(375) SNAP & WIC: CF program knowledge and utilization

Background: One in 3 people with cystic fibrosis (CF) experience food insecurity (FI) [1]. There are federal nutrition programs (FNPs) in the U.S. that can aid food insecure people. The goal of this project is to understand CF care teams’ knowledge of eligibility and the referral process for the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), learn what tools they use to track referrals, and what barriers they have encountered to these programs. The results of this survey will help inform development of education materials for CF care teams about SNAP & WIC.

Methods: A survey was emailed on Feb. 4, 2022, to 911 CF program coordinators, social workers, and dietitians, and was posted to the CF Exchange forums. A reminder email was sent 1 week later. One response per CF program was requested. A thematic analysis was conducted on open text responses.

Results: There were 90 complete responses. 53% of respondents (48/90) were from a pediatric program, 7% (6/90) from an affiliate program, and 40% (36/90) from an adult program. Program knowledge of eligibility and referrals was high for both SNAP and WIC across all programs. Responses on SNAP indicate that 94% (85/90) of programs have a team member with knowledge of eligibility and 93% (84/90) have a team member with knowledge of the referral process. Responses on WIC indicate that 96% (86/90) of programs have a team member with knowledge of both eligibility and the referral process. Only 2% (2/90) of programs had no knowledge of eligibility and the referral process. With step logic, only programs who refer to WIC or SNAP were invited to continue the survey (87/90). 83% (72/87) of referring programs answered that they follow up at consecutive appointments to determine if families remain in SNAP or WIC. However, most programs (83%, 72/87) are not formally tracking referrals. 66% (57/87) of respondents felt a tool to help track referrals to SNAP or WIC would be helpful. Thematic analysis showed several barriers to accessing SNAP and WIC. The top 5 reported barriers include patient/family follow-through (41%, 36/87), eligibility requirements (21%, 18/87), complicated application (9%, 8/87), transportation (6%, 5/87), and benefit worth (6%, 5/87). 12% of respondents stated no barriers.

Conclusions: The results of the survey indicate that responding CF programs are aware of and refer to SNAP and WIC. While it is encouraging that many programs report following up with patients and families after a referral, not tracking referrals could present issues with follow-up. Thematic analysis of barriers to the programs underscores the importance of patient follow-up after a referral. A survey of patients and families will be important to understand the barriers to entry for SNAP and WIC. A potential limitation to the survey could be program bias; responses may only be from programs engaging with SNAP or WIC.
The Cystic Fibrosis Foundation has created a FI quality improvement screening tracking log to assist with tracking FI screens and interventions located in the My.CFF Resource Library. The CF Foundation will also be sharing a presentation on the FNPs in 2022 and will continue to monitor the use of these materials by tracking dissemination and utilization.

Acknowledgements:

References: [1] Seyoum, S., Regenstein, M., Nolan, L. "Risk indicators of food insecurity in the CF population" (2021). Health Policy and Management Issue Briefs. Paper 59. https://hsrc.himmelfarb.gwu.edu/sphhs_policy_briefs/59