Forging a Pediatric Primary Care–Community Partnership to Support Food-Insecure Families

Abstract

BACKGROUND AND OBJECTIVES: Academic primary care clinics often care for children from underserved populations affected by food insecurity. Clinical-community collaborations could help mitigate such risk. We sought to design, implement, refine, and evaluate Keeping Infants Nourished and Developing (KIND), a collaborative intervention focused on food-insecure families with infants. METHODS: Pediatricians and community collaborators codeveloped processes to link food-insecure families with infants to supplementary infant formula, educational materials, and clinic and community resources. Intervention evaluation was done prospectively by using time-series analysis and descriptive statistics to characterize and enumerate those served by KIND during its first 2 years. Analyses assessed demographic, clinical, and social risk outcomes, including completion of preventive services and referral to social work or our medical-legal partnership. Comparisons were made between those receiving and not receiving KIND by using χ2 statistics. RESULTS: During the 2-year study period, 1042 families with infants received KIND. Recipients were more likely than nonrecipients to have completed a lead test and developmental screen (both P < .001), and they were more likely to have received a full set of well-infant visits by 14 months (42.0% vs 28.7%; P < .0001). Those receiving KIND also were significantly more likely to have been referred to social work (29.2% vs 17.6%; P < .0001) or the medical-legal partnership (14.8% vs 5.7%; P < .0001). Weight-for-length at 9 months did not statistically differ between groups. CONCLUSIONS: A clinical-community collaborative enabled pediatric providers to address influential social determinants of health. This food insecurity–focused intervention was associated with improved preventive care outcomes for the infants served.