Screening for and Intervening in Food Insecurity in Vermont Pediatric Primary Care

Purpose: Food insecurity places patients at risk for adverse health outcomes, and in VT, one in six children are food insecure. Despite this finding, the validated 2-item food insecurity screening tool is not routinely being utilized in pediatric primary care settings. The purpose of this project was to increase rates of food insecurity screening and subsequent connection to appropriate resources in a pediatric practice in VT. Methods: In this quality improvement project, the 2-item food insecurity screening tool was implemented in the health maintenance visits of patients age 1-21 at three pediatric primary care offices. Positive screenings were referred for intervention utilizing the community health team at the practice, or HelpMeGrow Vermont. Data was analyzed for frequency of screening tool completion, positive screenings, and intervention options. Variance and statistical significance of screening rates over time were analyzed using descriptive statistics. Results: Fourteen practice providers participated. Between May and December 2018 4,243 children were screened. 47 % of children seen for health maintenance visits were screened. Of the children screened, 6.33% screened positive. There was a 42% increase in screening rates throughout the 8-month study period. Results were further delineated by provider, office location, zip code, and age of patient. An intervention was documented for 19.5% of the positive screens from September to December 2018. Conclusion: Implementing a 2-item questionnaire increased screening rates and facilitates connection of food insecure patients with appropriate resources. Further study is recommended to determine if identifying food insecurity and subsequent intervention leads to improved health outcomes