O0113 Oct.3: 3:43pm - Increasing Food Insecurity Screening at a Pediatric Community Clinic During the COVID -19 Pandemic

Introduction: Food Insecurity is a household’s lack of access to adequate food necessary for a healthy life. In 2018, 11.1% of the United States households were considered food insecure which translates to about 14.3 million people. Although the US Department of Agriculture and its agency Food Nutrition Services have been monitoring the prevalence of food insecurity for over two decades, this social issue has gained its most attention as a result of the CDC’s recommendation of primary prevention strategies in curbing Adverse Childhood Experiences (ACEs). It is now a fundamental part of the pediatrician’s role to screen families and take measures to minimize food insecurity in order to prevent children from developing the long term effects of ACEs. During COVID-19 pandemic, the actions taken to prevent spread, such as school closures, and the rise in unemployment will increase the percentage of families touched by food insecurity. For example, about 52,600 students who depend on free or reduced school meals have not received this aid because of school closures.

Objective: This quality improvement initiative aims to increase the percentage of patients screened for food insecurity by 50% in 6 months. This project takes place in a teaching safety-net pediatric clinic, which acts as a medical home for children of low-income families on Medicaide or without insurance, including undocumented individuals who do not qualify for federal aid.

Methods: A screening tool was developed. It is made up of a four- item questionnaire including the Hunger Vital Sign promoted by the American Academy of Pediatrics (AAP) Policy, Promoting Food Security for All Children, an assessment of any direct effects of the COVID -19 pandemic, and a question that identifies families who need immediate assistance. A handout of local food resources was created and can be printed for clinic visits and also texted or emailed for virtual visits. All patients receive this list;, and patients with emergent needs are referred to receive same day aid. An educational module was created for resident physicians on food insecurity, its impacts and local rates, as well as recommendations from the AAP on screening. The primary outcomes are the percent of patients who utilize local food resources and the change in food insecurity by telephone follow-up. The process measure is the percent of patients screened for food insecurity.

Results: Thus far, interventions have increased the percentage of families screened from 1.5 to 5. By the time of the AAP Conference, outcome measure results will also be available.

Discussion: Ultimately, we aim to increase the percentage of families with food insecurity who are able to access food through local resources and upon follow-up have a lower food insecurity risk score.