Health Equity/Social Determinants of Health
Health Equity/Social Determinants of Health 6
Aditi Vasan, MD, MSHP (she/her/hers)
Instructor of Pediatrics
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
The American Academy of Pediatrics recommends that pediatric primary care providers routinely screen families for household food insecurity. Some primary care clinics have responded by incorporating clinic-based nutrition assistance programs and referrals to community-based support. However, it remains unclear how to best connect families to nutrition resources that are aligned with their specific needs and preferences.
Objective: To explore pediatric caregiver perspectives on and preferences for clinic-based nutrition support, including clinic-based food banks and prepared meals, home food delivery, benefits enrollment support, and information about available community-based food resources.
Design/Methods: We conducted semi-structured interviews with caregivers of pediatric patients seen at two urban primary care clinics within a large academic health system. Caregivers whose children were Medicaid-insured and who reported current or previous use of government nutrition benefit programs were invited to participate. Interviews were recorded, transcribed, and coded by 2 independent coders using content analysis, resolving discrepancies by consensus. Interviews continued until thematic saturation was reached.
Results: We interviewed 40 caregivers of Medicaid-insured children, who were mostly mothers (90%) and were predominantly Black (88%). All caregivers had previous experience using WIC and SNAP, and 83% were current SNAP beneficiaries, while 53% were current WIC beneficiaries. We identified six primary themes. Caregivers felt (1) clinics were a comfortable and convenient environment in which to receive nutrition resources; (2) food resources should be offered as a routine part of all clinic visits; (3) clinic-based prepared meals can help meet families’ acute needs; (4) meal deliveries are a convenient source of support, particularly for families with barriers to transportation; (5) clinics should help families navigate burdensome WIC and SNAP enrollment processes; and (6) geographically-tailored information about food banks may help improve families’ awareness of community-based resources.
Conclusion(s): Pediatric primary care clinics represent a comfortable and convenient environment for families to receive food resources. Clinics should consider partnering with community-based organizations to provide different types of nutrition support, including prepared meals, meal deliveries, benefits enrollment assistance, and information about community-based food resources, to ensure they are able to meet families’ needs.