CommunityRx-Hunger

Study Overview
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Brief Summary
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CommunityRx-Hunger (CRx-H) is a hospital-based intervention that addresses food insecurity and other health-related social needs such as transportation, housing, utilities, and safety. Study team members are recruiting caregivers at the time of their child's hospital admission at a large urban children's hospital. For Aim 1, the primary outcome is self-efficacy among food insecure caregivers compared to those who receive the usual standard of care. For Aim 2, the primary outcome is satisfaction with care compared between food secure and food insecure caregivers.

Detailed Description
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CommunityRx-Hunger (CRx-H) is a double-blinded randomized controlled trial aimed at increasing self-efficacy among caregivers with food insecurity in the household. CRx-H is recruiting primary caregivers of hospitalized children at a large urban children's hospital at the time of admission. Aim 1: Researchers are studying whether the intervention will increase self-efficacy among food insecure caregivers compared to those who receive the usual standard of care. Aim 2: Researchers will enroll and randomize caregivers with and without food insecurity to the intervention to compare satisfaction with care. Eligible, self-identified caregivers will complete a baseline survey during the child's hospital stay, followed by phone surveys at 7, 30, 90, 180 days, and 12 months. Caregivers randomized to the intervention will receive a tailored list of resources to address food insecurity and other health-related social needs, plus a brief educational component delivered by a trained member of our research team. Cases will receive a booster dose of the resource list prior to discharge. After discharge, cases will receive proactive text messages about those same community resources. All caregivers (regardless of research arm) will receive a series of text messages related to the study such as reminders to schedule the phone survey with a member of the research team.

Official Title
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CommunityRx-Hunger: A Hospital-based Intervention for Primary Caregivers of Children Admitted to the Hospital

Conditions
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Food Insecurity

Intervention / Treatment
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* Other: Community Rx-Hunger (CRx-H)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Native English or Spanish speaker Living in 1 of 27 zip codes in the study's target region Self-identify as a primary caregiver of a child <18 years old hospitalized in a large urban children's hospital Ability to send and receive text messages Access to a mobile phone and agrees to receive text messages from the study Exclusion Criteria: Previous participation in a CRx research study. Caregivers of newborns in the hospital Patient hospital stay is less than 24 hours Patient hospital stay is 30 days or more Patient has an eating disorder as indicated in the EMR
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Usual Care + Intervention (Case)<br>Cases will receive the CommunityRx Intervention. | Other: Community Rx-Hunger (CRx-H)<br>* The CRx-H Intervention provides dosages of health content that offer assistance for food insecurity and other health-related social needs. A caregiver randomized to the intervention will receive a hard-copy print-out of their tailored list of resources to address food insecurity. A member of our research team will deliver this list and provide a brief educational component which includes: a brief, structured script about the common problem of food insecurity in households with children and co-occuring HRSNs, review of the resource list which includes nearby, vetted resources to address these needs and coaching on how to activate resources on the list. Prior to discharge, the caregiver will receive a duplicate copy of the list of resources. After discharge, the caregiver will receive text messages at a frequency based on the Critical Time Intervention (CTI) Model, from baseline to 3 months post discharge, in order to receive ongoing support by a research team member.<br>|
| No Intervention: Usual Care (Control)<br>Controls will receive the usual standard care, which consists of information about hospital food resources and access to Feed1st hospital food pantries prior to discharge. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| (Aim 1) Change in caregiver self-efficacy at 12 months from baseline | Self-efficacy is measured by Bandura's Self-Efficacy Scale which asks, How confident are you in your ability to find resources in your community that help you manage your health? Responses will be assessed on a 5-point Likert scale ranging from not at all confident to completely confident. | Baseline, 12 months | 
| (Aim 2) Caregiver satisfaction with hospital care | Satisfaction with hospital care is measured by the Hospital Consumer Assessment of Healthcare Providers Survey (HCAHPS); Child HCAHPS which includes 8 items plus one item added by the research team for a total of 9 items. Response options are Yes, definitely, Yes, somewhat and No. The items ask about the child and the hospital related to their recent stay. | 7 days post discharge from the hospital | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Food Insecurity, Caregivers, Clinical Trial, Hunger, Self-Efficacy, Health-Related Social Needs