An Innovative Pilot Program Addressing Food Insecurity in the Pediatric Primary Care Setting

ABSTRACT

Background: Food insecurity has long been established as a social determinant of health. Food insecurity in children is correlated with adverse health outcomes including poor overall health, obesity, asthma, allergies, anxiety and depression. Traditional interventions for food insecurity in the pediatric primary care setting have included referral to food banks, food vouchers and assistance programs. Limited research has been done examining the impact of meal delivery or of the feasibility of integrating food assistance directly into the pediatric practice. The objective of this pilot study is to determine if a medical home centered meal delivery program is acceptable, feasible and effective in reducing food insecurity and stress in families with children ages 0-5. Methods: The Division of Community Pediatrics (DCP) provides healthcare to vulnerable children in an urban area. DCP partnered with Share Our Strength's No Kid Hungry, and the Power of 10, a restaurant industry non-profit, to design and implement a pilot program to address food insecurity for families with young children during the COVID-19 pandemic. Ready to heat and serve healthy meals were delivered to the household twice a week to provide one meal per day per family member for 10 weeks. Surveys were conducted before and after receipt of 10 weeks of meal delivery during the pandemic among an adult caregiver. Survey questions were adapted from existing survey tools that examine meal delivery program implementation effectiveness, program acceptability, food insecurity and caregiver stress. Results: 43 families with at least one child age 0-5 enrolled and received meals. The majority (83%) stayed in the program until the conclusion. 31 families completed both the pre-test and the post-test. The average household size of participants was 5.6 members with an average of 2 children under age 5. Most (84%) participants were already receiving food assistance like WIC and/or SNAP benefits. The number of families who experienced food insecurity decreased with program participation (Table 1). Satisfaction and acceptability with the program was high (Table 2). Most (77.4%) said they and their children ate more fruits and vegetables than normal. Of those worried about food before the intervention, 66.7% were no longer worried at the end of the program (p=0.0001). Of those who ran out of food before the intervention, 71% reported no longer running out of food at the end of the intervention (p=0.0001). Conclusion: This innovative pilot program demonstrated that meal delivery through the primary care setting is feasible and effective in reducing food insecurity. It improved the quality of food consumed. Participants were satisfied with the program and there was a high retention rate. There was less reported worry about food running out by the conclusion of the program.