities based on what they believed best reflected CPNP clients' needs, contributed to evidence-based program development, and aligned with the realities of community-based service delivery. All priorities were viewed as important for programming. From the relative rankings, two research topics were highest-ranked: assessing the impacts of the CPNP and conducting a needs assessment to identify community-defined perinatal health needs. Maternal mental health was the highest-ranked outcome measure, because of its perceived central role in supporting parent-infant health, well-being, and social connectedness. Collectively, these applied findings offer strategic direction to advance the CPNP's adaptive program delivery model, and demonstrate the methodological value of engaging community knowledge holders to inform perinatal program delivery.