Emergency Preparedness and Scalability Readiness in Community Food Pantries: Systems Insights for Nutrition and Dietetics Practice

BACKGROUND: Food pantries serve as critical community nutrition access points, particularly during emergencies when demand for food assistance increases. However, the operational systems needed to sustain nutrition services under surge conditions are not well characterized. This study assessed emergency preparedness and scalability readiness among food pantries to identify systems-based leverage points for improving continuity of nutrition care during crises. METHODS: A cross-sectional evaluation was conducted with 19 food pantries in Baltimore City and Baltimore County. Directors completed two instruments: a 38-item preparedness questionnaire grouped into four domains (Training/Knowledge, Operations, Communication, and Safety) and an 87-item environmental checklist measuring characteristics relevant to scalability. Descriptive statistics, Pearson correlations, and nonparametric group comparisons were used to examine preparedness, scalability, and associated pantry characteristics. RESULTS: Overall preparedness was moderate (mean = 1.18 on a 0-2 scale), with large variability across domains. Communication preparedness was lowest, and 42.1% of pantries had low scalability readiness. Preparedness and scalability were strongly correlated (r = 0.90, p < 0.001). Pantries able to deliver food to off-site locations and those with higher recent neighbor throughput demonstrated significantly higher preparedness and scalability (p < 0.05). Traditional infrastructure characteristics showed no associations. CONCLUSION: Communication systems, surge workflows, and workforce capacity were the primary determinants of emergency response capability. Strengthening these interconnected system functions may support both preparedness and scalability, helping food pantries maintain equitable nutrition access during emergencies. These findings highlight opportunities for registered dietitian nutritionists to advance systems-based practice within the charitable food system.