Perspectives of caregivers experiencing persistent food insecurity at an academic primary care clinic

Objective: Food insecurity (FI) is often transitory and instigated by changes in family circumstances or environmental events. Clinics have developed interventions to address FI, yet families may face persistent FI. Little is known about persistently food insecure families’ experiences with clinic-based interventions. The objective of this study was to evaluate the perspectives of caregivers experiencing persistent FI in a clinical setting. Methods: We conducted 40 semi-structured interviews at one academic primary care clinic between July 2019-December 2019. The clinic routinely screened families for FI at every visit; families screening positive could meet with a care navigator and receive bags of non-perishable foods. Caregivers who received food bags at ≥3 visits, spoke English or Spanish, and were ≥18 years old were eligible to participate. Interviews were recorded, de-identified, transcribed, and systematically coded using inductive content analysis. A modified constant comparative method was used to iteratively review codes, identify emerging themes, and resolve differences through consensus. Results: Forty caregivers were interviewed; all were women; 45% were Hispanic/Latinx and 37.5% African American/Black. Three major themes emerged: (1) unmet social and medical needs and the challenges of caregiving complicate FI; (2) social supports help address FI and other social challenges that present barriers to accessing resources; and (3) caregivers provide practical recommendations for addressing persistent FI. Conclusion: Families experiencing persistent FI described important social supports that help address FI and other social challenges that present barriers to accessing resources. Clinic-based resources were welcomed interventions, but their impact may be limited; practical recommendations were made. What's New: This qualitative study explores the perspective of caregivers experiencing persistent food insecurity at one primary care academic clinic that implemented a food insecurity screening and referral intervention. Participants provided practical recommendations for addressing food insecurity in clinical settings.