by Elizabeth Shoaf
Vizient Consulting Director

I began pursuing my Doctor in Nursing Practice (DNP) degree in August 2020. To graduate, I had to identify a significant practice problem in my area of interest with considerable potential for quality improvement and then develop and implement a change in practice to improve outcomes as recommended by the American Association of Colleges of Nursing (AACN).

I live in Davidson County, North Carolina, where most of the population resides in food deserts — which can have devastating consequences for human health. In 2021, for example, obesity was reported in 36% of Davidson County’s adult population. Though it seems food insecurity would be linked to under nutrition, the relationship tends to be the opposite. Individuals experiencing food insecurity alternate between a state of hunger and a state of consumption of low-cost, high-calorie, nutrient poor foods to avoid hunger.

That’s what led me to partner with the local food pantry in Lexington to start my DNP project, the objective of which was to study a sample of low-income adults who visited the food pantry with the purpose of identifying health problems and establishing a relationship between food insecurity and adult obesity in vulnerable populations.

The food supply at the pantry contains foods that are nutritionally empty and energy dense, resulting in a lack of healthful caloric intake and adequate nutrition for its clients. Within the local food pantry’s electronic record system, there is inconsistent documentation of the health and dietary restrictions of each client. Household food insecurity results in health issues such as obesity, diabetes and hypertension due to a lack of nutritional food, which highlights the importance of health and dietary documentation to dictate special food distribution and provide customized education.

Considering the connection between food insecurity and obesity, it’s imperative that these populations receive foods that correlate to their health needs — and clinicians play a critical role in identifying high-risk populations and leading improvements in health outcomes.

Opportunities for bettering health outcomes

As a clinician working with the food pantry, I was able to use my expertise to help provide low/no sugar and reduced/low sodium food box options to clients with diabetes and high blood pressure, which were the highest documented health issues. Considering the limited resources at food pantries, creating a stronger connection between healthcare and healthy food options at local pantries can radically better the health outcomes of community members by:

  • Having health educators recommend the healthiest options for clients with complex illnesses
  • Collaborating with local farmers to increase fresh food donations
  • Developing partnerships with local policy leaders to enhance funding
  • Using health data to pinpoint the health and nutritional issues that most need attention to promote healthier living
  • Supporting an educational, conversational and welcoming environment — fostering a connection between food pantry clients and food pantry volunteers is vital to strengthening and maintaining strong bonds

Key takeaways from the DNP project

Effective approaches to changes are often driven by food pantry clients, who are acutely aware of their individual challenges. The project created a process of gathering their feedback, ideas and insights on how healthy choices might be implemented and collected information on their eating habits, food challenges and underlying health issues. Clinicians are uniquely primed to use that data to help prioritize nutritional quality over food quantity and launch a tailored food distribution program based on the health issues most present in the community. To create greater health equity, experts must partner with organizations that address hunger to also empower diet-related health.


About the author: Elizabeth Shoaf, registered nurse, is an innovative, solution-driven healthcare professional who blends creativity and practical clinical expertise. She brings over 20 years of experience in healthcare rooted in clinical practice, having served as a registered nurse transitioning to business operations. Her areas of expertise and professional skills include quality and safety management, throughput improvement and staff development. Prior to joining Vizient, she spent 10 years at Wake Forest Baptist Medical Center.

Published: May 9, 2022