Facilitators and Barriers to Patient Attendance at a Free Health Center Produce Market.
Facilitators and Barriers to Patient Attendance at a Free Health Center Produce Market.
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DOI：
10.1016/j.amepre.2022.03.034
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发表时间：
2022-09
影响因子：
5.5
通讯作者：
Cortes, Dharma E.
中科院分区：
文献类型：
--
作者：
Zack, Rachel M.;Bronico, Jackie V. Rodriguez;Babbin, Molly;Nguyen, Tra;Weil, Rachel;Granick, Jean;Fiechtner, Lauren;Mulugeta, Wudeneh;Odayar, Varshini;Cortes, Dharma E.
患者参与医疗保健系统发起的努力，以解决粮食不安全的差异很大。这项混合方法研究旨在了解患者的社会人口学因素，以及与剑桥健康联盟与大波士顿食品银行合作举办的每月农产品市场的使用相关的障碍和促进因素。基线调查（n=715）于2019年2月至2020年3月在上市前进行，随后进行了1年的随访调查（n=514）和定性访谈（n=45）。稳健泊松回归估计社会人口特征和市场参与之间的关联。分析于二零二一年至二零二二年进行。37.1%的人参加市场≥1次。市场参与率与年龄30-49岁相关（RR=1.36，95% CI=1.00，1.86）;家庭月收入<1，000美元（RR=1.73，95% CI=1.29，2.32）;确定为亚洲人（RR=2.48，95% CI=1.58，3.89）;首选英语以外的医疗语言（RR=1.35，95% CI=1.03，1.76）、退休（RR=1.90，95% CI=1.17，3.08）、居住在市场所在城市（RR=1.36，95% CI=1.12，1.63）。障碍包括时间有限（28%），工作冲突（23%），健忘（23%）和不知道市场位置/日期（22%）。访谈揭示了无障碍障碍（例如，有限的市场营业时间、交通问题、竞争性需求、医疗条件、排长队等）是出席会议的障碍，而获得新颖、健康的食品则是出席会议的动力。以保健为基础的粮食分配有可能帮助那些无法或不愿获得其他形式粮食援助的粮食需求得不到满足的病人。时间限制，物理限制和交通挑战影响出勤率;计划修改是必要的，以提高可访问性。
Patient participation in healthcare system-sponsored efforts to address food insecurity varies widely. This mixed-methods study sought to understand patient sociodemographic factors associated with, and barriers and facilitators to, use of a monthly produce market held at Cambridge Health Alliance in partnership with The Greater Boston Food Bank. Baseline surveys (n=715) were conducted from February 2019–March 2020 prior to market attendance, followed by 1-year follow-up surveys (n=514) and qualitative interviews (n=45). Robust Poisson regression estimated associations between sociodemographic characteristics and market attendance. Analyses were conducted from 2021–2022. 37.1% attended the market ≥1 time. Market attendance was associated with being aged 30–49 years (RR=1.36, 95% CI=1.00, 1.86); having a monthly household income of <$1,000 (RR=1.73, 95% CI=1.29, 2.32); identifying as Asian (RR=2.48, 95% CI=1.58, 3.89); having a preferred language for medical care other than English (RR=1.35, 95% CI=1.03, 1.76); being retired (RR=1.90, 95% CI=1.17, 3.08); and living in the city of the market’s location (RR=1.36, 95% CI=1.12, 1.63). Barriers included limited time (28%), work conflict (23%), forgetfulness (23%), and not knowing market location/date (22%). Interviews revealed accessibility barriers (e.g., limited market hours, transportation issues, competing demands, medical conditions, long lines) were obstacles to attendance, while access to novel, healthy foods motivated attendance. Healthcare-based food distributions have the potential to reach patients with unmet food needs who cannot, or would not, access other forms of food assistance. Time constraints, physical limitations, and transportation challenges impact attendance; program modifications are necessary to improve accessibility.
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作者：
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