O22 Food Insecurity and Opportunities for Interventions: Perspectives of American Indian Elders from an Urban Health Care Clinic

Abstract

<h3>Background</h3> Food insecurity can negatively impact chronic disease management. Older adults often have more nutrition-related chronic disease and barriers to healthful eating such as unreliable transportation and living on a fixed-income. Urban American Indian (AI) serving clinics provide a trusted source of care for American Indian elders and services to mitigate food insecurity among American Indian elders are warranted. <h3>Objective</h3> The objective of this study was to explore the perspectives of AI elders living in 1 large city regarding locally available food insecurity resources and opportunities for the urban clinic to expand food insecurity support. <h3>Study Design, Setting, Participants</h3> Qualitative individual interviews with AI elderly (≥60 years old) patients from an urban AI clinic. Participants (n = 24) engaged in 1 30–90-minute telephone interview. Participants were recruited by clinic staff. <h3>Measurable Outcome/Analysis</h3> One researcher conducted all interviews using a semi-structured moderator guide with probes. "Scenario-based" questions were included to obtain interviewee responses to each scenario. This approach was intended to de-stigmatize food insecurity for participants who may have felt shame in sharing their own experiences with food insecurity. Interviews were audio recorded, transcribed verbatim, and analyzed using the constant comparison method and Atlas.ti. <h3>Results</h3> Four key themes emerged: 1) hunger-mitigating resources exist but don't necessarily lessen food insecurity; 2) multiple layers of challenges present barriers to healthy nutrition for AI elders; 3) unique facilitators rooted in AI culture can help decrease food insecurity; and 4) there are many clinic-based opportunities for programs to improve food insecurity. <h3>Conclusion</h3> These findings provide a foundation for urban-serving AI clinics to develop and implement food insecurity resources for their elders. Resources should build on cultural strengths and be specific to the challenges faced by elders. Some challenges are not unique to AIs and similar resources could be developed for other urban organizations serving elders.