Background & Significance

Primary health issue/problem

Food insecurity is described as the inability to access sufficient food to maintain a well-balanced and healthy lifestyle (Banach, 2016). Aside from hunger, symptoms of a person with food insecurity may also include depression, fatigue, and lack of concentration (Makelarski et al., 2015). Food insecurity is a huge public health issue in the U.S where 1 in 5 households with children are food insecure (Coleman-Jensen et al., 2014; Makelarski et al., 2015). While food insecurity affects adults and children both physically and emotionally (Siefert et al., 2004; Makelarski et al., 2015), little is known about the patterns and food insecurity prevalence in caregivers who have hospitalized children. Makelarski et al. (2015) conducted a study of 200 caregivers and found that, aside from personal, financial, and social costs of their child’s hospitalization, 32% found it difficult to provide adequate and affordable meals for themselves thus falling under the definition of food insecure. Additionally, Lee et al. (2019) discovered that 13.5% of caregivers who were food secure at home found themselves food insecure while having a child hospitalized.

While the lack of consistency or having no meals throughout the day can take a toll on a person’s health, that is just one part of the problem. The other issue is ensuring that caregivers are receiving the proper nutrition whilst taking care of their mental health. There is vast opportunity in the topic at hand to explore and find solutions to minimizing the threat of food insecurity that families experience while attending to their critically ill child in the hospital.

Caregivers faced with the tough situation of caring for a severely ill child in the hospital is no easy task. Factors that are associated with food insecurity among families with ill children in the hospital are loss of job or unemployment, low-income, single-status parent or caregiver, not living near their home, or no (or lack of) transportation capabilities (Lee et al., 2019). As such, RMHH also found that these factors contribute to the growing number of families who experience food insecurity while staying in their facility. The majority of caregivers, 66%, obtains food from the hospital’s cafeteria and 42% of caregivers receive food from their family or friends (Lee et al., 2019).

As such, meals that are being consumed may or may not have proper nutritional value as one might have when choosing or cooking their own meals. The lack of food for inpatient caregivers goes beyond being able to access food near or in the hospital. The health impact is far greater than going about on an empty stomach as food insecurity symptoms can impair the caregiver’s decision-making, increase the probability of misunderstanding the medical provider, increase distrust, and facilitate lack of cooperation with their child’s medical needs (Hamelin et al., 1999; Siefert et al., 2004). In Texas, 42.7% of adults reported eating fruit less than once a day and 21.5% reported eating vegetables less than once a day (Center for Disease Control and Prevention, 2016). Furthermore, in the U.S., only 12.2% of adults meet the recommended daily fruit intake and 9.3% meet the recommended daily vegetable intake (Center for Disease Control and Prevention, 2018; Lee et al., 2017). For these reasons, ensuring that hospital caregivers receive the necessary meals each day while also obtaining proper nutritious food is key for healthy, coherent, and compliant caregivers.

Partnering Organization

Ronald McDonald House Houston

1907 Holcombe Blvd.

Houston, TX 77030

https://rmhhouston.org/

Mission statement/vision

The mission of the Ronald McDonald House- Houston is to offer “… a home away from home providing care, compassion and hope to families with seriously ill children being treated in Texas Medical Center member institutions” (Ronald McDonald House Houston, 2015).

The Ronald McDonald House- Houston works collectively with its donors and stakeholders to embody the following vision and core values (Ronald McDonald House Houston, 2015):

Collaboration – work together to ensure families receive the services and attention they need

Partnership – partner with each other to join families on their unique journey

Compassion – understand and meet the physical and emotional needs of families and each other

Excellence – strive for excellence in service, community, and volunteerism for the benefit of families

Relevance – leverage innovation while honoring history to best serve families

The central focus of RMHH has been to provide lodging, always near a hospital or medical center, for families who need to be close to their child (Ronald McDonald House Houston, 2015b). The intent to provide a home away from home atmosphere for RMH families goes beyond a hotel-like room for suitcases and sleeping. It is an all-encompassing effort, to ease obstacles faced by families within the organization’s reach. The opportunity to be steps away from a loved one who is sick is a burden lifted by the spaces that RMH Houston facilities offer.

In addition, RMHH offers shuttle services available to guests as a replacement for expensive parking rates and also aids families who are not familiar with the area to avoid confusing streets in a new city (Ronald McDonald House Houston, 2020b). While RMHH receives generous food/meal donations from the community for families staying in the facility, these donations are not always guaranteed. However, RMHH hosts events such as Spirit of Hope Luncheon, The RMHH Cup Golf Tournament, and Run for the House, to raise funds to support the mission to serve families with children receiving treatment in the Medical Center (Ronald McDonald House Houston, 2020)

The impact of Ronald McDonald House on patients and their families has been documented by external evidence-based research. Franck, Gay, & Rubin (2013) conducted a study which found that the family-centered care that Ronald McDonald House programs provide enhances the psychosocial well-being of seriously ill children all while helping them cope better.

In Houston, the internal family surveys show that 92% of families experience less financial burden because of the services provided by RMHH, which are carried out through funding from donors and hands-on assistance of volunteers (Rolls, 2021). In addition, 94% of families feel a positive impact from the support of other families in the house (Rolls, 2021).

In 2020, across all four locations in the Houston Medical Center, RMH Houston provided 694 meals to patients and families (Rolls, 2021). While in the midst of the COVID-19 pandemic, operations required the suspension of on-site volunteering in which the number of meals provided only fell by 7% from the previous year (Rolls, 2021). In addition, meals were provided by 149 unique groups, with 55 of those being first-time meal donors (Rolls, 2021).

Service population and demographics

The Ronald McDonald House Houston (RMHH) serves families who have extremely ill children in various hospitals within the Medical Center and cannot afford to stay in hotels for long periods of time. Oftentimes these families have very ill children who seek and obtain treatment and must remain in the hospital for several weeks or even months as they come from different parts of the world. In 2019, RMHH positively impacted families who were 60% from Texas, 33% from other states in the U.S., and 7% international families, thus serving more than 12 different countries (Ronald McDonald House Houston, 2020a).

There are four sites families can stay in as part of RMHH: Holcombe House, Texas Children’s Hospital, Children’s Memorial Hermann, and MD Anderson Cancer Center. As such, families must meet certain qualifications to stay in any of their four sites. The main qualification a family must meet is that they must be a patient or have a child patient who is diagnosed with a life-threatening condition (Ronald McDonald House Houston, 2020b). Diagnoses vary within this population, however, the most common among the patients at Holcombe House are heart-related diagnoses (31.6%), oncology (30.44%), and antepartum (10.9%) (Arnold, 2021).

Families who are served by the organization come from different walks of life and are not necessarily considered low-income. In terms of ethnicity, 44% of visitors who stayed at RMH Holcombe House are Caucasian, 34% were Hispanic, 13% were Black and 9% indicated other (Rolls, 2021). Children ranged in age from 39% under 1-year-old, 35% between 1 – 12 years old, and 26% between 13-21 years old (Rolls, 2021). Of the families staying at Holcombe House, 65% had children in treatment at MD Anderson, 31% at Texas Children’s Hospital, and 4% at Children’s Memorial Hermann Hospital (Rolls, 2021).