Client-driven modifications to food assistance and related resources for households affected by type 2 diabetes

Authors: HINGLE, MELANIE - University Of Arizona; SHORT, ELIZA - University Of Arizona; SHARMA, JAYATI - University Of Arizona; TAREN, DOUG - University Of Arizona; GONZALEZ, RHONDA - Community Food Bank Of Southern Arizona; SHEAVA, JESSI - Community Food Bank Of Southern Arizona; Thompson, Deborah - Debbe

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 2/7/2020
Publication Date: 6/18/2020
Citation: Hingle, M., Short, E., Sharma, J., Taren, D., Gonzalez, R., Sheava, J., Thompson, D.J. 2020. Client-driven modifications to food assistance and related resources for households affected by type 2 diabetes [abstract]. International Society of Behavioral Nutrition and Physical Activity (ISBNPA) Annual Conference (Virtual). June 15-25, 2020. Symposium.

Interpretive Summary:

Technical Abstract: The Community Food Bank of Southern Arizona (CFB) provides emergency food assistance to 33,500+ households across 5 counties monthly; 41.7% of CFB households have reported >1 member with Type 2 diabetes (T2D). The objective of this study was to identify CFB clients' perspectives regarding whether and how modifications to food assistance boxes (5-7 items including canned/dried legumes, vegetables, and grains) should occur, and if additional resources were needed to support diet quality in food-insecure households with T2D. Twenty food bank clients with T2D or living with a person with T2D were recruited to participate in one in-depth interview. Eligible participants spoke and understood English or Spanish and received food assistance currently. A semi-structured script was used to guide participants as they examined food items typically offered by CFB and discussed how they utilized them. Participants were asked to select two foods to hypothetically remove from current offerings and, suggest two new foods to include. Interviewers probed for additional information regarding what constituted appropriate foods (e.g., utility, cultural relevance, preferences, health concerns). Interviews were conducted in English (n=10) and Spanish (n=10), audio-recorded, and transcribed. Transcripts were independently coded by two researchers. A code book was developed based on the interview script and verified by a senior researcher. Themes were identified using data-driven analysis in NVivo. Participants were majority female, Hispanic, 64.9-years-old, and at risk of food insecurity. Participants reported utilizing most foods provided by CFB. There was high agreement regarding which foods to remove (e.g., split peas and black beans) and the rationale (e.g., lack of knowledge, cultural incongruence). Participants also agreed on substitutions (e.g., whole oats, cooking oil) citing health and/or flexibility and cost. Additional resources suggested by participants to manage T2D included monthly classes, recipes, help obtaining medical supplies, and access to health providers. Client-suggested modifications of food assistance and related resources included increased cultural responsiveness of foods, greater instrumental support with regard to meal preparation, medical management of T2D, and improved access to care.