73 - Behind the Screens: Does Screening for Food Insecurity in Pediatric Primary Care Improve Family’s Access to Food Resources?

Poster Number: 73

Jessica A. Kuhn, UNC Gillings School of Global Public Health, Chapel Hill, NC, United States; Emily B. Vander Schaaf, University of North Carolina at Chapel Hill School of Medicine, Carrboro, NC, United States

Background: Screening for food insecurity (FI) and other social determinants of health (SDOH) is widely recommended, and has become standard practice for many clinics. However, little literature describes how this process impacts patients’ FI status.

Objective: To determine how frequently families that screened positive for FI in a pediatric primary care clinic were successfully connected to resources, and to understand families’ experiences with the process.

Design/Methods: English- and Spanish-speaking caregivers of pediatric primary care patients with documented FI via ICD-10 or designated health record domain from June 2020 to June 2021 were eligible. Chart review for all identified patients collected demographic and available FI data. Patients’ primary caregivers were then called and asked to participate in a brief phone survey. This survey assessed connection to resources and recommendations for future steps, and included Likert scales, yes/no, multiple choice, and open-ended questions. An interpreter was used with Spanish-speaking participants. This study was exempt by the IRB.

Results: 51 eligible patients were identified with FI; after accounting for families, 46 distinct caregivers were identified. Of those, 39% (n=18) were willing to complete the survey, 13 of whom spoke primarily Spanish. 50% (n=9) of participants reported that the clinic did not play a role in improving access to sustainable food resources. 67% (n=12) denied ever being given resources or referrals to help them acquire food, despite health record documentation for 9 of those 12 (e.g. referral to institution’s community health worker (CHW) program, list of food pantries, and/or WIC/SNAP application information). Of 8 total participants with referral to and documentation from a CHW, only one caregiver recalled the conversation. In open-ended responses, caregivers expressed difficulty accessing long-term food resources, including federal assistance or community programs. Fear, false information, lack of trust, and struggling with other unmet needs were reported barriers. Caregivers rated proposed new resource interventions highly on a 5-point Likert scale, including gift cards to grocery stores (mean 5.000), in-clinic facilitation of WIC/SNAP enrollment (4.969), and in-clinic food pantry (4.875).Conclusion(s): Despite apparent connection to resources in chart reviews, few families endorsed that their FI status improved as a result of the clinic’s screening and referral process. In order to improve the health and well-being of pediatric patients, future initiatives must prioritize connection to resources above screening for SDOH alone.