Presentations

Abstract

Introduction:

Food insecurity (FI), defined as uncertain access to nutritious food, has numerous adverse effects on health and well-being and disproportionally affects racial and ethnic minority groups, low-income households, uninsured individuals, and immigrant families. In particular, student-run free clinics have reported that up to 74% of patients experience food insecurity, many times the national average (10.2%). However, screening for and addressing food insecurity in clinics serving at-risk populations is rare. Furthermore, little is known about experiences with food insecurity among Hispanic immigrant families. HOPES is a student-run free clinic in Norfolk, Virginia,. HOPES provides primary and select specialty care to patients without health insurance, including many Hispanic undocumented patients and their children. The purpose of The HOPES Food Insecurity Project is two-fold: (1) To measure food insecurity and food assistance resource utilization among our patients, (2) To pilot an intervention connecting patients to food assistance resources based on their needs and preferences.

Methods:

We are collecting data from HOPES patients via a self-report survey. A project team member (PTM), consisting of EVMS medical students, approaches patients and caregivers while they are in the clinic's waiting room and invites them to complete the survey either independently via iPad or verbally with the assistance of the PTM. The survey is available in both English and Spanish and the PTMs who interact with the participants speak both languages. The 17-item survey consists of the validated 2-item Hunger Vital Sign, which measures food insecurity, and questions assessing utilization of food pantries, SNAP, WIC, soup kitchens, and Meals on Wheels. For participants not enrolled in WIC or Meals on Wheels we assess their eligibility for these programs. Participants also provide their first name, zip code, and phone number. Finally, participants check off their interest in receiving more information about the following resources: federal food assistance programs, local food pantries, soup kitchen/hot meals, food delivery, or none of the above. Based on each participant's zip code, interest in resources, and eligibility for services, a PTM generates a tailored resource booklet in English or Spanish using the Bridge2Resources VA database, which is printed out and provided to the patient before they leave the clinic. To assess utilization of the resource booklet, a PTM will call patients after 1 month to ask them whether they still have the booklet, whether they are getting the help they need from it, and if they have any feedback they would like to share.

Results:

As of August 31, 2023, we have attended five HOPES Clinic shifts with 36 out of 39 patients filling out our survey. One patient refused to complete the survey and two patients were missed by volunteers. Of the 36 patients, 28 (78%) screened positive for food insecurity, defined as responding "often true" or "sometimes true" to either or both of the Hunger Vital Sign questions, and eight (22%) screened negative. Of the patients who screened positive for food insecurity, only 13 (46%) used some form of food resource in the past 12 months and 22 (79%) requested information about food resources.

Conclusion:

These preliminary data suggest that food insecurity is prevalent among HOPES patients, but food resource utilization is low. Patients may benefit from concerted efforts to address food insecurity as part of routine health care offered at HOPES.