A University and Community Partnership to Address Diaper Insecurity Among Infants in Suburban Communities Through Home Visiting Services

CONTEXT: Despite overall affluence in a suburban county, diaper insecurity affects many families in low-income communities where poverty rates are 3 times the county average. Existing federal assistance programs do not cover diapers, and transportation barriers in this car-dependent suburb limit access to traditional diaper bank models. OBJECTIVE: To describe and evaluate a university-community-federally qualified health center (FQHC) partnership model for addressing diaper insecurity among Medicaid-eligible families with infants and toddlers through community health worker (CHW) home visiting services. DESIGN: Mixed-methods program evaluation using descriptive statistics and thematic analysis of open-ended survey responses. SETTING: Nassau County, New York. PARTICIPANTS: Medicaid-eligible families with infants and toddlers enrolled in the Perinatal and Infant Community Health Collaborative (PICHC) program who received 3 or more diaper deliveries (n = 88). INTERVENTION: A community diaper bank established through a university-FQHC partnership distributed diapers to families via CHW home delivery, eliminating transportation barriers and leveraging existing CHW-client relationships. MAIN OUTCOME MEASURES: Diaper distribution volume, participant demographics, financial trade-offs made to afford diapers, psychosocial well-being, and child health outcomes. RESULTS: From May 2023 to April 2025, the bank distributed 31 457 diapers to 218 family units. Among survey respondents, 45.5% reported that they had previously chosen between diapers and food; 85.2% reported reduced stress; 81.8% reported fewer diaper rashes; and 86.4% felt their community cared about their family. CONCLUSIONS: Integrating diaper distribution into existing CHW home-visiting infrastructure is a feasible, low-barrier model for addressing material hardship in suburban communities experiencing hidden poverty. Survey participants reported reductions in financial trade-offs and parental stress, and an increased sense of community support; however, the post-only survey design precludes causal inference about program impact.