Table 5.
Representative quotes from each theme in group one.
| Themes | Quotes |
|---|---|
| Cultural factors either impede or enhance screening/referral efforts | Q1: “A lot- because of their documentation status- didn't get any government assistance. Many are day laborers or self-employed with side jobs. They're not eligible for SNAP, and with COVID, the need is really pressing since our patient load in clinic is getting higher.” GG |
| Q2: “The success has been that the partners now how to have the staff that speak multiple languages. So definitely with Houston Foodbank, Brighter Bites, Legacy, Hope clinic, - they have multiple people who speak multiple languages. So, that help with the screening for us as a district.” NB | |
| Clinic capacity and attitudes impacting screening efforts | Q3: “If the clinic becomes very busy, they may ask the question to the patient instead of giving it to the patient in the paper format and that becomes challenging because we know that in the verbal format, the patients really don't express it. They're like- yeah no. And the volume of the clinic: It does get missed if there's a lot of people waiting.” EG |
| Q4: “With our specific program- we offer direct training to the case workers on how to walk through the tool, they have it in front of them when they are able to screen clients. Most of them kind of end up internalizing it and knowing the questions and know how to guide the conversation without having to read it verbatim. But they do have that as a resource.” JK | |
| Greater attention to upstream influences of food insecurity and SDOH needs | Q5: “Food insecurity needs a systems' approach– but an encompassing and encouraging language that's very much a partnership. When you talk to people, they are doing the absolute best they can with what they have– It's not a poverty thing. It's sometimes geographic location or cultural or education level.” TVO |
| Q6: “I would like to echo what LH was saying about upstream factors. If we don't fix the bigger system, it doesn't matter what we ask about food- if we don't make a change to the system overall, then people are still going to go to the food pantry and still going to be hungry and still not have access to nutritious food, so I think it's a bigger question or a bigger issue than just food insecurity.” EF | |
| The COVID-19 pandemic impact on food insecurity | Q7: “COVID certainly has been a big challenge, just with loss of access to being in person in some sites…So that's definitely been a challenge. And I think we've also seen a pretty large increase in disconnected phone numbers with COVID, which can make it hard.” LH |
| Q8: “We've seen an increase in clientele demand than what we've ever seen, specifically during COVID. With our resource partner network, we've been able to fulfill and meet the demand, but there have been some hiccups in terms of coordination logistics at some points in time.” MH | |
| Health Equity Collective support in addressing food insecurity reduction | Q9: “I found that that what is helpful is like, broadcasting this information to everyone so that we know what other people are doing and can pick up some good ideas from other people and share our ideas. So we're not reinventing the wheel every single time.” SM |
| Q10: “The community information exchange infrastructure creates a network and web of integrated systems, [and]. is going to be helpful. Just the sharing infrastructure around it. The CIE from my perspective, feels like the right direction, which does not involve a lot of duplication, but a lot of connection, which is where hopefully, we have systems created in place that can show the impact.” PJ |