P3B236: Utilization of a Food Prescription Program by Pediatric Patients with an Elevated BMI and Food Insecurity

Background: Food insecurity and obesity often co-exist in patients as consequences of poverty. The lack of healthy and affordable food can make it difficult for families with food insecurity to maintain healthy weights. Food prescription programs that provide nutritious food are seen as a possible solution to addressing these health concerns. We sought to measure the utilization of a food prescription program from a pediatric clinic, as well as determine if there was a change in BMI percentile among utilizers.

Methods: We conducted a retrospective chart review of patients who were enrolled in a partner food prescription program between January 1, 2020, and December 31, 2021. The study was done at an urban clinic located in Houston, Texas that serves patients with Medicaid or CHIP insurance only. Patients had to have an elevated BMI percentile (>85%) and screen food insecure on the 2-question Hunger Vital SignTM to be eligible for the program. The food insecurity screen was done at well check visits and relied upon clinic staff and providers to identify eligible patients. Quality improvement strategies were implemented to integrate the program in clinic workflows. Once enrolled, participants could access up to 30 pounds of produce and 4 healthy items twice a month from participating food pantries. Participant demographics and BMI percentiles were analyzed comparing program utilizers and non-utilizers.

Results: Over the 24-month period, 170 patients, ages 2-18 years old, were enrolled into the program, 64% were male, 70% Spanish-speaking, and 85% Hispanic. Demographics were similar between program utilizers and non-utilizers. Eighty-eight participants (52%) received a follow up phone call. Only 34 participants (20%) utilized the program of which 22 went to a food pantry at least once to receive food; 12 utilized a volunteer home delivery program. Twelve participants visited a food pantry more than 5 times. The mean BMI percentile at enrollment was 96.77% and similar in both groups. A follow up BMI percentile was available for 138 enrolled participants. BMI percentiles decreased among utilizers and non-utilizers during the follow up, but there was no statistically significant difference between the groups.

Conclusion: A large majority (80%) of patients enrolled in the food prescription program did not utilize the program even once. Further investigation is needed to determine barriers to program utilization (e.g., transportation, pantry accessibility). There was not a significant change in BMI percentile among the utilizers during the follow-up period, which was one of the intentions of the food prescription program. Additional research is needed to determine the best way to address childhood obesity from the medical home.