ORIGINAL RESEARCH
Elena T. Broaddus-Shea, PhD, MSPH; J. Kyle Haws, PhD; Kathryn Jantz, MSW, MPH; Maria Gifford, PT, DPT; Amy G. Huebschmann, MD, MSc; Heather Sorensen, MSN, RN; Andrea Nederveld, MD, MPH
Corresponding Author: Elena T. Broaddus-Shea, PhD, MSPH; Department of Family Medicine, University of Colorado Anschutz; Adult & Child Center for Outcomes Research & Delivery Science, University of Colorado Anschutz
Email: elena.broaddus@cuanschutz.edu
DOI: 10.3122/jabfm.2025.250470R2
Keywords: Food Assistance, Food Insecurity, Health Workforce, Practice-based Research Networks, Primary Health Care, Social Determinants of Health
Dates: Submitted: 12/11/2025; Accepted: 5/13/2026
Status: In Press.
BACKGROUND: Healthcare organizations can play a key role in addressing food insecurity among their patients. Although healthcare workers’ experiences and beliefs likely shape how their organizations address food insecurity, little is known about those perspectives, particularly in rural areas. We therefore sought to assess lived experience with and beliefs about food insecurity among healthcare staff and clinicians in rural western Colorado.
METHODS: We distributed an online survey to healthcare organizations across western Colorado in August-September 2021. Following descriptive and bivariate analyses, we used structural equation modeling to examine constructs of interest. These included perspectives attributing food insecurity to “structural” influences (e.g., high cost of food) and “individual” level influences (e.g., “budgeting poorly”), as well as perceived negative judgement around use of assistance programs.
RESULTS: We received responses from 347 clinicians, support workers, and operations staff across 16 counties. Eighteen percent reported current food insecurity; 46% reported past food insecurity. Sixty-nine percent and 95% believed that food insecurity was caused by individual and structural influences, respectively. Over 60% believed that there was negative judgment around use of food assistance programs in their community. The structural equation modeling indicated that respondent factors (age, sex, personal experience with food insecurity) may influence 1) beliefs about causes of food insecurity and 2) perceived judgment around use of food assistance programs.
CONCLUSIONS: These findings raise concerns that nearly one-fifth of the health care workers surveyed were food insecure themselves as well as questions about how healthcare organizations can address food insecurity in an effective and non-stigmatizing manner.