This is a randomized controlled trial to assess whether a personalized food kit to pregnant women is feasible, improves diet quality, and enhances pregnancy and birth outcomes compared to standard prenatal care.

The goal of this clinical trial is to examine the effects of a personalized food kit on diet quality and pregnancy outcomes in pregnant women. The main questions it aims to answer are:

• Does receiving the food kit improve the quality of a mother's diet and specified pregnancy outcomes, compared to standard prenatal care?
• Researchers will compare participants who receive the Harvesting Health Food Kit (intervention group) with those who do not; all participants submit verification that they are receiving or intend to receive standard prenatal care. From an implementation evaluation perspective the study will address logistical issues (frequency, ease of use and utilization) of a personalized food kit in pregnancy.

Participants will:

• Be randomly assigned to either receive the food kit or not (all participants submit verification that they are receiving or intend to receive standard prenatal care, which is not provided by the study).
• Attend regular study visits for clinical data collection and complete questionnaires about their diet and health.
• (Intervention group only) Order and receive and a food kit that can be updated and personalized every two weeks within designated food categories and amounts.

Inclusion Criteria:

• Pregnant individuals 7-12 weeks of gestation at the time of enrollment
• Aged 18-45 years
• Carrying a singleton pregnancy
• Able to read and speak in English or Spanish
• Reside and plan to receive prenatal and postpartum care within the Dallas-Fort Worth (DFW) metropolitan area or College Station area.
• Willing to travel to Collin, Dallas, Denton, Ellis, Kaufman, Rockwall, or Tarrant counties for in-person data collection visits
• Willing to receive the food kit from local partners through delivery or in-person pick-up, as applicable
• Verification of established or planned prenatal care with a prenatal healthcare provider
• Access to a smartphone
• Willing and able to provide informed consent

Exclusion Criteria:

• Diagnosis of pre-existing type 1 diabetes
• Significant chronic medical conditions that might impact pregnancy outcomes or study participation (e.g., severe hypertension, renal disease)
• Multiple gestation
• Fetal anomaly
• History of bariatric surgery or other conditions that affect nutrient absorption
• Current eating disorder
• Current use of exclusionary medications (i.e., systemic steroids or anti-seizure medications)
• Continued use of weight loss medication
• Substance use disorder
• Current or planned enrollment in another intervention study of any type
• Inability to comply with study procedures (e.g., cognitive impairment, plan to move away before study completion, loss of pregnancy)

Deidentified individual participant data, including quantitative and qualitative human health and behavioral data collected via survey, clinical assessment, and related methods, will be made available to qualified researchers upon request. Data will be shared in open, non-proprietary formats (e.g., .csv for tabular data; .txt/.doc for text/qualitative data) accompanied by a file documenting experimental design, data collection methods, software/versions used for processing, variable/column definitions, and units or abbreviations. No personally identifiable information will be shared. Prior to release, datasets will be reviewed for intellectual property, patent, or proprietary constraints. Access will require execution of a data use agreement, approved manuscript proposal plan with statistical analysis details, and approval by the study's data access committee, which will evaluate requests to balance scientific value with participant privacy and the terms of informed consent.

Beginning 24 months following publication of the primary outcome and three key secondary outcome papers and for at least 3 years following project completion.

Requests will be reviewed by the PIs (Seguin-Fowler, Bender, Shankar) and/or designated data access committee. Researchers must submit a written proposal describing the scientific rationale and intended use, and must agree to a data use agreement governing confidentiality, security, and citation requirements. Approved users will receive deidentified data along with a data dictionary and the study protocol. Users are required to cite the dataset in any resulting peer-reviewed publications. Requests and inquiries should be directed to the study PI or designated contact listed in the trial registry record and associated publications.