No abstract

Journal of Patient-Centered Research and Reviews (JPCRR) is a peerreviewed scientific journal whose mission is to communicate clinical and bench research findings, with the goal of improving the quality of human health, the care of the individual patient, and the care of populations.

Context: The United States Department of Agriculture (USDA) defines food insecurity as lacking "access to enough food for an active, healthy life for all household members". The projected food insecurity rate for the City of Milwaukee was 13.1%. Milwaukee is known for poor health outcomes ranking 71 out of 72 Wisconsin counties in health. The reasons are wide-ranging. While poverty undoubtably plays a role, food deserts limit access especially in low-income neighborhoods. Our clinics see a predominately urban underserved patient population many of who are medically complex and socially at-risk (hotspots). Many are on fixed budgets and struggle with food insecurity. As a result, there is a lack of healthy food options both physically and economically. Furthermore, food insecurity is not routinely screened for in our clinics. Objective: Our quality improvement study aimed to highlight the importance of not only screening for food insecurity but to also pilot home deliveries to food insecure patients. Study Design & Analysis: Experimental; pre/post-test design with the collection of both qualitative & quantitative data. Setting: Two residency primary care clinics; Milwaukee, WI. Population Studied: Patients who at the time of the study had been identified as hotspots. Intervention: For 6 months households selected for the intervention group received monthly food deliveries from a local food pantry, which were delivered by the medical team. Results: Of the 45 patients, 49% screened positive for some level of food insecurity and a surprising 68% of those had "very low food security" defined as "reports of multiple indications of disrupted eating patterns and reduced food intake" (USDA). While overall QOL scores remained unchanged, in the social relationships' domain, a statistically significant improvement was noted (P=0.01). In gathering qualitative data from the intervention group 4 themes emerged: Appreciated Food Visits, Enjoyed Food Quality and Quantity, Improved Food Insecurity & Bridged Transportation Access. Conclusions: Home food deliveries to our food insecure patients were viewed in a positive manner. In the future the hope is to expand this pilot project to screen all patients during office visits for food insecurity and to find creative approaches to provide home food deliveries to the most vulnerable households as it matters.

Context: Primary care providers in Milwaukee are surrounded by a diverse community, often hearing stories of overcoming adversity. Celebrating patients' and staffs' successes are part of what makes medicine so rewarding. The concept of Humans of Family Medicine (HFM) stems from the Instagram account Humans of New York, which highlights the stories of everyday people in NYC. Objective: The purpose of our study was to highlight and share unique patient and staff stories in hopes of bringing a humanitarian side to family medicine. Study Design: Quality improvement. Setting: Milwaukee, WI, USA. Population: Patients and staff from urban family medicine clinics. Intervention: We conducted a quality improvement project at two family medicine clinics within Milwaukee during 2019. The project was approved by our local IRB. Consent was obtained from patients and staff who agreed to have their story told. The stories were written and then vetted by our social media team, before being published on institutional social media accounts. Family medicine providers and staff were surveyed before and after the project to gauge use of social media. Pre/post-survey responses were compared with Fisher Exact Tests. P≤0.05 was considered significant. Outcome measures: The stories and their outcome on social media platforms. Results: A total of 25 individuals were asked to participate and share their story; 1 declined. Overall, 24 stories were written; 18 have been published (3 on Facebook (FB) alone, and 15 on both Instagram and FB). Of the 24 stories, 12 were patients, 10 were staff, and 2 were resident physicians. Mean FB likes were 485 (range 75-1155) and mean IG were 96 (range 45-490). Mean FB comments were 33 (range 3-173) and mean IG were 5 (range 0-56). Family medicine providers and staff (N=23 pre-survey; N=28 post-survey) were significantly more likely to follow our institution on FB following project implementation (P=0.005). Also, providers and staff were significantly more likely to think it was a good idea to showcase stories on social media following the project (P≤0.001). Those surveyed initially were unsure patients would like their stories showcased (36% yes would like). However, 82% thought patients would like being showcased on social media following the project (P=0.001). Conclusion: Storytelling is powerful. Showcasing stories about those we serve is something our patients may enjoy, and it may allow us to be better caregivers, listeners, and people.