Increasing Rates of Screening for Food Insecurity in a General Pediatrics Teaching Practice

Abstract

Food insecurity is a widespread and complex problem that affects approximately 21% of the nation’s children. Demographic and socioeconomic data alone are not indicative of all families that are unable to access enough food to fully meet basic nutritional needs because of insufficient means. Screening for food insecurity is essential to identify these families so that they can be set up with resources to increase their access to resources. This study assesses if the implementation of a two-question food insecurity screen at well child checks improves screening rates through prospectively looking at patients in PCH’s General Pediatric Clinic. The validated screen includes the questions, “In the past 12 months, did you ever worry whether the food for you and your family would run out before you had enough money to buy more?” and “In the past 12 months were there times when the food for you and your family just did not last and there was no money to get more?” (Hagar et al. 2010). A family who answered positively to either of these questions was identified as food insecure and set up with resources. Three stages of data were analyzed for identification of food insecurity. These included: 1) previous practices, 2) following provider education, and 3) following integration of the validated screening tool in the EMR. 60 well child visits, 20 from each age group (<1yr, 1-4yr, and 5-11yr), were randomly selected and reviewed for each stage. The integration of the screening tool into the EMR showed statistically significant improvement of screening rates and consequently more families were able to be identified as food insecure. This increase in identification improved overall quality of care by allowing providers to then share resources with families to gain access to food. The screen also has the potential to lower the cost of care through prevention of poor/fair health, hospitalizations, and developmental risks that are associated with FI in children. The next steps include identifying more resources to provide the families, improve follow up to see if the resources are actually being accessed, and encourage the use of the screen in other clinical settings seeing how not everyone presents for primary care.