Funded Projects

Food Insecurity & Asthma: Community Perspectives

Project Year

2026

City & State

Washington, D.C.

Program Name

Planning

Topic

Food Insecurity

Program Description

The Problem: Pediatric asthma is the most common chronic disease of childhood and a major driver of healthcare utilization and expenditures.1,2 Significant disparities exist in asthma prevalence, morbidity, and healthcare use.3–5 Food Insecurity (FI)— the limited ability to obtain nutritionally adequate food in socially acceptable ways—is associated with higher asthma prevalence and poorer asthma control.6,7 Despite growing evidence linking FI and asthma morbidity, little is known about caregivers’ perceptions of FI’s impact on their child’s asthma and how acceptable they find FI resources as a part of routine asthma care. Engaging families about their preferences is an evidence-based strategy for identifying effective interventions for children with chronic conditions like asthma, ultimately improving asthma morbidity and reducing disparities.8–10 Current healthcare FI interventions rely on referrals to federal programs or emergency food assistance, but barriers such as complex paperwork and confusing eligibility requirements limit engagement.11–14 To improve food resource engagement, caregiver and community partner perspectives in this population are critical.

The Goal: Collaborate with caregiver and community food resource partners to better understand (1) the perceived association between FI and pediatric asthma, (2) the current food resource assistance landscape and its acceptability to caregivers, and (3) facilitators and barriers of current food resources, serving as a launching pad for an improved food resource toolkit.  

The number of children affected: Both pediatric asthma and FI are common in Washington, DC.1,15,16 A recent estimate suggests that over 100,000 children across Washington DC experience FI.15 Further, the pediatric asthma prevalence is higher than the national average (14% compared to national average of 6.2%) with disproportionate rates of morbidity concentrated in under-resourced neighborhoods.1,16,17  The primary setting: This qualitative work will be primarily situated within Improving Pediatric Asthma Care in the District of Columbia (IMPACT DC) Program at Children’s National Hospital (CNH), which provides comprehensive asthma care to at-risk children across DC. IMPACT DC accepts referrals from general pediatricians, the emergency department, the inpatient setting, and schools across the region and has a strong community presence in providing asthma care and asthma-associated social needs interventions. A recent survey in IMPACT DC revealed that over 1/3 of families reported a food need, highlighting the critical need for effective resource connection in this population.18

The Intervention: The current food referral process utilized by IMPACT DC does not adequately address families’ needs, creating an opportunity to leverage caregiver and community partner voices to improve food resource connection. I will use semi-structured interviews with caregivers of children with asthma who endorse a food need, as well as with community food resource partners, to understand both the current food resource landscape in Washington, DC, and barriers and facilitators of effective resource navigation to improve referral processes in IMPACT DC and promote effective FI resource connection.

The Outcome: This preparatory work will result in a refined, patient-informed, community-supported toolkit that outlines effective food resource connection processes and customized local resource lists tailored to food insecure caregivers of children with asthma in Washington, DC.

Project Goal

Partner with both caregiver and community food resource partners to develop and refine a caregiver-informed, community-supported toolkit for food insecure families who seek care for their child’s asthma.

Project Objective 1

Objective 1: By November, 2026, assess caregiver perceptions of the relationship between FI and asthma and understand their awareness of available food resource assistance in Washington, DC. 

Project Objective 2

Objective 2: By April, 2027, identify current-day facilitators and barriers of accessing food resources among caregivers and community food partners and co-develop potential strategies to improve food resource assistance access.  

Project Objective 3

Objective 3: By June, 2027, increase awareness of and access to caregiver-informed and community-supported food resource interventions for families with a child with asthma.  

AAP District

District III

Institutional Name

Children's Research Institute

Contact 1

Megan Smith, MD,MPH