Navigating Food Insecurity: Insights From Families Participating in a Produce Delivery Program.

Food insecurity (FI) disproportionately affects households with children: nearly 1 in 5 US children experience FI. Previous studies demonstrate negative health outcomes for children with FI, including adverse developmental effects, increased risk of chronic health problems, and mood disorders. Pediatric clinicians are encouraged to advocate for nutrition–focused FI interventions that support healthy child development. Health care–based FI interventions include on-site food distribution, connection to federal nutrition benefits (eg, Supplemental Nutrition Assistance Program [SNAP] and Special Supplemental Nutrition Program for Women, Infants, and Children [WIC]), referral to community resources such as local food pantries, produce prescription programs, and home food delivery. Challenges for many approaches include the inability to distribute fresh, healthy food and the need for transportation. Prior studies of WIC-eligible caregivers of pediatric patients found that they prefer home food delivery, particularly for produce. Structural inequities in food access experienced by racially and ethnically minoritized and underinvested communities present additional challenges to healthy eating, leading to lower produce consumption among populations with FI. To improve food security and nutrition quality with participant dignity in mind, our pediatric primary care practice enrolled families with FI and transportation barriers to the local foodbank’s established fresh produce home delivery program. Produce delivery can help families access fresh produce and overcome common barriers to healthy eating. Food is Medicine programs, defined as interventions that provide healthy food directly to patients facilitated by the health care system, have a more substantial literature base in the adult population, most often adults with existing chronic health conditions. By targeting pediatric populations, our program has an opportunity to prevent diet–related chronic diseases in addition to improving family well-being. Given the relative novelty of pediatric produce delivery programs, this qualitative study aimed to explore the program’s: 1) effect on the experience of FI, 2) changes to family dietary behaviors (food preparation, serving, eating), and 3) barriers and facilitators to program participation and use of the produce box. This study was approved as exempt by the Cincinnati Children’s Institutional Review Board.