637 - Perceptions of a Newly-Implemented SNAP Screening and Enrollment System in the Pediatric Clinical Setting

Publication Number: 3617.637

Leila Dewitt, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Allison Chandler, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Kimberly Montez, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Deepak Palakshappa, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Wins, NC, United States; Joseph Skelton, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Selina Quinones, Wake Forest School of Medicine, Winston Salem, NC, United States; Mazie Hughes, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Anaya Gregory, Wake Forest Baptist Health - Brenner Children's Hospital, Winston-Salem, NC, United States; Codi King, Wake Forest Baptist Health - Brenner Children's Hospital, Winston Salem, NC, United States; Callie Brown, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States

Background: Food insecurity (FI) is a persistent problem with negative effects on child physical and psychosocial health. Supplemental Nutrition Assistance Program (SNAP) is known to reduce FI and improve health outcomes; yet barriers to SNAP enrollment contribute to a growing population of eligible but unenrolled participants. Pediatric clinical settings provide an opportunity to enroll families in SNAP, addressing structural barriers to SNAP enrollment.

Objective: To assess perspectives of caregivers and study staff of a newly implemented SNAP screening and enrollment program in pediatric clinical settings.

Design/Methods: This qualitative study used semi-structured interviews to explore caregiver and study staff perceptions of SNAP enrollment in clinical settings. SNAP screening/enrollment were implemented across the pediatric outpatient, newborn nursery, and inpatient settings within a children's hospital. Caregivers endorsing FI and/or requesting SNAP evaluation were referred via the electronic health record to an onsite Community Health Worker (CHW) and Department of Social Services (DSS) employee during their child's hospitalization/clinic visit, facilitating bedside SNAP enrollment. Eligible caregivers included English and Spanish speakers who successfully enrolled in SNAP through this intervention. Eligible study staff included the CHW and DSS employees. Interviews were recorded and transcribed. Preliminary data were analyzed using a rapid, modified version of a matrix analysis approach. A matrix was constructed for each group of participants and content within each domain was analyzed for each group. Patterns and cross-cutting findings were identified.

Results: 9 caregivers and 3 study staff completed interviews. Of caregivers, the majority were mothers (89%) and identified as White (44%), Black (1%), and Hispanic (89%).(Table 1) Identified findings include: (1)Families welcomed SNAP enrollment in the clinical setting and valued the support provided, (2)SNAP enrollment was simple, especially compared to past attempts, (3)Clinical-based enrollment addressed structural barriers including transportation, time, and language issues, (4)Families were receptive to the process, though it could be stressful for undocumented families, and (5)SNAP benefits following clinical enrollment reduced FI and boosted household stability.(Table 2)

Conclusion(s): SNAP screening/enrollment in pediatric clinical settings is feasible and acceptable to caregivers. Onsite CHWs and DSS employees within the healthcare system to facilitate SNAP enrollment in clinical settings provide a unique intervention to address enrollment barriers.

Table 1: Demographics of Caregiver Participants


Figure 1: Emergent Themes Identified Through Matrix Analysis