(343) Developing Cystic Fibrosis Patient Food Insecurity Education with Circle of Care Partnership.

Background: The CF Center of Idaho (CFCI) uses multidisciplinary staff for patient care. Each discipline interacts with the patient during a routine CF appointment. It is known that patients will reveal information to one staff member but not necessarily another, especially if it is sensitive information such as not being able to afford enough food for themselves or their family. A center level action plan was proposed for food insecurity and staff applied for the Vertex Circle of Care Grant.

Methods: Staff used the USDA definition of food insecurity: the household-level economic and social condition of limited or uncertain access to adequate food.1A research study in 2013 found a significant level of food insecurity. Follow up done in 2019 focused on Hunger Vital Signs.2 It was found that the level of food insecurity had lessened slightly in the interval. Staff determined that education was needed, and undertook a project to develop educational tools and partner with community agencies.

Results: In 2013, 33% of pediatric patients’ families and 44% of adult patients reported food insecurity. In 2019, 26% of the pediatric patients’ families and 20% of the CF adults reported food insecurity. The CFCI food insecurity committee found it difficult to partner with state and local agencies. Consultation with the state agency in charge of SNAP revealed that there was a lack of resources for patients complete paperwork outside the agency’s physical location. A Food Action Plan (FAP) was developed to create a process to assess food insecurity. The FAP includes a collection of local and state resources for Idaho CF patients to enable direct referrals to community resources. A small food pantry in the clinic was implemented. Donations were sporadic. However, the staff identified a partner in the institution who regularly received a ample food donations. This led to increased supply and improved food access. Besides monitoring food insecurity in the CFCI, staff worked to raise the awareness of food insecurity in people with CF regionally and nationally. Staff developed printed materials for education to normalize and educate about food insecurity and targeted resources. Two posters were developed for clinic exam rooms. A brochure outlining food resources and available programs were developed.

Conclusions: An increased awareness of food insecurity in CF on a national level as well as regionally and locally has been observed. The Vertex Circle of Care grant was a major contributing factor in creating this awareness in the CFCI. The CFCI was able to quantify the level of food insecurity seen in CF locally, and to develop a food action plan and educational materials. Continuing surveys of CF patients has led to increased ease in talking about the subject and lessened the stigma of being food insecure.

Acknowledgements: Vertex Pharmaceuticals Circle of Care Grant, Boston, MA [Grant70349313]

References:

1. 
   1. Food Insecurity. United States Department of Agriculture (USDA) Economic Research Service. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security.aspx. Retrieved August 19, 2015.
   
   

3. 
   2. Hager, E. R., Quigg, A. M., Black, M. M., Coleman, S. M., Heeren, T., Rose-Jacobs, R., Cook, J. T., Ettinger de Cuba, S. E., Casey, P. H., Chilton, M., Cutts, D. B., Meyers A. F., Frank, D. A. (2010). Development and Validity of a 2-Item Screen to Identify Families at Risk for Food Insecurity. Pediatrics, 126(1), 26-32. doi:10.1542/peds.2009-3146. Retrieved 3 January 2019