Health inequities exist throughout the life course, resulting in racial/ethnic and socioeconomic disparities in obesity and obesity-related health complications. Obesity and its co-morbidities appear linked to COVID-19 mortality. Approaches to reduce obesity in the time of COVID-19 closures are urgently needed and should start early in life. In New York City, we developed a telehealth pediatric weight management collaborative spanning NewYork-Presbyterian, Columbia University Vagelos College of Physicians and Surgeons, and Weill Cornell Medicine during COVID-19 with show rates 76-89%. To stave off the impending exacerbation of health disparities related to obesity risk factors in the aftermath of the COVID-19 pandemic, effective interventions that can be delivered remotely are urgently needed among vulnerable children with obesity. Challenges in digital technology access, social and linguistic differences, privacy security, and reimbursement must be overcome to realize the full potential of telehealth for pediatric weight management among low-income and racial/ethnic minority children. Accepted Article

Despite recommendations for systematic food insecurity screening in pediatric primary care, feasible interventions in clinical settings are lacking. The goal of this study was to examine reach, feasibility, and retention in Food FARMacia, a pilot clinically based food insecurity intervention among children aged <6 years. We examined electronic health record data to assess reach and performed a prospective, longitudinal study of families in Food FARMacia (May 2019 to January 2020) to examine attendance and retention. We used descriptive statistics and bivariate analyses to assess outcomes. Among 650 pediatric patients, 172 reported household food insecurity and 50 registered for Food FARMacia (child mean age 22 ± 18 months; 88% Hispanic/Latino). Demographic characteristics of Food FARMacia participants were similar to those of the target group. Median attendance rate was 75% (10 sessions) and retention in both the study and program was 68%. Older child age (retention: age 26.7 ± 18.7 months vs. attrition: age 12.1 ± 13.8 months, p = 0.01), Hispanic/Latino ethnicity (retention: 97% vs. attrition: 69%, p < 0.01), and larger household size (retention: 4.5 ± 1.1 vs. attrition: 3.7 ± 1.4, p = 0.04) correlated with retention. A clinically based mobile food pantry pilot program and study reached the target population and were feasible.

Purpose This study aimed to assess whether produce prescription redemption was associated with food insecurity (FI), sociodemographics, and nutrition-related health measures, and to identify factors affecting participation. Design Retrospective, cross-sectional study. Patients, equally divided between groups who redeemed and did not redeem prescriptions, completed a follow-up survey. Setting Northern Manhattan, NY. Subjects 242 patients referred to Nutrition at an academic medical center between June and November 2019. Intervention All patients referred to Nutrition received prescriptions for produce at local Greenmarkets (patients with FI received $20; other patients received $10). Measures We assessed patient satisfaction and factors impacting participation. Sociodemographics and nutrition-related health measures were extracted from medical records. Analysis The χ 2 test for categorical data and Student’s t-test for continuous variables. Results Prescription redeemers were significantly more likely to be very satisfied with the program ( P < .001), have FI ( P < .01), and have elevated hemoglobin A1C than non-redeemers (6.3 vs 5.5%, P < .001). Distance, time constraints, and forgetting or losing the prescription were common barriers, while convenience and valuing healthy eating facilitated redemption. Conclusion Higher FI and worse hemoglobin A1c in patients who redeemed prescriptions suggests that our program reaches the target audience: patients needing food assistance and a healthier diet. Awareness of barriers offers areas for improvement. This provides a feasible model for hospital investment to increase access to produce to improve health and health equity.