PC1251: Food Insecurity in the Pediatric Office: A Fresh Approach Through Education, Screening, and Connection

Purpose/Objectives: Food insecurity is a growing problem across the United States, further exacerbated by the COVID-19 pandemic. Food insecurity is commonly defined as a lack of adequate access to enough food to maintain a healthy life. The U.S. Department of Agriculture (USDA) estimates that 38.3 million individuals in the United States lived in households experiencing food insecurity in 2020. Pediatricians play an exceptionally important role in the identification of food insecurity in pediatric patients, as well as connection of affected families with resources, particularly federal nutrition programs.

The goal of this process improvement project was to improve accurate identification of food insecurity through screening, increase physician level of comfort in addressing food insecurity, and connect at risk families with resources.

Design/Methods: The first phase of this program was focused on caregiver education about food insecurity. A food insecurity educational session was performed by the clinic’s food insecurity champion and was provided to the entire clinical team. Next, clinic well child visit questionnaires were reviewed to ensure they included food insecurity screening questions, specifically the validated Hunger Vital Sign questions recommended by the American Academy of Pediatrics Food Resource & Action Center. The following phase included efforts to support the clinical team in better addressing positive food insecurity screens. Smart phrases for the electronic health record were created for the ease of documentation and also to help guide discussion about food insecurity and available resources in the community. The clinic collaborated closely with the local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) office to streamline the referral process and perform a warm handoff for referrals. This included creation of a new WIC referral form and integration of WIC referrals into the clinic standard workflows. Packets were also created with basic information about the WIC program, including contact information for the local WIC office, as well as local emergency food resources. These were distributed to families in need by clinic pediatricians. Referrals were then followed up by the clinic’s food insecurity champion to ensure patients and their families were successfully connected with resources.

Results: The pediatric clinic successfully screened for food insecurity at rates over 90% for well child visits. Clinic physicians expressed increased comfort with how to address positive food insecurity screens, including with how to better counsel families regarding federal nutrition programs and how to connect families with available resources in the community.

Conclusion/Discussion: By educating pediatricians and pediatric office staff about food insecurity and integrating food insecurity screening into the standard office workflow, food insecurity screening increased and provider comfort with addressing food insecurity improved. More research is needed to determine how best to connect families with available resources, including federal nutrition programs.