Multiple Comorbidities and Interest in Research Participation Among Clients of a Nonprofit Food Distribution Site

Abstract

Background Persons accessing food from nonprofit distribution sites face numerous challenges and typically have significant unmet health needs. However, given limited and intermittent healthcare system engagement, this vulnerable population is under-represented in clinical research. We sought to better understand the health needs of a non-clinical population to inform future research and interventions. Methods Focus groups were conducted in English (n=4) and Spanish (n=4) with clients of Crossroads Community Services (CCS), the largest distributor of North Texas Food Bank. Discussions probed participants' health status, healthcare utilization, understanding and utilization of mammography, and attitudes toward participation in research. Results Participants included 42 CCS clients, primarily Hispanic or African-American women. Participants reported multiple co-morbid conditions among household members, yet utilization of health services was often limited by cost. The majority expressed interest in participating in research to communicate their health concerns and obtain emotional support. Conclusion CCS clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges. The Community Assistance Research (CARe) Initiative, a community-academic collaboration, establishes a much-needed opportunity for ongoing clinical research and intervention among this underserved population.

Health Research Participation, Opportunity, and Willingness Among Minority and Rural Communities of Arkansas

“…This was somewhat surprising, as prior research has shown that those with chronic conditions are more likely to participate 6, 40, 41, 42. Another unexpected finding was that those who have insurance were less likely to have had the opportunity to participate, and those who were uninsured reported greater opportunity.…”

“…This was somewhat surprising, as prior research has shown that those with chronic conditions are more likely to participate. 6,[40][41][42] Another unexpected finding was that those who have insurance were less likely to have had the opportunity to participate, and those who were uninsured reported greater opportunity. Furthermore, those who reported not being able to afford to go to the doctor, and those without a job reported greater willingness to participate.…”

Who Is Food Insecure? Implications for Targeted Recruitment and Outreach, National Health and Nutrition Examination Survey, 2005–2010

“…We measured health correlates in 3 broad areas associated with food security and food assistance: general health and functional status, health risk behaviors, and health care access indicators ( 2 , 4 , 5 , 9 , 17 – 21 ). Health characteristics — except body mass index (BMI, kg/m 2 ), which was measured directly — were self-reported.…”

“…Most previous studies on the health of food insecure populations recruited participants from a single food assistance program (eg, a WIC office, a food pantry) ( 9 – 12 ). This practice limits our knowledge as to whether health status varies among people participating in public and private programs.…”

Family and Social Context Contributes to the Interplay of Economic Insecurity, Food Insecurity, and Health

“…Elsewhere we described how clients of the same center reported multiple health challenges and comorbidities, including among others, high blood pressure, diabetes, arthritis, and mental health conditions such as depression, schizophrenia, and anxiety (Higashi et al. ). In the present analysis, we show how household health, economic instability, and food insecurity are inextricably linked across family and social networks, creating cumulative and interdependent challenges faced by multiple household members.…”