Abstract A136: Perceptions of screening for and addressing food insecurity in cancer patients
Authors: Jacobson Kendal , Jaffe Shoshana Adler , Guest Dolores D. , Sussman Andrew L. , Shaver Tori L. , Page-Reeves Janet , Adsul Prajakta , Tawfik Bernard , McDougall Jean A. 
Published: December 2023

Objectives: 1. To explore attitudes and perceptions of oncology providers and patients on food insecurity screening and ideas for future interventions. 2. To develop and pilot an unconditional cash transfer (UCT) intervention to address food insecurity among cancer patients. Background: The United States Department of Agriculture defines food insecurity as a lack of consistent access to enough food for every person in a household to live an active, healthy life. Food insecurity during cancer treatment negatively impacts treatment adherence and quality of life. Screening for and addressing food insecurity is not systematically or universally performed in oncology clinics. Food insecurity is a condition created by poverty. Increasing evidence supports the use of UCTs to address social needs, including food insecurity. We assessed institutional perspectives on food insecurity screening and developed and tested a UCT intervention. Methods: We conducted semi-structured interviews with interested parties in the clinic including patients (n=6) and providers (physicians, nurses, dieticians, research coordinators and patient support service support staff) (n=14). We collected information about the acceptability of implementing the Hunger VitalSignTM food insecurity screening tool in the clinic and ideas for addressing food insecurity among cancer patients. We then enrolled patients (n=19) into a randomized pilot trial to explore the effectiveness of a UCT of $100 a month for 3 months. Patients in the trial completed a series of surveys and a semi-structured exit interview. We iteratively coded and analyzed data from semi-structured interviews and exit interviews in Dedoose.  Results: Qualitative interviews supported the acceptability and need for food insecurity screening by all participants. However, logistical concerns about ongoing staffing shortages and the ability to provide immediate access to resources for all patients identified as food insecure were common concerns. In addition, the need for staff training on screening implementation was emphasized as a concern. Of the 19 patients enrolled in the UCT trial, 14 completed an exit interview. Themes from the exit interviews included the challenges of accessing nutritious food, barriers to preparing food, and challenges navigating existing food resources. Patients expressed appreciation of the UCT and felt it positively impacted their ability to budget and meet their social needs.   Conclusion: The food insecurity screening tool was considered acceptable and warranted by providers and patients, however additional research on implementation in understaffed and resource-constrained settings is needed. Investigation of the use of UCTs with cancer patients demonstrated strong potential for addressing social needs. Future trials are warranted to determine dimensions of implementation and the extent to which addressing social needs improves cancer outcomes.

Citation Format: Kendal Jacobson, Shoshana Adler Jaffe, Dolores D. Guest, Andrew L. Sussman, Tori L. Shaver, Janet Page-Reeves, Prajakta Adsul, Bernard Tawfik, Jean A. McDougall. Perceptions of screening for and addressing food insecurity in cancer patients [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A136.