Abstract B129: The LBJ Hospital Food Farmacy: A mixed methods evaluation of a food prescription program for food insecure cancer patients being treated in a safety net setting
Authors: Raber Margaret , Vazquez Maria , Laffoon Kylee , Ho-Pham Thy , Ma Hilary , Baum Miranda , Kizub Darya , La Rue Denise , De La Cruz Maria , Prideaux Melissa , Rechis Ruth , Basen-Engquist Karen 
Published: September 2024

Abstract
The purpose of this study was to examine the implementation and perceived impact of a food prescription program (Food Farmacy) targeting food insecure oncology patients at the Harris Health LBJ Hospital, a safety net hospital in Houston, Texas. The Food Farmacy program offers food insecure cancer patients fresh produce, lean meats, and healthy grains and staples through automated referral to an on-site food pantry. Qualitative interviews with cancer patients (n=20) and oncology clinic providers (n=7) as well as a focus group with Food Farmacy staff (n=4) were conducted. Electronic medical records (EMR) were reviewed to assess patient food insecurity screening rates, food insecurity rates, Food Farmacy referral rates, and Food Farmacy redemption rates. Qualitative data was thematically analyzed using a hybrid inductive-deductive coding process. EMR data was analyzed using descriptive statistics. During the first year of program implementation, 9,809 patients (72.2%) were screened for food insecurity in the oncology clinic. Of those, 3,254 (33.2%) were positive for food insecurity. Most (88.9%) of food insecure cancer patients were referred to the Food Farmacy using automated referral in the EMR, and 1,468 patients (50.7% of those referred) redeemed prescriptions at the Food Farmacy. Patients that utilized the Food Farmacy gave feedback on the referral and redemption process, described how Food Farmacy redemptions were integrated into the home food environment, and indicated overall positive impact of the Food Farmacy on financial, nutritional, and emotional health. Barriers to using the Food Farmacy included transportation and physical impairment. Facilitators to using the Food Farmacy included the ability to set up redemption appointments that co-occurred with scheduled medical care. Healthcare providers perceived that the Food Farmacy supported nutrition counseling during patient visits by reducing food access barriers and described positive impacts to patient diet and quality of life. Providers expressed high satisfaction with the referral process for linking patients to the Food Farmacy program, and described it as equiptable and well integrated into clinical practice. Food Farmacy staff emphasized the impact of the Food Farmacy on patient socioemotional wellbeing, including reduced stress, improved quality of life, and increased financial wellness. Together, these findings demonstrate the success of the Food Farmacy program in identifying and referring food insecure patients to a hospital-based resource. Patients, providers, and staff recognized the success of the integrated referral process and opportunity for food redemption co-occurring with medical visits. Other centers aiming to launch food prescription programs may consider integration of referral into the EMR system and co-medical appointments for clients in safety net settings. Future research is needed to better understand the clinical outcomes of Food Farmacy utilization among cancer patients being treated in safety net settings.
Citation Format: Margaret Raber, Maria Vazquez, Kylee Laffoon, Thy Ho-Pham, Hilary Ma, Miranda Baum, Darya Kizub, Denise La Rue, Maria De La Cruz, Melissa Prideaux, Ruth Rechis, Karen Basen-Engquist. The LBJ Hospital Food Farmacy: A mixed methods evaluation of a food prescription program for food insecure cancer patients being treated in a safety net setting [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B129.