(P24-086-23) Formative Research To Assess Food Is Medicine Programs During COVID-19 Among Individuals Accessing Federally Qualified Health Center Services in Northern California

Objectives: This formative, mixed-methods study aimed to 1) understand the effects of the COVID-19 pandemic on health care access and food security, and identify related coping strategies, among Federally Qualified Health Center (FQHC) clients; and 2) assess potential barriers and facilitators to access to services, with emphasis on FQHC Food is Medicine programs.

Methods: From December 2021 to September 2022, 19 interviews (10 English, 9 Spanish) were conducted with FQHC clients in Yolo County, CA (14 female, 14 Hispanic). Participants were asked questions about their experiences, including use of FQHC programs, for two time periods: pre-pandemic (before March 2020) and “during-pandemic” (last 12 months). For qualitative analysis, transcripts were coded with NVivo and analyzed with the Framework Method. Descriptive statistics were conducted for pre-coded questions.

Results: During the pandemic, participants felt increased difficulty with healthcare access and healthcare cost, and reported an increase in food insecurity (N=11 pre, N=16 during). Participants relied on more community resources such as the local food bank (N=4 pre, N=9 during), and on social networks, such as friends and families, to cope with these difficulties. Telehealth was seen as a form of health care continuation for most but was difficult for some. Regarding FQHC programs, participants reported increased knowledge and skills from participation in culinary education, and increased access to vegetables through clinic food distribution. Barriers to program use included client time constraints and limited program awareness. Additional themes included difficulty managing diabetes with the quality of food received from the food bank, and desire for more information on social protection programs, charitable food system resources, and program opportunities.

Conclusions: FQHC programs, community resources, and social networks were coping strategies at a time of increased food insecurity and decreased access to care during the COVID-19 pandemic. In this Yolo County FQHC, potential avenues to strengthen and integrate food programs with primary care include increased outreach and advertising and more flexible program offerings.

Funding Sources: Henry A Jastro Research Award and Clinical and Translational Science Center Award