P0042 - Complete Eats: A Hybrid Type I Effectiveness and Implementation Study of a Clinically Based Summer Food Service Program

Background: 21.5 million low-income children rely on free or reduced-price meals during the school year. The USDA Summer Food Service Program (SFSP) provides meals to children during summer months, but due to lack of awareness fewer than 1 in 8 eligible children participate. The medical center is one of the few institutions that children access during the summer months, and as such may be a prime location for these programs. We evaluate the effectiveness of situating a SFSP in the clinical setting in terms of 1) intended and ultimate repeated use of the SFSP, and 2) subsequently reported family level food insecurity (FI), while gathering information on implementation.

Methods: We partnered with a community agency to provide free lunch to all children ages 2-18 and their siblings during clinical visits at 4 outpatient centers associated with an urban children’s hospital. Families were offered boxed meals along with information regarding how to access community SFSP sites. Parents completed a survey at time of participation and 30 days afterwards regarding intended and actual use of the SFSP and family level food security. We also measured implementation acceptability, feasibility, and reach, as well as factors influencing implementation success.

Results: A total of 15,757 meals were distributed across the 4 clinical sites. The program was rated as highly acceptable to families and clinical staff, feasible in all 4 settings without reported impact on clinical flow, with a reach of over 455 families per day at its peak. 107 caregivers, with a median of 1 child per family (IQR 1-4) and 51.4% reported rate of FI, participated in our longitudinal study. 45.8% reported previous knowledge of the SFSP. The majority (92.5%) planned to use the program again and felt that it would be easy to find a SFSP site in their community (57.7%). 49.5% used the program again during the subsequent 30 days, with 28.6% using the program 5 or more times in that period. Of the 47 families initially experiencing FI, 21% (10) fewer families reported FI during the study period (p=0.025).

Conclusions: This study demonstrates that situating the SFSP in the clinical setting increases awareness of and engagement with community resources among families. Furthermore, it provides compelling evidence of the potential of co-locating direct service programs along with referrals in the clinical setting to positively impact family level-food security.