** AWARDS ISSUED PRIOR TO JANUARY 20, 2025, WERE FUNDED UNDER PREVIOUS ADMINISTRATIONS AND MAY NOT REFLECT THE PRIORITIES AND POLICIES OF THE CURRENT ADMINISTRATION.** HIGH RATES OF NUTRITION RELATED CHRONIC DISEASES SUCH AS OBESITY, DIABETES AND HYPERTENSION AMONG PREGNANT WOMEN AND CHILDREN HIGHLIGHT THE NEED TO IDENTIFY PROTECTIVE STRATEGIES DURING THESE CRITICAL LIFE CYCLE PERIODS. IN 2011, WITH USDA FUNDING, OUR RCT OF THE ORIGINAL STARTING EARLY PROGRAM (STEP) CHILD OBESITY PREVENTION INTERVENTION ENROLLED WOMEN IN THE THIRD TRIMESTER OF PREGNANCY AND CONTINUED THROUGH CHILD AGE 3 YEARS. THE STEP INTERVENTION INCLUDES INDIVIDUAL AND GROUP SUPPORT FOR HEALTHY DIET AND LIFESTYLE PRACTICES PROVIDED BY REGISTERED DIETITIANS, COORDINATED WITH PRENATAL AND PEDIATRIC HEALTH CARE VISITS. OUR STEP:PRENATAL SINGLE ARM TRIAL, ENROLLED WOMEN IN THE FIRST TRIMESTER AND WAS TRANSITIONED TO REMOTE DELIVERY IN 2020 DUE TO THE COVID-19 PANDEMIC.MOBILE HEALTH (MHEALTH) INTERVENTIONS CAN SIGNIFICANTLY IMPACT DIET AND LIFESTYLE BEHAVIORS LINKED TO NUTRITION RELATED CHRONIC DISEASES, AND MAY HAVE ADVANTAGES IN TERMS OF ATTENDANCE AND COST. ALTHOUGH OVER 80% OF PREGNANT PATIENTS IN SAFETY-NET PRENATAL CLINICS RECEIVE WIC, AND HAVE HIGH RATES OF NUTRITION RELATED PREGNANCY RISK FACTORS, EXISTING INTERVENTIONS HAVE NOT SYNCHRONIZED COUNSELING ACROSS PRENATAL CARE AND WIC.WE PLAN AN RCT OF REMOTE DELIVERY OF STEP:PRENATAL IN AN URBAN SAFETY-NET PRENATAL CLINIC WITH EXTENSION INTO AN AFFILIATED WIC PROGRAM AND MHEALTH SUPPORT. PARTICIPANTS WILL BE ENROLLED AT THEIR FIRST PRENATAL VISIT AND RANDOMIZED TO CONTROL VS INTERVENTION GROUPS. WIC NUTRITIONISTS WILL INCORPORATE STEP:PRENATAL CONTENT IN PREGNANCY CERTIFICATION VISITS. OUTCOMES WILL INCLUDE DIET, PHYSICAL ACTIVITY AND PREGNANCY OUTCOMES, CHANGES IN NUTRITION KNOWLEDGE AMONG FAMILIES AND NUTRITION PROVIDERS, AND ACCESS AND USE OF STEP:PRENATAL MATERIALS.