With rising rates of food insecurity (FI) during the pandemic, we implemented a clinic-based, community-supported agriculture program at 2 outpatient centers in low-income areas associated with an urban children's hospital and evaluated (1) the program's ability to reach FI families without preceding eligibility criteria, and (2) caregiver experiences and preferences for programming. Free boxes of produce were distributed weekly to caregivers of pediatric patients during a 12 week pilot period. Ability to reach the target population was measured by number of participating families and caregiver demographic information. We purposively sampled 31 caregivers for semistructured interviews on a rolling basis to understand program preferences. Content analysis with constant comparison was employed to code interviews inductively and identify emerging themes. Of 1472 caregivers who participated in the program, nearly half (48.3%) screened positive for FI, and 45% were receiving federal food assistance. Although many caregivers were initially "surprised" by the clinic-based program, they ultimately felt that it reinforced the hospital's commitment to "whole health" and perceived it to be safer than other food program settings during the pandemic. Several programmatic features emerged as particularly important: ease and efficiency of use, kindness of staff, and confidentiality. This advocacy case study demonstrates that a community-supported agriculture program in the clinical setting is an acceptable approach to supporting food access during the pandemic, and highlights caregiver preferences for a sustainable model. Furthermore, our data suggest that allowing families to self-select into programming may streamline operations and potentially facilitate programmatic reach to families who desire assistance.

中文翻译：

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农场到家庭：以诊所为基础的农产品供应，以解决大流行期间的粮食不安全问题。

随着大流行期间粮食不安全 (FI) 率的上升，我们在与城市儿童医院相关的低收入地区的 2 个门诊中心实施了一项以诊所为基础、社区支持的农业计划，并评估了 (1) 该计划的覆盖面的能力没有先前资格标准的 FI 家庭，以及 (2) 照顾者的经验和对编程的偏好。在为期 12 周的试点期间，每周向儿科患者的护理人员分发免费的产品盒。通过参与家庭的数量和照顾者的人口统计信息来衡量达到目标人群的能力。我们有目的地对 31 名护理人员进行滚动式半结构化访谈，以了解项目偏好。采用持续比较的内容分析对访谈进行归纳编码并识别新出现的主题。在参与该计划的 1472 名护理人员中，近一半 (48.3%) 的 FI 筛查呈阳性，45% 的人正在接受联邦食品援助。尽管许多护理人员最初对以诊所为基础的计划感到“惊讶”，但他们最终认为这加强了医院对“整体健康”的承诺，并认为在大流行期间它比其他食品计划设置更安全。几个程序化的特点变得特别重要：使用的方便和效率、员工的友善和保密性。该倡导案例研究表明，临床环境中的社区支持农业计划是在大流行期间支持食品获取的可接受方法，并强调看护者对可持续模式的偏好。此外，我们的数据表明，允许家庭自行选择参与计划可能会简化操作，并有可能促进计划对需要帮助的家庭的影响。