Aim This study aimed to assess the impact of the Supporting Wellness at Pantries (SWAP) system on client food selections at a food pantry. Subject and methods In a pre–post comparison study design, a client-choice food pantry implemented SWAP by reorganizing its inventory to promote healthy options. Each product was ranked as “choose often” (green), “sometimes” (yellow), or “rarely” (red) based on saturated fat, sodium, and sugar. Signage was added to indicate each item’s SWAP rank and healthier foods were placed at eye level. Client food baskets were assessed at time 1 (n = 121) and time 2 (n = 101). The proportions of green and red foods selected were compared using regression analyses. Results The regression analyses showed that the proportion of green foods selected by clients increased by 11% (p < 0.001) and the proportion of red foods selected decreased by 7% (p < 0.001) after SWAP was implemented (n = 222). Conclusions SWAP has the potential to positively shift client choices among the items available in a food pantry setting. SWAP is one component of a suite of changes to the charitable food system that have the potential to alleviate food insecurity, improve diet quality, and assist clients in managing diet-related diseases.

Heightened obesity risk among food-insecure food pantry clients is a health equity issue because the co-occurrence of obesity and hunger is deeply-rooted in systematic social disadvantage and historical oppression. This qualitative study examined key stakeholders' perspectives of the relationship between the U.S. food banking system and obesity disparities among food insecure clients. Methods We conducted in-depth, semi-structured interviews with 10 key stakeholders (e.g., food bank director, food bank board member, advocate) who are familiar with food bank operations. Data were transcribed verbatim, coded in NVivo [v11], and analyzed using thematic analysis. Results Multiple themes emerged drawing linkages between structural characteristics of the food banking system and disparities in the dual burden of food insecurity and obesity: [a] access to unhealthy food from donors; [b] federal emergency food policy and programming; [c] state-level emergency food policy and programming; [d] geography-based risk profiles; and [e] inadequate food supply versus client need. Interviewees also identified social challenges between system leaders and clients that maintain disparities in obesity risk among individuals with very low food security including: [a] media representation and stereotypes about food pantry clients; [b] mistrust in communities of color; [c] lack of inclusion/representation among food bank system leaders; and [d] access to information.

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One in eight people in the U.S. experience food insecurity (FI). To date, the food banking sector has been at the forefront of efforts to address FI, but the healthcare sector is becoming increasingly involved in such efforts. The extent of collaboration between the two sectors remains unclear. We explored food banking stakeholders’ views on the current state of partnerships between the two sectors. We used purposive sampling to recruit ten key informants for semi-structured interviews. We also conducted a national online survey to gather data from food bank directors (n = 137). Thematic analysis generated two major themes: (1) Healthcare and food banking stakeholders are coordinating to achieve collective impact, and (2) Food banking-healthcare partnerships are leveraging various resources and vested interests within the medical community. We found evidence of ongoing partnerships between the two sectors and opportunities to strengthen these partnerships through the support of backbone organizations.

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