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Published on: August 21, 2015
Food Pantry Referral and Utilization in a Pediatric Primary Care Clinic
Kelsey A Egan1, Ziming Xuan2, Melissa Hofman3
1Division of Health Services Research, Department of Pediatrics, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
Insights
Many children screened for food insecurity risk do not receive food pantry referrals or utilize services. Factors like proximity to the clinic and clinician referrals impact utilization, highlighting gaps in pediatric care.
Area of Science:
- Pediatric Primary Care
- Public Health
- Health Services Research
Background:
- Food insecurity is a significant issue affecting child health and development.
- Pediatric primary care settings offer opportunities to screen for and address food insecurity.
- Understanding the referral and utilization pathway is crucial for effective interventions.
Purpose of the Study:
- To characterize the progression from food insecurity risk screening to food pantry referral and utilization in pediatric primary care.
- To identify patient-level and system-level factors influencing this pathway.
Main Methods:
- Retrospective study of 14,280 pediatric patients (0-21 years) with primary care visits (March 2018-February 2020).
- Multivariable regression analysis to examine factors associated with referral and utilization.
- Analyses conducted between 2020-2022.
Main Results:
- 31.9% of screened patients were food insecure; 18.5% received a referral; 28.9% of referred patients utilized the pantry.
- Factors increasing referral odds included proximity to clinic and additional health-related social needs.
- Factors increasing utilization included preferred language, Hispanic ethnicity, clinic hours coinciding with pantry hours, clinician referral, and food emergency referrals.
Conclusions:
- Substantial attrition exists from screening to food pantry utilization.
- Patient demographics, socioeconomic factors, and system-level elements significantly influence successful referrals and pantry use.
- Optimizing the food insecurity care pathway in pediatric settings requires addressing these identified factors.
Introduction:
This study aimed to characterize progression from screening for food insecurity risk to on-site food pantry referral to food pantry utilization in pediatric primary care.
Methods:
This retrospective study included 14,280 patients aged 0-21 years with ≥1 pediatric primary care visit from March 2018 to February 2020. Analyses were conducted in 2020-2022 using multivariable regression to examine patient-level demographic, clinical, and socioeconomic characteristics and systems-related factors associated with progression from screening positive for food insecurity risk to food pantry referral to completing ≥1 food pantry visit.
Results:
Of patients screened for food insecurity risk, 31.9% screened positive; 18.5% of food-insecure patients received an on-site food pantry referral. Among patients referred, 28.9% visited the food pantry. In multivariable models, higher odds of referral were found for patients living near the clinic (AOR=1.28; 95% CI=1.03, 1.59), for each additional health-related social need reported (AOR=1.23; 95% CI=1.16, 1.29), and when the index clinic encounter occurred during food pantry open hours (AOR=1.62; 95% CI=1.30, 2.02). Higher odds of food pantry visitation were found for patients with a preferred language of Haitian Creole (AOR=2.16; 95% CI=1.37, 3.39), for patients of Hispanic race/ethnicity (AOR=3.67; 95% CI=1.14, 11.78), when the index encounter occurred during food pantry open hours (AOR=1.96; 95% CI=1.25, 3.07), for patients with a clinician letter referral (AOR=6.74; 95% CI=3.94, 11.54), or for patients with a referral due to a screening-identified food emergency (AOR=2.27; 95% CI=1.30, 3.96).
Conclusions:
There was substantial attrition along the pathway from screening positive for food insecurity risk to food pantry referral and utilization as well as patient-level characteristics and systems-related factors associated with successful referrals and utilization.
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