Caregiver and pediatrician perspectives on a meal kit delivery program for children with food insecurity and obesity: A qualitative analysis

BACKGROUND: The importance of addressing food insecurity in clinical settings has been highlighted in the American Academy of Pediatrics clinical guidelines for the treatment of childhood obesity. There is limited research on food-security interventions for childhood obesity in the health care setting, particularly research that includes caregiver and pediatrician perspectives. 

OBJECTIVE: The aim of this study was to explore caregiver and pediatrician perspectives related to a meal kit delivery program for families with children aged 6 to 11 years with obesity and food insecurity. DESIGN: This was a qualitative analysis using semi-structured interviews with caregivers and pediatricians conducted between July and November 2023. 

PARTICIPANTS/SETTING: Of 29 caregivers and 12 pediatricians enrolled in a meal kit delivery program based at a clinic in Boston, MA, 13 caregivers and 7 pediatricians were interviewed. 

STATISTICAL ANALYSES PERFORMED: Codebooks were generated using an inductive approach. NVivo 12 software was used to perform thematic coding analysis. 

RESULTS: Most caregivers reported that the meal kits were easy and convenient to use. A few caregivers noted that the use of the meal kits was limited by time and a lack of preferred foods. Caregivers were split on the sufficiency of the meal kit food quantity. Most caregivers perceived that the program improved food security and provided "hands-on" nutrition education. Several desired a longer program duration, more variety, and customization to align with preferred foods. Pediatricians perceived that the meal kits met a social and clinical need, although barriers to referral included forgetting to refer and competing demands. 

CONCLUSIONS: A meal kit delivery program was perceived to be beneficial for families with children with obesity and food insecurity. However, caregivers identified several barriers to using meal kits, and both caregivers and pediatricians suggested areas of improvement, such as through customization and program financial sustainability, which warrant addressing before integration in the health care setting.