Navigating food insecurity: Insights from families participating in a produce delivery program

OBJECTIVE: Our pediatric primary care office enrolled families with food insecurity, transportation barriers, and children ≤5 years old in a fresh produce home delivery program. We explored families' perspectives on 1) the effect of the produce box on food insecurity, 2) changes to family dietary behaviors, and 3) barriers and facilitators to program participation. 

METHODS: We enrolled English and Spanish-speaking caregivers to participate in virtual, individual semi-structured interviews. Interview questions explored feedback on the produce delivery program, influence on household food insecurity, and family eating behaviors. We conducted inductive thematic analysis of interview transcripts to thematic sufficiency. We coded one transcript as a group, and at least two team members coded the remaining transcripts. The research team developed themes. 

RESULTS: Twenty-six caregivers completed interviews; 96% identified as female, 73% as non-Hispanic Black, 12% preferred Spanish. Qualitative analysis resulted in five themes: 1) Families are resourceful in managing food insecurity and maximizing use of the produce box, 2) Families struggle balancing food security and other needs; even with help from the produce boxes, finances weigh heavily on decision making, 3) The program facilitated healthier eating habits, 4) Caregivers appreciated the simple, convenient, supportive program processes from referral through delivery, 5) Caregivers provided constructive feedback and desired to continue enrollment. 

CONCLUSION: Fresh produce home delivery facilitates healthy dietary habits and relieves stress among families experiencing food insecurity. Primary care practices can serve as trusted facilitators to connect families to community-based resources. Produce home delivery mitigates food insecurity and may promote nutrition-related outcomes.