90 - Hospitalized and hungry: a mixed methods study describing inpatient food insecurity among immigrant caregivers of hospitalized children

Poster Number: 90
Publication Number: 90.211

Marina Masciale, Baylor College of Medicine, Houston, TX, United States; Michelle Lopez, Baylor College of Medicine, Houston, TX, United States; Mariana Carretero Murillo, Texas Children's Hospital, Houston, TX, United States; Karla Fredricks, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, United States; Karen D. Gibbs, Texas Children's Hospital, Houston, TX, United States; Rathi Asaithambi, Baylor College of Medicine, Houston, TX, United States; Heather Haq, Baylor College of Medicine, Houston, TX, United States; Claire E. Bocchini, Baylor College of Medicine and Texas Childrens Hospital, Houston, TX, United States

Background: Immigrant families have high levels of household food insecurity (FI) and significant barriers in accessing resources to address FI. Little is known about the prevalence of inpatient FI and its associated factors among immigrant caregivers of hospitalized children.

Objective: Assess the prevalence of inpatient FI in immigrant caregivers of hospitalized children, associated individual/household factors, and caregiver perspectives on FI screening and interventions.

Design/Methods: This is a mixed-methods study of a subset of immigrant patients in a larger inpatient FI study. We recruited English and Spanish-speaking primary caregivers of hospitalized children at a large children’s hospital from March-December 2021. Caregivers completed a 136-item survey, including a validated 18-item U.S. Household Food Security Survey and a modified version of the survey to identify inpatient FI. Caregivers who screened positive for either household or inpatient FI were given free meal trays during hospitalization and referred to the local food bank. We compared categorical variables using Fisher’s exact and chi-square tests. Semi-structured interviews with a convenience sample of immigrant participants with inpatient FI are ongoing. Interviews were transcribed, and Spanish transcriptions were translated to English. Codes were assigned to interviews using Dedoose and themes were identified using inductive thematic analysis.

Results: Of 339 immigrant participants, 57% screened positive for inpatient FI. Compared to caregivers without inpatient FI, more caregivers with inpatient FI identified as Hispanic, had annual household income levels < $10,000, did not speak English, and were single (Table 1). Caregivers with inpatient FI had higher levels of household FI, higher food pantry use, and lower Supplemental Nutrition Assistance Program (SNAP) use compared to those without (Table 2). Seven caregiver interviews (6 in Spanish, 1 in English) revealed barriers to inpatient food access, including feeling uncomfortable leaving the bedside, language barriers leading to confusion about food options, and cost. Hospital COVID visitation policy limited options for outside family members to bring in food. Caregivers described skipping meals and rationing leftovers prior to enrolling in our study and expressed gratitude for assessing their level of food security, free meal trays, and food bank referral.Conclusion(s): Over half of immigrant caregivers in this study experienced inpatient FI with several barriers to food access. Immigrant caregivers are receptive to inpatient FI screening, resource referral, and inpatient food provision.
Table 1: Comparison of demographics among immigrant participants with and without inpatient food insecurity (FI)
Table 2: Comparison of household characteristics and benefit use among immigrant participants with and without inpatient food insecurity (FI)