“Food engages people, as we know”: health care and service providers’ experiences of using food as an incentive in HIV care and support in British Columbia, Canada

Figures & data

Table 1. Sample characteristics.

What year were you born?
1950s–1960s	4
1970s–1980s	15
1990s	6
How would you describe yourself?
Man	5
Woman	19
Non-binary	1
What is your highest level of education?
High School	2
College	6
Undergraduate	16
Graduate	1
What is your position?
Registered Nurse	15
Social Worker	2
Community Worker	3
Peer Worker	5
How long have you worked in this position?
<5 years	6
5–10 years	14
>10 years	5
How long have you worked with people at risk or living with HIV?
<5 years	6
5–10 years	15
>10 years	4

Table 2. Key themes and selection of quotes.

Theme 1

Participant 24: Like, you know, even chatting and then bringing up the concerns that we were having. And they’ll want to go for coffee with you or they want to go get a [name of restaurant] or a burger or whatever, you know? But using those kind of things as tools in your pocket helped us to definitely get people to engage with us, for sure. Participant 17: So, a big part of our job, most of our job, is almost just the engagement, building the relationships and having an incentive like going for coffee is a huge thing. But yes, it certainly is helpful. I will get some people before I even have a conversation with them ask “Oh, could we go get a coffee?” or “I’m really hungry, I haven't eaten all day. Can I get a piece of pizza?” Participant 8: It was always, it would be if you, you know, say we did have someone that was challenging to go get their blood work done, it would be like, “Okay, if you go do your blood work today, we can go for coffee after. Or we can go for lunch.” Participant 19: Well, we have a small budget to help build rapport and therapeutic relationships with our clients and get them to trust us. We can take them out for coffee, you know, before an appointment or something. Or buy them a burger from [name of restaurant], that kind of thing. Participant 6: But you know, I have different opinions on the type of incentives. Like I like the juice and granola bar. Like why not? You know? Would I even call it an incentive? I guess it is, but I just feel like food, food I have, I’m more, like I just felt I wanted to be a part of the food part of things.

Theme 2

Participant 25: Well I think for me as a care provider, definitely food felt like a cleaner transaction. But, yeah, like it felt more aligned with my values as like a [name of the position] to be, you know, nourishing people's bodies, giving them something that their medications can kind of absorb into. Participant 13: I was trying to think of kind of incentives that they provide there. They also offered food, but that's more of just a kind of stabilization and helping with absorption for HIV medications and a lot of antibiotics and that kind of thing (…) And a lot of people who start at the program are really, like they’re people who don't have access to food. Sometimes people come in and it's their only meal of the day. Participant 4: And I think part of it is this idea of like, there are certain things that we can do to, yeah, to address those basic needs that we have at our disposition. Like, for example, a snack because you know that you can't really have a conversation with someone if they’re stomach is growling and they’re, you know, starving. Participant 11: Sometimes we do buy people a snack and meals out of our own pocket because there's no money in the program to do that. I think all of us has kind of made that decision because we knew that this is the last dot that will connect us with the client who is very difficult to engage. You know what I mean? Participant 16: So we would really try hard to like kind of make sure that everybody's needs were met. But also, at the same time, sometimes that did require limiting and rationing of the resources that we do have. From a therapeutic perspective, that's tough when a person is legitimately hungry and they want two sandwiches.