Food pantry referral and utilization in a pediatric primary care clinic

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 ages 0-21 years with ≥1 pediatric primary care visit from March 2018-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)], with each additional health-related social need reported [1.23 (1.16-1.29)], and when the index clinic encounter occurred during food pantry open hours [1.62 (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)], Hispanic race/ethnicity [3.67 (1.14-11.78)], when the index encounter occurred during food pantry open hours [1.96 (1.25-3.07)], with a clinician letter referral [6.74 (3.94-11.54)], or with a referral due to a screening-identified food emergency [2.27 (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.