Purpose <p>The aim of this study was to develop and refine Cardiovascular Health Equity through Food (CHEF), an intervention to address food insecurity (FI) in early childhood cancer survivors (CCS).</p> Methods <p>Single-center mixed-methods pilot study of a novel “food is medicine” intervention evaluating acceptability, satisfaction, and opportunities for refinement. CHEF participants were provided: (1) meal-kit delivery for 3 household meals/week for 3&#xa0;months and (2) application assistance for federal nutrition benefits. Eligible participants were CCS &lt; 1&#xa0;year from cancer therapy completion, with self-reported FI or household income &lt; 200% federal poverty level. Acceptability was defined as &gt; 75% consent to participation, &lt; 25% attrition, and &gt; 75% program-component utilization. Surveys were completed at baseline and end-intervention, and semi-structured interviews were completed at months 1, 2, and 4.</p> Results <p>Ten families (100%) consented to participation, with 0% attrition. Ninety-seven percent of meal kits were successfully received and &gt; 90% cooked. Four families utilized study-team assistance in navigating benefits participation. One hundred percent of families would participate again, and 80% would recommend to others. Qualitative feedback supported CHEF’s timing following treatment and positive impact on family cooking engagement. Broader non-English language accessibility, formalized benefits counseling, and extended duration were identified as refinement opportunities.</p> Conclusion <p>CHEF was highly acceptable among CCS in early survivorship. The next steps include proof-of-concept evaluation of the refined intervention’s impact on cardiovascular-relevant outcomes among CCS with FI.</p> Implications for cancer survivors <p>Interventions directly addressing food insecurity, a known cardiovascular risk factor, have the potential to support well-being and address health disparities among childhood cancer survivors.</p>