CORE Posters Fall 2025

A Public Health Implementation Science Study by DO Students to Increase Community Engagement and Promote Social Cohesion in Historical Underserved Population in Central Virginia Brunda Devi Bellamkonda, Gabrielle Kaiser, Anush Kaovasia, Brooke Morris, Trushaben Patel, Evelyn Schendler, Jessica Nicholson, Bernard Kadio, MD, MPH, PhD Edward Via College of Osteopathic Medicine – Virginia Campus; Preventive Medicine, Epidemiology, and Public Health; Blacksburg, VA

Group T

Results

Abstract. In Danville, Virginia, local leaders struggle to engage the community with the resources that are designed to improve the lives of local residents. This is seen in the struggles of the nonprofit organization Maternal Infant Physical Leisure Activity Nutrition (MIPLAN) to mobilize families in Danville in the usage of God’s Storehouse, the local food bank. The poverty rate in Danville is well above the national average, with nutritional shortcomings presenting as one of the area's largest problems. The strife of families in Danville can be attributed to the city’s tumultuous social history slowing the progress of the city, leaving residents with inadequate public transportation, mistrusting of community leaders, and fearful of the stigma that surrounds the label of “food insecure.” This implementation science study lays the groundwork for developing techniques to combat nutritional shortages in Southwest Virginia as phase I of a IV-part plan that includes a pilot study, implementation project, and analysis of the project’s success. Based on data collected through a systemic literature review of how other nonprofit organizations have mobilized the community in engagement with local resources, it was determined that mobilizing the food banks to venture into the community as “Pop - Up Foodbanks” alleviates the burden of transportation on Danville residents and directly engages community members with local support systems. Additionally, the usage of surveys at local afterschool programs can help identify families suffering from food insecurity and provide them with resources such as vouchers to the local food bank . Introduction . The byproducts of Danville’s tumultuous social history still exist today, evident in the slow progress of the city as residents and local leaders remain discordant with one another. In Danville, the poverty rate is nearly 10% higher than the national average 4 . This is further highlighted by the statistics shown in Figure 1, which shows the discrepancies between the average income level in Danville as opposed to the national average. In light of the high poverty rate, occurrences of food insecurity are anticipated. In an effort to conquer some of the public health issues affecting the community in Danville, the Virginia Rural Health Association established the nonprofit organization Maternal Infant Physical Leisure Activity Nutrition (MIPLAN). According to MIPLAN, the population that most utilizes the current food insecurity resources Danville offers is families. This is supported by the data shown in Figures 2 and 3, with a much higher percentage of children living below the poverty line than elderly individuals. Based on conversations with leaders of MIPLAN, many Danville residents struggle with the lackluster public transport system when trying to utilize the local foodbank, God’s Storehouse, as a resource. To overcome the weaknesses of the public transportation system in Danville and mobilize community members in utilizing the local foodbanks, this literature review utilizes a snowball approach to analyze the successes of other cities in these same areas. The ultimate goal of this research is the development of a pilot study that will execute the strategies employed by other areas with hopes to achieve the same successes in Danville.

Conclusion. With the prevalence of food insecurity in Danville, a survey-voucher program coupled with pop-up foodbanks on site at the Boys and Girls Club of America can bolster community engagement with local resources while circumnavigating the weaknesses of the public transport system. As seen in the Emergency Department Screening Study, the utilization of well-crafted surveys to determine the level of food insecurity among families in the area helped determine the best population to provide with vouchers to pop-up food pantries. Since MIPLAN identified families as the population facing the most insecurity, employing these surveys to the parents of children enrolled in after-school programs at the Boys and Girls Club of America targets this key demographic. After identification of families who are experiencing food insecurity, vouchers can be distributed for pop-up food pantries that will be hosted by local volunteers on the campus of this after-school program. This level of community engagement by volunteers is designed to build trust with community members. The combined approach of surveys with pop-up foodbanks will be executed as part of the pilot study in phase II of this implementation science survey, serving to reduce food insecurity in Danville, VA, as seen in Figure 4.

Emergency Department Food Insecurity Screening Study:

➢ Of 379 patients consenting to the study, 228 screened positive for food insecurities

➢ 98.2% of positive patients accepted a food voucher; 86 vouchers were redeemed

➢ 41% of patients discharged during market hours redeemed vouchers, while 31% of patients discharged outside of hours redeemed vouchers

➢ 175 patients reported "yes" to both statements on Hunger Vital sign screening tool

▪ "Within the past 12 months, we worried whether our food would run out before we got money to buy more"; "Within the past 12 months, the food we bought just didn’t last and we didn’t have the money to get more" 5 Pediatric Emergency Department Food & Housing Insecurity Cross Sectional Study: ➢ Guardians presenting in pediatric ED answered a 16 question survey regarding demographics, food access, safety, healthcare use, and insecurities; Hunger Vital sign score was used as well

➢ 1,908 responses were recorded; 416 participants reported food +/- housing insecurity

➢ Food insecure families were given printed resources for food +/- housing support

➢ Challenges with the lack of referral use: losing printed materials, lack of time to utilize the resources, or referrals unrelated to patients needs 1

Richmond Community Engagement Study:

➢ Nonprofits’ reliance on college -educated student volunteers reinforced power imbalances, creating a sense of hierarchy and disconnect with community members ➢ These dynamics contributed to mistrust, as community members felt less represented and less comfortable engaging. ➢ In contrast, when community members volunteered, tensions decreased, fostering trust within the organization and strengthening community engagement. 2

* Data listed above was pulled from research studies reviewing success of surverys and community engagement

Discussion

Emergency Department Food Insecurity Study: While the emergency room shows survey success, our goal is to improve convenience and accessibility for our patients, as well as mitigate transportation challenges. • We plan to incorporate surveys and vouchers in the Boys and Girls Club to gauge family wide food insecurity and set up “pop up” banks that this location. Families interacting with this organization are likely to consider access to food a pertinent positive compared to patients in the emergency room. Pediatric Emergency Department and Housing Insecurity Cross Sectional Study: This study shared a primary challenge of individuals losing their paper referral resources. • We aim to implement an electronic record of families screening positive for food insecurities to combat this problem. Richmond Community Engagement Study: To strengthen engagement and trust , we propose adapting strategies from the Richmond study to create a tailored plan for God’s Storehouse in Danville. Building on the active base of community volunteers , these individuals could distribute surveys to parents at the Boys and Girls Club. This approach would: • Bridge power differences : Volunteers reduce hierarchy and mistrust, fostering stronger relationships. • Improve participation: Trusted volunteers increase survey acceptance and honesty, ensuring meaningful feedback. By centering community members in this process, God’s Storehouse can promote lasting trust , stronger relationships, and sustainable collaboration .

Figure 4. Implementation science study phases

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Figure 1. Income levels in Danville, VA 3

References.

1. Assaf RR, Knudsen-Robbins C, Heyming T, et al. Food and Housing Insecurity, Resource Allocation, and Follow up in a Pediatric Emergency Department. Western Journal of Emergency Medicine . 2025;0(0). doi:https://doi.org/10.5811/westjem.19435 2. Bailey M. Examining Community Engagement Strategies in Richmond, VA Nonprofits Addressing Food Insecurity: A Case Study. UR Scholarship Repository. Published 2022. https://scholarship.richmond.edu/spcs nonprofitstudies-capstones/35/ 3. Census Reporter. Census Reporter. Published 2023. https://censusreporter.org/profiles/16000US5121344 danville-va/ 4. Henry Martinsville Community Health Equity Assessment 2023. Virginia Department of Health. 2023. https://www.vdh.virginia.gov/content/uploads/sites/111/2023/09/HM-Community-Health-Equity-Assessment 2023.pdf. 5. Ulintz AJ, Patel SS, Anderson K, et al. Emergency Department Food Insecurity Screening, Food Voucher Distribution and Utilization: A Prospective Cohort Study. Western Journal of Emergency Medicine. 2024;25(6). doi:https://doi.org/10.5811/westjem.18513 Acknowledgements. We would like to thank Dr. Bernard Kadio and Mrs. Jessica Nicholson for their guidance and mentorship throughout the development of this project. Special thanks to Beth O’Connor and Cindi Poteat from Danville MIPLAN, who have been diligent in their communication with us and empowered us to come to Danville to see the community we are working for the betterment of. We would also like to recognize Dr. Jim Mahaney and Mrs. Alyson Farrar for their work in making this research a possibility.

Figure 2. Percentage of children in Danville, VA living below the poverty line 3

Figure 3. Percentage of seniors in Danville, VA living below the poverty line 3