Combating Food Insecurity Through Implementing Food Pantry Amenities in Clinical Settings
Authors: Neal Amber Nicole , Hawthorne Jenci , Root Emily , Myers Cameron , Stephens Danielle S. , Miller Edward 
Published: June 2024

OBJECTIVE:
Now more than ever, attention has turned to addressing social determinants of health, nonmedical factors that influence health outcomes. Food insecurity is a social determinant of health that describes household-level economic and social conditions of limited or uncertain access to food. Food insecurity has substantial effects on health and well-being across a lifespan, but especially during pregnancy and the postpartum period. In this study, we describe our experiences combating food insecurity through the implementation of food pantry amenities through community partnership and engagement.

PROJECT SUMMARY:
Patients presenting to our resident-driven outpatient clinic for prenatal care were screened for food insecurity using a modified version of the U.S. Department of Agriculture’s 10-Item Adult Food Security Survey. Patients who screened positive were provided access to food pantry amenities at each prenatal visit. Screening data were entered into the REDCap system. A quality-improvement study was conducted to assess program implementation and identify areas for improvement. Demographic information, prenatal characteristics, and delivery information were collected, and descriptive statistics were run to describe program outcomes and highlight demographic characteristics within our population.

OUTCOMES:
A total of 677 patients were seen in the clinic for prenatal care between August 1 and December 30, 2022. Of these patients, 223 were screened and 60 screened positive for food insecurity. The average age in our population was 31 years. The average gestational age at time of intervention was 29 weeks. The majority of patients were English-speaking (43.3%). The most common patient-reported ethnicity was Latina (40%). The most common insurance type was public insurance (71.7%). Of the 60 patients who screened positive for food insecurity, 40 delivered during the study period, 52.5% by vaginal delivery. Of neonates born during the study period, 37.5% were admitted to the neonatal intensive care unit. When reviewing survey responses, more than 50% of patients reported concern about food running out before their next paycheck, being able to afford meals, and cutting down meal sizes to make food stretch.

RELEVANCE TO WOMEN'S HEALTH OR PHYSICIANS IN PRACTICE:
Formal food insecurity screening is an evidenced-based strategy that identifies patients and connects them to food pantry amenities. We describe the process of establishing a food pantry within our outpatient clinical setting, including a Preparation and Performance Food Pantry Amenities Checklist as a blueprint for other residency programs considering food security interventions. Through a run chart, we demonstrate program effectiveness. By incorporating food security screening as part of the prenatal care workflow, providers can identify families experiencing food insecurity and, with an onsite food pantry, address health care disparities and social determinants of health