Services to address food shortage concerns among people undergoing cancer treatment in the US.

161 Background: In line with recommendations from cancer research and advocacy organizations, including ASCO, there has been an increased interest in addressing food insecurity (FI) among people with cancer, and recent clinical trials have evaluated the effectiveness of food-specific services (e.g., food delivery programs, food vouchers) on FI and clinical outcomes in this population. However, non-food-specific services (e.g., education, financial assistance) may be used by community-based organizations to promote food security and address the underlying financial strain. To date, little is known about the nature and distribution of services to address FI from community-based organizations for people with cancer undergoing treatment. Methods: This cross-sectional study included adults undergoing cancer treatment from 2020-2023 who had food shortage concerns and received services from Family Reach, a national cancer support organization that provides support to people with cancer undergoing treatment. The primary outcome was supportive service to address food shortage concerns, which were categorized as either food-specific (i.e., food pantry, food delivery) or non-food-specific (i.e. financial assistance, resource navigation). Multivariable logistic regression was performed to evaluate factors associated with receiving food-specific services. Results: Among 4166 adults with cancer undergoing treatment who had food shortage concerns, the median (IQR) age was 45 (18) years; 41.4% identified as non-Hispanic white, and 68.2% were female. The most common cancer types were breast (32.3%) and hematologic (23.0%). Overall, 100% with food shortage concerns received non-food-specific services and 24.2% received both non-food specific services and additional food-specific services. The most common food-specific services were referrals to food pantries (16.9%; 704/4166) and food delivery programs (14.1%; 585/4166). The most common non-food-specific services were a stipend for financial assistance (43.2%) and resource navigation with tailored referrals for patients’ needs (37.9%). On multivariable analysis, People living in a dual unemployment household (aOR 0.50, 95% CI 0.34-0.74) and people whose preferred language was Spanish (aOR 0.68, 95% CI 0.48-0.96) were less likely to receive food-specific services to address their food shortage concerns, while people with Medicaid health insurance were more likely to receive food-specific services than those with private insurance (aOR 1.33, 95% CI 1.07-1.66). Conclusions: In a large nationwide financial support organization serving people with cancer, food shortage concerns are managed with a combination of food-specific and non-food-specific services. Additional research is needed to identify the package of financial supportive care services that are most beneficial for each person’s social and clinical situation.