Background Food insecurity is defined as not having reliable access to sufficient, affordable and nutritious food. One approach to address food insecurity are food membership clubs which charge a small fee for a set number of items and may incorporate cooking skills and benefit maximisation. This project measured acceptability and impact of these clubs on food insecurity, diet quality and mental wellbeing, and developed an implementation toolkit.

Methods Individuals accessing two food membership clubs and one cookery scheme in Wessex were recruited between March and November 2022. Participants provided informed consent and completed a survey which collected data on diet and health at baseline and after 3 months of using food clubs. We used the modified six-item United States Department of Agriculture (USDA) food security survey module and the short form Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) to capture a measure of wellbeing. Participants who completed a baseline survey were invited to a semi-structured interview exploring views of food clubs and household eating habits.

Results 97 participants were recruited, of which 49 completed the follow-up survey and 11 were interviewed. Among participants with follow-up data, 71% of participants were aged 25-54 years, 68% female, 74% of White ethnicity and 48% had two or more dependent children.

Very low food security reduced from 32% at baseline to 16% at follow-up, low food security reduced from 58% to 42% and high or marginal food security increased from 11% to 42%. There was a decrease in the proportion reporting consuming one or less portions of fruit (57% to 41%) and vegetables (50% to 33%). High mental wellbeing increased from 0% at baseline to 8% at follow-up, average mental wellbeing increased from 44% to 54% and low mental wellbeing decreased from 56% to 38%.

Key themes from the interviews included impact of food club, community building, trying new food and strategies around food cost and storage. Participants reported positive impacts of food club on their diet, finances, health and social life with the main negative comment being the need to get to food club early for maximum choice.

Conclusion This study highlights the positive impact of food clubs on food security, diet and mental wellbeing. Evaluating the impact of food aid to support decision-making and identify possible modifications is needed. Study protocols and data collection tools are incorporated into a toolkit co-developed with local authorities and food aid stakeholders to support decision-making and evaluation.