Inpatient Food Insecurity in Caregivers of Hospitalized Pediatric Patients: A Mixed Methods Study.

Abstract BACKGROUND AND OBJECTIVES Amongst U.S. households with children, 14% are food insecure. Household food insecurity (FI) is associated with poorer health outcomes and increased hospital admissions. There is less known about caregivers’ ability to obtain adequate food during hospitalization (inpatient FI). METHODS We conducted a mixed methods study of primary caregivers of hospitalized children 0-18 years. A modified US Household Food Security Survey was used to identify inpatient FI. Associated factors were identified using logistic regression adjusted for covariables. Caregiver semi-structured interviews were conducted to elicit perceptions on food accessibility and effects of and solutions for inpatient FI. RESULTS The prevalence of inpatient FI was 43%. Household FI was present in 38% of families. Inpatient FI was associated with household FI (p 30 miles from the hospital (aOR 2.80), self-rated fair/poor health (aOR 3.31), maternity leave (aOR 4.75), and past/current Supplemental Nutrition Assistance Program benefit utilization (aOR 2.52). Qualitative analysis identified barriers to food access, such as lack of affordable options, and found that caregivers made sacrifices for their hospitalized child, including skipping meals. Caregivers viewed their presence at their child's bedside and personal nourishment as important factors affecting their child's care. CONCLUSIONS Inpatient FI may affect a significant proportion of hospitalized children's caregivers. Pediatric hospitals should ensure that caregivers have access to food in order to fully engage in their child's care.