Experiences of food access in hospital. A new questionnaire measure

Summary Background & aims People in hospital experience problems gaining access to food. We aimed to develop an experience-based measure of access to food. Methods The 27-item questionnaire has five domains: feeling hungry, physical barriers, organisational barriers, food choice and food quality. A survey was implemented on 29 wards in four hospitals using both self-completion and interview administration formats. Results Questionnaires were analysed for 764/1154 (66%) eligible participants. Values for Cronbach's alpha were: feeling hungry 0.886; physical barriers 0.809; organisational barriers 0.632; food choice 0.414; and food quality 0.738. The proportions of compromised patients in each domain were: hunger 30%; physical barriers 24%; organisational barriers 29%; food choice 24%; and food quality 21%. Poor self-rated health was associated with increased problems from feeling hungry (adjusted odds ratio 2.39, 95% confidence interval 1.10–5.18); older age was associated with increased difficulties with physical problems (2.67, 1.31–5.42) as were admission to a stroke ward (16.8, 5.09–55.3) or elderly care ward (3.50, 1.08–11.40). Problems with food access varied between hospitals and wards. Conclusions We have developed a reliable and valid questionnaire measure of hospital food access. The measure reveals widespread problems of food access in hospital.