The purpose of this study is to evaluate whether providing families experiencing food insecurity, whose children have medical dietary needs, with access to an online grocery delivery platform (Instacart Health) that includes medically necessary foods—along with an additional monthly stipend for platform use—improves food and nutrition security, child health outcomes, and household food habits. 

Inclusion criteria

• Parents of patients of Nicklaus Children’s Hospital
• Medical Condition of the child: The family must have a child (ages 5-18) diagnosed with one of the following chronic medical conditions requiring specific dietary needs: 
  • Celiac disease (ICD-10 Celiac disease K90.0) 
  • Type I diabetes (ICD 10 codes: Diabetes (E11.9), Diabetes type I (E10.9) 
  • Type II diabetes (ICD 10 codes: Diabetes (E11.9), Diabetes type II (E11.9) 
• Diabetes-Specific Criteria: For families with a child diagnosed with diabetes (type I or type II), the diagnosis must have been established for at least 12 months prior to enrollment. 
• Food Insecurity: The family must have screened positive for food insecurity within the past 90 days, using a validated 2-item screening tool (Hunger Vital Sign), which is integrated into the hospital’s visit registration process. 
• Primary Language: The family must primarily speak and understand either English or Spanish, as study materials and the grocery platform will only be available in these languages. Spanish-language support videos will be available for caregivers who need assistance navigating the platform. 
• Technological Readiness: The caregiver must be comfortable using an online grocery platform, including managing transactions and deliveries in English. The family must have a valid email address and the ability to check their email and respond to electronic surveys. The family must also have a credit or debit card that can be uploaded to the platform for grocery purchases. 
• Geographical Eligibility: The family must reside within the designated delivery area for the online grocery platform, as outlined in the eligible ZIP code list provided in the study’s appendix (Exhibit A).

Exclusion criteria

• Language Barrier: The family does not speak either English or Spanish, as these are the only supported languages for the study materials and grocery platform.