To assess families’ food access needs and translate findings into programs that meet them, our team has focused in on one of the few places families are still going: the doctor’s office. In July 2020, we partnered with the St. Christopher’s Foundation for Children, Lancaster Farm Fresh Cooperative and the Garden at Karabots to launch Farm to Families, a cost-subsidized community-supported agriculture program (CSA). In addition to alleviating some of the immediate burden of food insecurity, the goals of Farm to Families include understanding the unprecedented food access challenges that families are facing in real-time, and evaluating whether clinical care sites are feasible and acceptable locations for a cost-subsidized CSA.

We conducted a 12-week pilot in the summer of 2020, distributing free boxes of produce at Children’s Hospital of Philadelphia’s (CHOP) Karabots Pediatric Care Center and the Buerger Center for Advanced Pediatric Care. Before receiving a produce box, participants completed a brief demographic and food insecurity survey and could opt-in to a follow-up phone interview. During the interview, participants were asked to share their experience with Farm to Families as well as provide feedback on how a CSA program based in a health care setting could better meet their needs. The interview also assessed how the pandemic affected caregivers’ ability to obtain enough food for their families, changes to benefits and how families engage with community resources during this time.

During this pilot, the team distributed boxes to reach more than 6,400 individuals. Without preceding eligibility criteria, the program reached families with nearly a 50% rate of reported food insecurity, highlighting that screening is not imperative to reach food insecure families. Interviews revealed that while many caregivers were initially “surprised” by the program setting within the clinic, they ultimately felt that it reinforced the hospital’s commitment to “whole health” and perceived it to be safer than other food program settings during the pandemic. Several programmatic features emerged as particularly important: ease and efficiency of use, kindness of staff, and confidentiality.

Participants reported that engagement with the Farm to Families program helped mitigate barriers to food access by reducing the frequency of shopping trips, and enabled the reallocation of finances to needs other than food. Further, the program cultivated caregivers’ and children’s’ favorable attitudes toward fresh produce, increased interest in purchasing produce, and developed confidence in preparing produce for family through exploration of recipes and exposure to new ingredients.

Source: Pediatrics