Measuring access to food banks and food pantries: A scoping review of spatial analysis approaches

Food banks and food pantries are crucial in supporting access to food and addressing food insecurity for millions of people. This scoping review identified eighteen articles that applied spatial analysis approaches to measure access to food banks and food pantries. The review summarizes the methods and primary findings of these studies, and examines how these address different dimensions of food access. Findings suggest that the majority of studies measured the accessibility and availability dimensions of food access, and two addressed accommodation. Through a discussion of these studies' methods and broader literature on food environments, we highlight opportunities to integrate advanced geospatial and mixed methods to support an empirically grounded and broader understanding of food bank and pantry access in future research. This will yield a more holistic picture of food environments and provide practical implications for site selection, resource allocation, and food assistance operations.

Experiences and perceived outcomes of a grocery gift card programme for households at risk of food insecurity

OBJECTIVE

This study explored programme recipients' and deliverers' experiences and perceived outcomes of accessing or facilitating a grocery gift card (GGC) programme from I Can for Kids (iCAN), a community-based programme that provides GGC to low-income families with children.

DESIGN

This qualitative descriptive study used Freedman et al's framework of nutritious food access to guide data generation and analysis. Semi-structured interviews were conducted between August and November 2020. Data were analysed using directed content analysis with a deductive-inductive approach.

PARTICIPANTS

Fifty-four participants were purposively recruited, including thirty-seven programme recipients who accessed iCAN's GGC programme and seventeen programme deliverers who facilitated it.

SETTING

Calgary, Alberta, Canada.

RESULTS

Three themes were generated from the data. First, iCAN's GGC programme promoted a sense of autonomy and dignity among programme recipients as they appreciated receiving financial support, the flexibility and convenience of using GGC, and the freedom to select foods they desired. Recipients perceived these benefits improved their social and emotional well-being. Second, recipients reported that the use of GGC improved their households' dietary patterns and food skills. Third, both participant groups identified programmatic strengths and limitations.

CONCLUSION

Programme recipients reported that iCAN's GGC programme provided them with dignified access to nutritious food and improved their households' finances, dietary patterns, and social and emotional well-being. Increasing the number of GGC provided to households on each occasion, establishing clear and consistent criteria for distributing GGC to recipients, and increasing potential donors' awareness of iCAN's GGC programme may augment the amount of support iCAN could provide to households.

Testing the Feasibility and Dietary Impact of a "Produce Prescription" Program for Adults with Undermanaged Type 2 Diabetes and Food Insecurity in Australia

BACKGROUND

There is growing interest in Food is Medicine programs that incorporate food-based interventions into health care for patients with diet-related conditions.

OBJECTIVES

We aimed to test the feasibility of a "produce prescription" program and its impact on diet quality for people with type 2 diabetes (T2D) experiencing food insecurity in Australia.

METHODS

We conducted a pre-post intervention study in n = 50 adults experiencing food insecurity with T2D and glycated hemoglobin (HbA1c) ≥8%. Once enrolled, participants received healthy food boxes weekly free of charge, with the contents sufficient to create 2 meals/d, 5 d/wk for the entire household, over 12 wk. Participants were also provided with tailored recipes and behavioral change support. The primary outcome was change in diet quality assessed by 24-h diet recalls. Secondary outcomes included differences in cardiovascular disease risk factors; blood micronutrients; and feasibility indicators. Differences in the baseline and 12-wk mean primary and secondary outcomes were assessed by paired t tests.

RESULTS

Participants were older adults with mean ± SD age 63 ± 9 y (range: 40-87 y), HbA1c 9.8% ± 1.5%, and 46% were female. Overall, 92% completed the final study follow-up for the primary outcome. Compared with baseline, diet quality improved at week 12, with an increase in the mean overall diet quality (Alternate Healthy Eating Index score) of 12.9 (95% CI: 8.7, 17.1; P < 0.001), driven by significant improvements in vegetables, fruits, whole grains, red/processed meat, trans fat, sodium, and alcohol consumption. Blood lipids also improved (total:HDL cholesterol: -0.48; 95% CI: -0.72, -0.24; P < 0.001), and there was significant weight loss (-1.74 kg; 95% CI: -2.80, -0.68 kg, P = 0.002), but no changes in other clinical outcomes. Participants reported high levels of satisfaction with the program.

CONCLUSIONS

These findings provide strong support for an adequately powered randomized trial to assess effects of produce prescription as an innovative approach to improve clinical management among individuals with T2D experiencing food insecurity. This trial was registered at https://anzctr.org.au/ as ACTRN12621000404820.

Community gardens and wellbeing amongst vulnerable populations: a thematic review

The aim of the thematic review is to document the effects of community gardens on wellbeing amongst vulnerable populations. We searched for articles published between 1980 and 2017 in major databases resulting in the inclusion of 51 articles. Vulnerable populations included, amongst others, ethnic minorities and refugees, socioeconomically disadvantaged neighbourhoods or low-income or food insecure families. Our findings suggest that community garden participation may have a positive impact on physical health, such as reducing body weight and hypertension, and increasing physical activity and food knowledge. However, findings relating to community gardens and their potential to enhance food security were inconsistent. Furthermore we found that community gardens can have a positive influence both at the individual level (i.e. self-esteem, independence, personal control, etc.), particularly for refugees; the relational and social level (i.e. relationships, social connections, community and neighbourhood). Community garden participation have the potential to enhance wellbeing amongst vulnerable populations. However, two articles in our review presented potential food safety concerns related to community gardens, indicating that, particularly in urban settings, attention must be given to minimizing potential food safety concerns, e.g. by using raised garden beds. Based on this review, we recommend that further research and evaluation on non-US-based community gardens is carried out, as community gardens are practiced globally but there is little research to document the effects of community gardens on wellbeing amongst vulnerable populations outside of the USA.

Food Insecurity amid the COVID-19 Pandemic: Food Charity, Government Assistance, and Employment

To mitigate the effects of the coronavirus disease 2019 (COVID-19) pandemic, the federal government has implemented several financial assistance programs, including unprecedented funding to food charities. Using the Canadian Perspectives Survey Series 2, we examine the demographic, employment, and behavioural characteristics associated with food insecurity in April-May 2020. We find that one-quarter of job-insecure individuals experienced food insecurity that was strongly associated with pandemic-related disruptions to employment income, major financial hardship, and use of food charity, yet the vast majority of food-insecure households did not report receiving any charitable food assistance. Increased financial support for low-income households would reduce food insecurity and mitigate negative repercussions of the pandemic.

Process Evaluation of a Community Garden at an Urban Outpatient Clinic

In addition to expediting patient recovery, community gardens that are associated with medical facilities can provide fresh produce to patients and their families, serve as a platform for clinic-based nutrition education, and help patients develop new skills and insights that can lead to positive health behavior change. While community gardening is undergoing resurgence, there is a strong need for evaluation studies that employ valid and reliable measures. The objective of this study was to conduct a process evaluation of a community garden program at an urban medical clinic to estimate the prevalence of patient awareness and participation, food security, barriers to participation, and personal characteristics; garden volunteer satisfaction; and clinic staff perspectives in using the garden for patient education/treatment. Clinic patients (n = 411) completed a community garden participation screener and a random sample completed a longer evaluation survey (n = 152); garden volunteers and medical staff completed additional surveys. Among patients, 39% had heard of and 18% had received vegetables from the garden; the greatest barrier for participation was lack of awareness. Volunteers reported learning about gardening, feeling more involved in the neighborhood, and environmental concern; and medical staff endorsed the garden for patient education/treatment. Comprehensive process evaluations can be utilized to quantify benefits of community gardens in medical centers as well as to point out areas for further development, such as increasing patient awareness. As garden programming at medical centers is formalized, future research should include systematic evaluations to determine whether this unique component of the healthcare environment helps improve patient outcomes.

Increasing access to healthful foods: a qualitative study with residents of low-income communities

BACKGROUND

Inadequate access to healthful foods has been identified as a significant barrier to healthful dietary behaviors among individuals who live in low-income communities. The purpose of this study was to gather low-income community members' opinions about their food purchasing choices and their perceptions of the most effective ways to increase access to healthful foods in their communities.

METHODS

Spanish and English focus groups were conducted in low-income, ethnically-diverse communities. Participants were asked about their knowledge, factors influencing their food purchasing decisions, and their perceptions regarding solutions to increase access to healthful foods.

RESULTS

A total of 148 people participated in 13 focus groups. The majority of participants were female and ethnically diverse (63% Hispanic, 17% African American, 16% Caucasian, and 4% “other”). More than 75% of the participants reported making less than $1999 USD per month. Participants reported high levels of knowledge and preference for healthful foods. The most important barriers influencing healthful shopping behaviors included high price of healthful food, inadequate geographical access to healthful food, poor quality of available healthful food, and lack of overall quality of the proximate retail stores. Suggested solutions to inadequate access included placement of new chain supermarkets in their communities. Strategies implemented in convenience stores were not seen as effective. Farmers’ markets, with specific stipulations, and community gardens were regarded as beneficial supplementary solutions.

CONCLUSION

The results from the focus groups provide important input from a needs assessment perspective from the community, identify gaps in access, and offer potential effective solutions to provide direction for the future.

Cross-sectional analysis of a community-based cooperative grocery store intervention in Saskatoon, Canada

OBJECTIVES

The aim of this research is to examine the awareness and use of the Good Food Junction (GFJ), a not-for-profit full service cooperative grocery store in a former food desert in Saskatoon, Canada.

METHODS

Through door-to-door sampling, 365 residents in their neighbourhoods surrounding the GFJ grocery store were recruited. Quantitative surveys examined awareness, use and primary use of GFJ, mode of transportation to and from GFJ and primary grocery stores, other food program use and demographic data. Differences between those who had or had not shopped at GFJ were characterized using descriptive statistics and Pearson's chi-square test. Univariate and multivariate logistic regression models were developed to predict shopping at GFJ and the use of GFJ as a primary grocery store.

RESULTS

Of those surveyed, 69% had shopped at GFJ. A significant proportion of shoppers were Aboriginal, had an annual household income per person of less than $20,000, and participated in other food-based programs and initiatives. Aboriginal people (OR = 2.0, p = 0.03) and users of neighbourhood-based fruit and vegetable markets (OR = 2.7, p = 0.04) were significantly more likely, but new immigrants to Canada (OR = 0.3, p = 0.05) were significantly less likely to have ever shopped at GFJ. Aboriginal respondents (OR = 2.6, p = 0.04) were significantly more likely to use GFJ as their primary grocery store.

CONCLUSION

Our results confirm both that GFJ is able to serve households where food insecurity is likely and, based on the prevalence of users, the importance and need for a full-service supermarket in Saskatoon's inner city.

A survey of food bank operations in five Canadian cities

BACKGROUND

Food banks have emerged in response to growing food insecurity among low-income groups in many affluent nations, but their ability to manage this problem is questionable. In Canada, in the absence of public programs and policy interventions, food banks are the only source of immediate assistance for households struggling to meet food needs, but there are many indications that this response is insufficient. The purpose of this study was to examine the factors that facilitate and limit food bank operations in five Canadian cities and appraise the potential of these initiatives to meet food needs.

METHODS

An inventory of charitable food provisioning in Halifax, Quebec City, Toronto, Edmonton, and Victoria, Canada was conducted in 2010. Of the 517 agencies that participated in a telephone survey of their operations, 340 were running grocery programs. Multivariate regression analyses were conducted to determine the association between program characteristics, volume of service, and indicators of strain in food banks' abilities to consistently achieve the standards of assistance they had established.

RESULTS

Extensive, well-established food bank activities were charted in each city, with the numbers of people assisted ranging from 7,111 in Halifax to 90,141 in Toronto per month. Seventy-two percent of agencies indicated that clients needed more food than they provided. The number of people served by any one agency in the course of a month was positively associated with the proportion of food distributed that came from donations (beta 0.0143, SE 0.0024, p 0.0041) and the number of volunteers working in the agency (beta 0.0630, SE 0.0159, p 0.0167). Food banks only achieved equilibrium between supply and demand when they contained demand through restrictions on client access. When access to assistance was less restricted, the odds of food banks running out of food and invoking measures to ration remaining supplies and restrict access rose significantly.

CONCLUSIONS

Despite their extensive history, food banks in Canada remain dependent on donations and volunteers, with available resources quickly exhausted in the face of agencies' efforts to more fully meet clients' needs. Food banks have limited capacity to respond to the needs of those who seek assistance.