UT MD Anderson Cancer Center, Houston, TX
Stephanie J. Wells, Brandon Douglas Brown, Kris Michael Mahadeo, Keri L. Schadler, Joya Chandra, Michael D. Swartz, Maria Chang Swartz
Background: Food insecurity (FI) affects 1 in 5 US households with children and is associated with malnutrition and poor diet quality in children. Malnutrition negatively impacts clinical trial outcomes, chemotherapy tolerance, and survival rate in cancer patients, who may be at higher FI risk given the financial toxicity of treatment. Thus, we aimed to assess FI prevalence and sociodemographics of pediatric patient caregivers at MD Anderson Cancer Center Children’s Cancer Hospital (MDACC-CCH) and to identify healthcare provider sociodemographics and FI practice considerations. Methods: We surveyed caregivers and providers at MDACC-CCH anonymously from December 2019 to January 2020. Caregiver surveys included sociodemographics and The Hunger Vital Sign FI screening tool. Oncologists and other providers were surveyed on FI-related practice considerations. Univariate relationships between known covariates and FI were explored using purposeful covariate selection and multivariable logistic regression to model variables associated with FI risk factors. Results: Baseline characteristics are listed in Table. Of 67 caregiver responses, 36% were positive for FI. Univariate analyses revealed that race, education level, spousal/child support, marital status, and household income were associated with FI status. Final logistic regression model indicated that race other than Non-Hispanic White and lower education level were positively associated with FI. Of 38 provider responses, 58% reported being knowledgeable about FI to some extent. No providers referred patients to community food access resources. Conclusions: In a small pilot study, FI is prevalent in families of pediatric cancer patients at MDACC-CCH and may be associated with race and education level. Further research is needed to assess the impact of the COVID-19 pandemic on FI in this population and to determine appropriate interventions and clinical pathways to improve FI status.
Characteristic | Mean (SD) or Percentage |
---|---|
Age (years) | 30.4 (14.8) |
Gender | - |
F | 64.2% |
Race | - |
Non-Hispanic White | 49.3% |
Other | 50.7% |
Education Level | - |
Elementary/Some high school | 20.9% |
High school/GED | 23.9% |
Some college and college grad | 20.9% |
College | 31.3% |
Marital Status | - |
Married/Partner | 40.3% |
Single | 46.3% |
Divorced | 11.9% |
Spousal/Child Support* | - |
Y | 4.5% |
N | 10.4% |
Household Income | - |
$0-29,999 | 22.3% |
$30,000-89,999 | 32.9% |
>$90,000 | 23.9% |
Insurance | - |
Y | 79.1% |
N | 14.9% |
*Of divorced/separated participants, how many receive spousal or child support
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