Food Insecurity Among Perinatal People with Substance Use Disorders: Integration of a Clinical Community Partnership

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  • Hammer, Amber Jean
    • School of Nursing
Abstract
  • Background: Food insecurity (FI) affects 17 million (12.8%) households in the United States. Perinatal people with substance use disorders (SUD) are at particularly elevated risk for FI. Food insecurity in these individuals contributes to malnutrition, gestational diabetes, mental health symptoms, and preterm labor. In addition to the physiological impact, FI has significant psychosocial implications. Because of these risks, perinatal people with SUD and their babies often have increased healthcare utilization, increased healthcare costs, and overall worse health outcomes. Methods: The 8-week pilot program included FI screening, education and resources, an on-site food pantry, and food purchasing assistance. An intervention design with a sequential mixed-methods approach was used to assess the pilot program's impact. Surveys assessed the FI prevalence rates (Hunger Vital Sign™), demographic trends, and participants’ perceptions of the program’s impact. In addition, clinician knowledge and beliefs about FI, program efficacy perception, and resource utilization were assessed with a pre-post implementation survey. Results: The pilot program engaged 19 survey participants. All participants found the educational materials and resources provided beneficial, and all participants were identified as either at risk of or currently facing food insecurity. Data from clinician pre- and post-surveys indicated there was a notable increase in the rates of screening for FI and linking clients to resources as a result of this pilot program. The themes identified in the qualitative analysis included 1) the importance of tailored nutritional support; 2) autonomy and personalization through food purchasing support, and; 3) the emotional and psychological impact of a clinical-community partnership that addresses FI. Implications for Practice, Research, and Policy: The implications for practice suggest broadening the scope to include addiction medicine practices, primary care settings that serve patients with SUD, and general perinatal clinics. To fully understand the impact of FI interventions, future longitudinal research with larger cohorts is required to investigate potential variations linked to clinically significant characteristics within this population. Additionally, future research efforts should be made to examine how food purchasing support encourages autonomy and empowerment in people experiencing FI. Future organizational and public policies should prioritize the expansion of FI programs.
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  • In Copyright - Educational Use Permitted
Advisor
  • Coombs, Lorinda A
  • Hirschey, Rachel
  • Johnson, Elisabeth
Degree
  • Doctor of Nursing Practice
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2024
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