Pediatric PracticeFood Insecurity Screening in Pediatric Primary Care: Can Offering Referrals Help Identify Families in Need?
Section snippets
Study Design
We surveyed parent/guardians (hereafter termed “caregivers”) of 3- to 10-year-old children visiting a pediatric hospital-based primary care clinic in Boston, Massachusetts, as part of a broader study focused on health-related social problems and diet quality. We chose 3 to 10 years as a range when eating-routine flexibility (lowest in infancy) and parental control (lowest in adolescence) were relatively balanced. Eligibility criteria included: 1) routine visit for 3- to 10-year-old well-child
Sample Characteristics
Of 554 eligible caregivers recruited, 432 (78.0%) agreed to participate. The most common reason caregivers declined to participate was lack of time or not wanting to delay their visit. Participation rates were higher for caregivers identifying as female versus male (77.2% vs 54.8%; P < .01) or as Hispanic versus black (86.1% vs 66.3%; P < .01). Of the 432 caregivers who participated, 340 (78.7%) completed the survey. These 340 caregivers comprised the final study sample. The most common reason
Discussion
In this sample, a menu offering food-assistance referrals identified 15% more families than standard food insecurity screening alone. These were families who did not report food insecurity but who selected one or more referrals for food assistance. Food insecurity and referral selection were linked, but the overlap was only partial. Over 20% of the caregivers who did not report food insecurity selected one or more referrals. Nearly half of the caregivers who did report food insecurity did not
Conclusions
In this sample, there was incomplete overlap between food insecurity and referral selection for food assistance. Offering referrals may be a helpful adjunct to standard screening for eliciting family preferences and identifying unmet social needs.
Acknowledgments
The authors thank the Academic Pediatric Association Bright Futures Young Investigator Award Program; American Academy of Pediatrics' Bright Futures for donating child activity books; ROIhealth for donating grocery coupons; the dedicated research assistants (Kristina Ten Haagen, Saira Khanna, Dorothea Letner, Alexandra Geanacopoulos, Larissa Wenren, Jeremy Mudd, Lindsay Tsopelas); the HelpSteps technical team (Emily Krull, Ellen Reisinger, Aaron Pikcilingis, Glenn Marmon, Laura Reilly, Peter
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Conflict of Interest: Dr Rhodes receives research funding from Merck. The other authors declare that they have no conflict of interest.