Med Journal February 2022 | Page 4

Case Study by Mary M . Bailey , MPH , MS 1 ; Brett Rowland , MA 1 ; Pearl A . McElfish , PhD , MBA 2 ; Rachel S . Purvis , PhD 2 ; Bonnie M . S . Faitak , MS , Med 1 ; Emily S . English , DrPH , MPS 2 ; Christopher R . Long , PhD 2

1
Office of Community Health and Research , UAMS Northwest , Fayetteville , Ark .
2
College of Medicine , UAMS Northwest , Fayetteville , Ark .

Events Precipitating Arkansas Food Pantry Utilization : A Qualitative Study

Abstract
Food pantry users experience high rates of food insecurity and chronic illnesses . Events leading to food pantry utilization are not well understood . Semi-structured interviews were conducted with 50 food pantry users to explore events that led to food pantry utilization . Unexpected changes in income , costs associated with acute and chronic illnesses , and changes in household structure were all common events that led to initial food pantry utilization . Future studies should evaluate the efficacy of coordinated responses among the charitable food system , primary care providers , and social services to meet acute needs of food insecure Arkansans .
Introduction
In 2019 , 4.4 % of households in the U . S . accessed food pantries . 1 Food pantry clients have high rates of food insecurity , which is defined as having difficulty providing sufficient food for all household members to live an active , healthy life . 1 Food insecurity is associated with a variety of chronic illnesses , including diabetes , obesity , asthma , hypertension , and various cardiac diseases . 2-5 Health researchers have recognized that food pantry clients have poor diet quality and poor medication adherence . 6 For these reasons , health researchers and clinicians have begun to implement chronic illness prevention and management interventions in food pantries . 7-9
As partnerships among health researchers , clinicians , and food pantries grow , it is important to understand events that lead to pantry utilization in order to better respond to food pantry clients ’ needs . The present study explored food pantry clients ’ experiences that led to food pantry utilization , including unexpected changes in income , costs associated with acute and chronic illnesses , and changes in household structure .
Methods
Fifty participants were recruited from the lines of seven food pantries in Northwest Arkansas . These participants were a subset of a larger study assessing food security status , frequency of food pantry use , and sociodemographic characteristics . 10 Every third survey respondent was asked to participate in a 15-minute interview until the recruitment target goal of 50 total participants was reached . Fifty ( 93 %) of the 54 participants who were asked to participate in the interview agreed to participate . The informed consent process was conducted by seven trained study team members ( two were bilingual ) in the language of choice of the participant . Participants received a total of $ 20 in gift cards for completing the survey and interview . A semi-structured interview guide was utilized to conduct interviews in July and August 2018 . The guide was developed based on feedback from local food pantry staff and prior experiences of the authors in food pantries , with the goal of better understanding the lived experiences of food pantry users . Interviews were conducted in quiet areas in food pantries to maintain participant privacy . Seven trained research team members conducted the interviews and informed consent process in the preferred language of the participants . Interviews were conducted in Spanish , Marshallese , or English , depending upon participant preference . All interviews were audio recorded , transcribed verbatim , and translated into English , as needed .
The study team analyzed interview data using the constant comparative method . 11 Two research team members , trained in qualitative methods , completed initial coding of the interviews using a priori codes developed from the interview guide and a review of interview responses . The initial codes were used to label data segments in short summaries and to organize the data for more focused codes . A codebook was developed to organize both the a priori themes and emergent themes related to participant experiences and perceptions of pantry use . One team member reviewed the coding scheme to ensure analytic rigor and reliability . Discrepancies in codes and data interpretation were resolved via consensus of the research team . The most salient quotes are presented . The UAMS Institutional Review Board reviewed and approved the study protocol ( IRB # 217560 ).
Results
Participant Characteristics Participants ’ demographic characteristics are presented in Table 1 . Participants ’ median age was 48 years . Most participants ( 76 %) identified as female , and 74 % of participants had been using food pantries for more than a year .
Experiences That Lead to Initial Food Pantry Use Pantry clients reported initial utilization of food pantries was precipitated by events in their lives . The most common events participants described were unexpected changes in income , costs associated with acute and chronic illness , and changes in household structure .
Unexpected Changes in Income Participants reported unexpected changes in income that led to their initial utilization of food pantries . One participant stated , “ Well me and my husband had both lost our jobs . We were working at the same place … the company was going under . We found ourselves unemployed . We had
172 • The Journal of the Arkansas Medical Society www . ArkMed . org