Volume 56, Issue S2 p. 81
SPECIAL ISSUE ABSTRACT

Utilization Patterns of a Clinic-Based Food Referral Program: Findings from the Mid-Ohio Farmacy

Daniel Walker

Corresponding Author

Daniel Walker

The Ohio State University, College of Medicine, Columbus, Ohio, USA

Correspondence

Daniel Walker Email: [email protected].

Search for more papers by this author
Matthew DePuccio

Matthew DePuccio

The Ohio State University, College of Medicine, Columbus, Ohio, USA

Search for more papers by this author
Jennifer Hefner

Jennifer Hefner

Ohio State University, College of Public Health, Columbus, Ohio, USA

Search for more papers by this author
Jennifer Garner

Jennifer Garner

The Ohio State University, Columbus, USA

Search for more papers by this author
Joshua Joseph

Joshua Joseph

The Ohio State University, Columbus, USA

Search for more papers by this author
Amy Headings

Amy Headings

Mid-Ohio Food Collective, Columbus, USA

Search for more papers by this author
Aaron Clark

Aaron Clark

The Ohio State University, Columbus, USA

Search for more papers by this author
First published: 15 September 2021

Abstract

Research Objective

Evidence suggests that clinic-based food referral programs (FRP) offer health benefits to food insecure patients, yet little attention has been paid to understanding patient utilization of such programs. Our study addresses this gap by reporting on the patient characteristics associated with uptake and utilization of a FRP—the Mid-Ohio Farmacy (MOF). The MOF is a partnership between a Midwestern regional foodbank and local healthcare providers, including a large, academic medical center (AMC). The MOF uses a variation on food vouchers: an electronic referral from a patient's primary care provider to one of 14 partner food pantries in the metropolitan area. Referred patients who visit a participating pantry are eligible to receive fresh produce once weekly.

Study Design

This observational study leverages data from two AMC family medicine clinics offering the MOF referral from September 2019 to November 2020. Using multivariable logistic regression, we examined the association between filling a MOF referral (i.e., pantry visitor vs. non-visitor) and patient demographic and clinical characteristics. Patients and their pantry visits were characterized based on their pre-referral utilization (i.e., new or existing patrons; pre- or post-referral pantry visit) to assess patterns of pantry utilization.

Population Studied

AMC patients 18 years or older who screened positive for food insecurity and had an eligible chronic condition. Eligible conditions included a diagnosis of diabetes with hemoglobin A1c (HbA1C) >9%, obesity (BMI ≥ 30 kg/m2), or hypertension; uncontrolled diabetes defined as a HbA1C > 9% with or without a diabetes diagnosis; or uncontrolled hypertension defined as blood pressure > 140/90 with a hypertension diagnosis.

Principal Findings

In total, 51% (164/322) of patients who received a MOF referral visited a pantry at least once during the study period. Three factors were associated with an increased likelihood of filling a MOF referral: a 1-year increase in age (0.7%; p < 0.01); diabetes diagnosis (11%; p < 0.05); and pantry visits prior to referral (36%; p < 0.001). Patients with uncontrolled hypertension were 19% (p < 0.001) less likely to visit a pantry following their referral. Relative to new visitors, existing visitors had a greater total number of visits following referral, shorter days to their first visit following referral, and travelled shorter distances. Existing visitors had more total pantry visits and more produce-specific visits in the 90-days following their referral relative to the 90-days prior to their referral.

Conclusions

Our results suggest that while the MOF can connect patients to food resources, further attention may be needed to encourage its use among patients who have not previously accessed pantries.

Implications for Policy or Practice

Changes to the MOF program may be necessary such as adding one additional question to the food insecurity screening process (e.g., “Have you used a food pantry in the last year?”), so that potential first-time users could be targeted for resources (e.g., transportation support such as Lyft credits or bus passes) to address barriers to pantry use. Additionally, reminding patients about the opportunity to visit the pantry, for instance through text message reminders or secure health portal messages, could help encourage patients to use this community resource.

Primary Funding Source

Crisafi-Monte Foundation.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.