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 semistructured interviews at one academic primary care clinic between July 2019 and 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 nonperishable 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.

中文翻译：

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在学术初级保健诊所经历持续粮食不安全的护理人员的观点

客观的

粮食不安全（FI）通常是暂时的，并由家庭环境或环境事件的变化引起。诊所已经制定了解决 FI 的干预措施，但家庭可能面临持续的 FI。对于持续粮食不安全的家庭接受基于临床的干预措施的经历知之甚少。本研究的目的是评估在临床环境中经历持续性 FI 的护理人员的观点。

方法

2019 年 7 月至 2019 年 12 月期间，我们在一家学术初级保健诊所进行了 40 次半结构化访谈。该诊所在每次就诊时都会对家庭进行常规 FI 筛查；筛查呈阳性的家庭可以与护理导航员会面并收到一袋不易腐烂的食物。接受食品袋次数≥3次、会说英语或西班牙语、年龄≥18岁的护理人员有资格参加。使用归纳内容分析对访谈进行记录、去识别化、转录和系统编码。使用修改后的恒定比较方法来迭代审查代码，识别新出现的主题，并通过共识解决差异。

结果

四十名护理人员接受了采访；全部都是女性；45% 是西班牙裔/拉丁裔，37.5% 是非裔美国人/黑人。出现了三个主要主题：1）未满足的社会和医疗需求以及护理挑战使金融机构变得复杂；2) 社会支持有助于解决金融机构和其他阻碍获取资源的社会挑战；3) 护理人员提供解决持续性 FI 的实用建议。

结论

经历持续性 FI 的家庭描述了重要的社会支持，有助于解决 FI 和其他阻碍获取资源的社会挑战。基于临床的资源干预措施受到欢迎，但其影响可能有限；提出了切实可行的建议。