Food Insecurity and Child Maltreatment: A Quality Improvement Project

Food insecurity affects both children and adults in 8% of households in the United States and 12.8% of households in Rhode Island, negatively impacting childhood health and development. Children with a history of child abuse or neglect are at higher risk for food insecurity than other pediatric populations. Patients evaluated at a child protection clinic - which completes evaluations for all forms of suspected child maltreatment - were screened for food insecurity using a validated two-item questionnaire. Data were collected over a four-month period, with three quality improvement cycles. A quality improvement cycle is a planned sequence of systematic and documented activities aimed at improving a process. Prior to the implementation of this protocol, children in the clinic were not screened for food insecurity. With the initiation of food insecurity screening, 8% of all households eligible for screening were found to be food insecure. Pediatric providers should identify food insecurity in their patients, including in subspecialty care clinics, to optimize care for pediatric patients and their families. When food insecurity is identified, referral to resources and support services is important.