A mixed methods study exploring food insecurity and diet quality in households accessing food clubs in England

Background Food clubs are a higher-agency food aid intervention that charge a small fee for a set number of items. Some incorporate longer-term solutions such as budgeting support and cooking skills. These are in place in England to help address inadequate reliable access to affordable, nutritious food. We used a convergent parallel mixed methods design to describe the food insecurity households accessing food clubs experience and to assess diet quality and wellbeing at the start and after at least three months of using food clubs in the South of England. Methods Participants accessing food clubs in Wessex from March 31 to November 3, 2022 were recruited after providing informed consent. They completed a survey at recruitment that collected data on diet and health. Food security was assessed using the modified six-item US Department of Agriculture (USDA) food security survey module, and wellbeing using the short form Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Follow-up surveys were conducted after participants used the clubs for at least three months. Participants were invited to take part in a semi-structured interview. Results Of the 90 participants recruited at baseline, 52% were aged 35–54 years, 74% were female, 81% were of White ethnicity, and 71% reported having at least one dependent child. Food security status was calculated in 69 participants who answered all six questions of the USDA module, with 42% reporting low and 43% very low food security. Among participants with follow-up (n = 52), low food security was 41% and very low food security was 18% at follow-up. Eleven participants were interviewed. Two themes explored impact and experiences of food club. Impact illustrated how participants consumed a more varied diet, experienced less financial pressure, and improved health, wellbeing and social interaction. Experiences of food clubs explored limitations of time and food range at clubs, developing a sense of community and overcoming stigma. Conclusion This study is the first in the UK to explore potential diet, food security and wellbeing impacts of food clubs. Ongoing impact evaluation will enable optimisation of interventions for the populations they serve, such as inviting other organisations/groups to attend/be available for members.