Food for Thought: Developing a Sustainable Method of Identifying and Addressing Food Insecurity in the Pediatric Emergency Department

Pilot Project

Food for Thought: Developing a Sustainable Method of Identifying and Addressing Food Insecurity in the Pediatric Emergency Department

Background: Food insecurity (FI), while related to poverty, is an independent predictor of poor health outcomes for children. The American Academy of Pediatrics recommends that all pediatric clinical settings screen for FI, but there is limited information about the best modality of screening, feasibility of screening, and usefulness of resources available.

Study Design: We will recruit adult caregivers arriving with pediatric patients in the Emergency

Department (ED) at the Children’s Hospital of Philadelphia (CHOP). Using a validated, two-question screen for FI, participants will be randomized to three different screening modalities: a verbal face-to-face screen, a written screen on a tablet, or a written screen on a tablet with an auditory component.

All participants with a positive screen will receive a list of food access resources. Participants will be contacted for follow up with a brief phone call 2-4 weeks after ED visit to assess participant perceptions of the screen and usefulness of resources provided.

Analysis: This is a prospective, randomized trial with both quantitative and qualitative components. We will use statistical software to analyze the captured rate of positive screen for FI among the three different screening modalities. Phone interviews will be recorded, transcribed, and analyzed to identify content themes.

Implications: Although there is a growing interest in screening for social determinants of health in the clinical setting, little evidence exists regarding the modality of screening that maximizes disclosure. This study will guide the implementation of screening for FI in the pediatric ED in a way that is feasible, acceptable, and sustainable, and will inform a model which can be replicated more widely.