Feed1st, No Questions Asked: How a Hospital-Based Food Pantry Program Grew Its Impact During the COVID-19 Pandemic

Frazier, Cristianne R. M.; Pinkerton, Elizabeth; Grana, Mellissa; Davis, Meryl; Asay, Spencer; Makelarski, Jennifer A.; Lindau, Stacy Tessler

doi:10.2105/ajph.2022.306984

Cited by 10 publications

(7 citation statements)

References 4 publications

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“…An introduction to Tech Savvy Friends enabled us to quickly incorporate this community resource into our enrollment protocols. Additionally, because these trials were identifying people with food insecurity -and rates were rising as a result of the pandemic(49,50) -our ability to sustain and rapidly expand the Feed1st pantries (32) was important to preserving the ethical conduct of research.…”

Section: Discussionmentioning

confidence: 99%

“…(15) Both RCTs involve community advisory boards (CABs) composed of community and clinical stakeholders, including caregivers, patients, clinicians, hospital staff, community advocacy organizations and volunteers. CABs convene regularly to review and advise on study protocols, intervention design and dissemination efforts.CommunityRx-Hunger is advised by the Feed1st CAB, a group originally formed to work with researchers to combat high rates of food insecurity among people seeking healthcare, including parents and other caregivers with children admitted to our children's hospital (31,32) (33). During the pandemic, to adjust to remote operations, CAB members recommended steps to ensure trial accessibility for caregivers with low technology literacy, connecting us to Tech Savvy Friends,(34) a medical student-led organization that provided technical support to caregivers who needed help with enrollment tasks, such as creating and accessing a personal email address and opening and navigating web links.…”

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confidence: 99%

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Two concurrent randomized controlled trials of CommunityRx, a social care intervention for family and friend caregivers delivered at the point of care

Abramsohn

Ornelas

Borson

et al. 2023

Preprint

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Background CommunityRx is an evidence-based social care intervention delivered to family and friend caregivers ("caregivers") at the point of healthcare to address health-related social risks (HRSRs). CommunityRx-Hunger is a double-blind randomized controlled trial (RCT) that enrolls caregivers of hospitalized children. CommunityRx-Dementia is a single-blind RCT that enrolls caregivers of community-residing people with dementia. Clinical trials that enroll caregivers face recruitment barriers, including caregiver burden and lack of systematic strategies to identify and track caregivers. COVID-19 pandemic-related visitor restrictions exacerbated these barriers and prompted the need for iteration of the CommunityRx protocols from in-person to remote operations. This study describes the novel methods used to iterate existing RCT protocols and factors contributing to their successful iteration. Methods CommunityRx uses individual-level data to generate personalized community resource referrals for basic, health and caregiving needs. Our research program uses an asset-based, community-engaged approach including study-specific community advisory boards (CABs). In early 2020, both RCT protocols were pre-tested in-person. In March 2020, when pandemic conditions prohibited enrollment during clinical encounters, both protocols were iterated to efficient, caregiver-centered remote operations. Iterations were enabled in part by the Automated Randomized Controlled Trial Information-Communication System (ARCTICS), a trial management system innovation engineered to integrate the data collection database (REDCap) with community resource referral (NowPow) and SMS texting (Mosio) platforms. Results Enabled by engaged CABs and ARCTICS, both RCTs quickly adapted to remote operations. Designed before the pandemic, we had planned to launch both trials by March 2020 and complete enrollment by December 2021. The pandemic postponed launch until November (CommunityRx-Hunger) and December (CommunityRx-Dementia) 2020. Despite the delay, 65% of all planned participants (CommunityRx-Hunger n = 417/640; CommunityRx-Dementia n = 222/344) were enrolled by December 2021, halfway through our projected enrollment timeline. Both trials enrolled 13% more participants in 12 months than originally projected in-person. Conclusions Our asset-based, community-engaged approach combined with widely accessible institutional and commercial information technologies facilitated rapid migration to remote trial operations. Remote or hybrid RCT designs for social care interventions may be a viable, scalable alternative to in-person recruitment and intervention delivery protocols, particularly for caregivers and other groups that are under-represented in traditional health services research. Trial Status Both studies are registered on ClinicalTrials.gov: CommunityRx-Hunger (NCT04171999); CommunityRx for Caregivers (NCT04146545); My Diabetes My Community (NCT04970810)

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Two concurrent randomized controlled trials of CommunityRx, a social care intervention for family and friend caregivers delivered at the point of care

Abramsohn

Ornelas

Borson

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…Both groups received usual care, which could include staff ad hoc efforts to identify or assist with HRSRs (no training or tools were systematically implemented in practice). All families also received an admission brochure including information about several on-site, self-serve, 24/7/365 Feed1st pantry locations . The availability of these pantries in the study setting enabled ethical conduct of this research.…”

Section: Methodsmentioning

confidence: 99%

“…Consistent with current guidelines, 21 a noninferiority approach was adopted, since usual care involved general efforts to address HRSRs, rendering a true control infeasible and unethical. 21,22…”

mentioning

confidence: 99%

Effect of a Social Care Intervention on Health Care Experiences of Caregivers of Hospitalized Children

Glasser,

Lindau,

Wroblewski

et al. 2023

JAMA Pediatr

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ImportanceHealth-related social risks (HRSRs), like food and housing insecurity, are stigmatized conditions that, when addressed in clinical settings, could inadvertently compromise health care experiences.ObjectiveTo test the noninferiority hypothesis that a low-intensity, high-scale social care intervention does not promote experiences of discrimination or diminish satisfaction with care compared to usual care.Design, Setting, and ParticipantsThis was a double-blind randomized clinical trial conducted from November 2020 to June 2022 with 12-month follow-up analyzing data obtained 1 week after baseline intervention at a 155-bed academic urban children’s hospital with 5300 annual admissions. Participants were recruited from their children’s hospital rooms during their children’s inpatient hospital stays. Inclusion criteria were identifying as the primary caregiver of a child younger than 18 years who was hospitalized in the general, intensive care, or transplant units; living in 1 of 42 target zip codes; and consenting to receive text messages. Caregivers of healthy newborns and caregivers of children expected to be hospitalized for less than 24 hours or greater than 30 days were excluded. A total of 637 eligible parents and caregivers were enrolled.InterventionsParticipants were randomized to usual care or usual care plus CommunityRx, a low-intensity, universally delivered, electronic medical record–integrated social care assistance intervention providing personalized information about local resources alongside education about HRSRs and how to access additional support. Usual care included an admission brochure about hospital-based free food options and nonsystematic provision of resource information.Main Outcomes and MeasuresExperiences of discrimination, measured using the Discrimination in Medical Settings Scale (range 7-35; higher scores indicate more frequent discrimination) and satisfaction with hospital discharge 1 week postdischarge using Child HCAHPS (range 0-100; higher scores indicate higher satisfaction). The a priori noninferiority margins (control minus intervention) were −0.9 (discrimination) and 1.6 (satisfaction).ResultsOf 637 eligible caregiver participants, most identified as female (n = 600 [94.3%]), Black (n = 505 [79.4%]), and had household income less than $50 000 per year (n = 488 [78.5%]). One-third were experiencing food insecurity (n = 223). Half of participants reported discrimination experiences during the pediatric hospitalization (n = 259). Discrimination experiences among the intervention group were noninferior to those among the control group (mean [SD] score: control, 10.3 [4.7] vs intervention, 10.0 [4.6]; difference, 0.2; 90% CI, −0.5 to 0.9). Mean (SD) satisfaction with discharge was high (control, 84.2 [23.8] vs intervention, 81.9 [24.8]), but evidence was insufficient to support intervention noninferiority for this end point (difference, 2.3; 90% CI, −1.2 to 5.8). Food security status did not moderate the relationship between intervention and either outcome.Conclusions and RelevanceThe findings suggest that a universally delivered social care assistance intervention did not promote caregiver experiences of discrimination during a child’s hospitalization but were inconclusive regarding satisfaction.Trial RegistrationClinicalTrials.gov Identifier: NCT04171999

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“…At the time of the study, study participants at the Chicago-based cancer center could receive a list of nearby community resources upon survey completion. The academic medical center that houses the Chicago-based cancer center also operated a food pantry that offered nonperishable food to patients and caregivers, with no eligibility criteria required to receive food or limits on how much food someone could take ( 42 ). The New Haven-based cancer center did not operate any program that provided patients with referrals to resources to address HRSRs.…”

Section: Methodsmentioning

confidence: 99%

Perceived Appropriateness of Assessing for Health-related Socioeconomic Risks Among Adult Patients with Cancer

Boyd

Marchis

et al. 2023

Cancer Research Communications

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Cancer treatment can trigger or exacerbate health-related socioeconomic risks (HRSRs) (food/housing insecurity, transportation/utilities difficulties, and interpersonal violence). The ACS and NCI recommend HRSR screening and referral, but little research has examined the perceptions of patients with cancer on the appropriateness of HRSR screening in healthcare settings. We examined whether HRSR status, desire for assistance with HRSRs, and sociodemographic and healthcare-related factors were associated with perceived appropriateness of HRSR screening in healthcare settings and comfort with HRSR documentation in electronic health records (EHR). A convenience sample of adult patients with cancer at two outpatient clinics completed self-administered surveys. We used chi-squared and Fisher’s exact tests to test for significant associations. The sample included 154 patients (72% female, 90% aged 45 years or older). Thirty-six percent reported ≥1 HRSRs and 27% desired assistance with HRSRs. Overall, 80% thought it was appropriate to assess for HRSRs in healthcare settings. The distributions of HRSR status and sociodemographic characteristics were similar among people who perceived screening to be appropriate and those who did not. Participants who perceived screening as appropriate were three times as likely to report prior experience with HRSR screening (31% versus 10%, p=0.01). Moreover, 60% felt comfortable having HRSRs documented in the EHR. Comfort with EHR documentation of HRSRs was significantly higher among patients desiring assistance with HRSRs (78%) compared to those who did not (53%; p<.01). While initiatives for HRSR screening are likely to be seen by patients with cancer as appropriate, concerns may remain over electronic documentation of HRSRs.

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Feed1st, No Questions Asked: How a Hospital-Based Food Pantry Program Grew Its Impact During the COVID-19 Pandemic

Cited by 10 publications

References 4 publications

Two concurrent randomized controlled trials of CommunityRx, a social care intervention for family and friend caregivers delivered at the point of care

Two concurrent randomized controlled trials of CommunityRx, a social care intervention for family and friend caregivers delivered at the point of care

Effect of a Social Care Intervention on Health Care Experiences of Caregivers of Hospitalized Children

Perceived Appropriateness of Assessing for Health-related Socioeconomic Risks Among Adult Patients with Cancer

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