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Published on: August 21, 2015
Referral and Resource Utilization Among Food Insecure Families Identified in a Pediatric Medical Setting
Cristin Q Fritz1, Jacob Thomas2, Mark S Brittan3
1Children's Hospital Colorado (CQ Fritz, MS Brittan, E Mazzio, J Pitkin, and C Suh), Aurora, Colo; Department of Pediatrics, University of Colorado School of Medicine (CQ Fritz, MS Brittan, E Mazzio, J Pitkin, and C Suh), Aurora, Colo.
Insights
Few families with identified food insecurity (FI) connect to resources. Emergency department and inpatient settings show higher referral rates, suggesting increased screening may be beneficial for pediatric patients facing food insecurity.
Area of Science:
- Pediatric healthcare
- Public health
- Nutrition security
Background:
- Routine screening for food insecurity (FI) is increasing in pediatric settings.
- Uptake of food resources after FI identification remains poorly understood.
Purpose of the Study:
- To describe the utilization of referral and supplemental food resources.
- To identify characteristics associated with resource utilization among families with FI.
Main Methods:
- Linked hospital screening and Electronic Medical Record data to Hunger Free Colorado (HFC) referral data (2017-2018).
- Compared demographic and clinical variables of FI families based on HFC referral acceptance and resource connection.
- Utilized Pearson's chi-square, Wilcoxon rank sum, and Poisson regression for analysis.
Main Results:
- Of 1952 patients with FI, 19% accepted an HFC referral, and 61% of those connected to a food resource.
- Families screened in the Emergency Department (ED) and inpatient settings had higher referral rates compared to Child Health Clinics.
- Larger families (≥3 people) were more likely to connect to resources.
Conclusions:
- A small proportion of families with FI identified in medical settings connect to food resources.
- Increased screening in ED and inpatient settings may improve resource connection for pediatric patients.
- Targeted interventions may be needed to enhance resource utilization for food-insecure families.
Objective:
Despite increased routine screening for food insecurity (FI) in pediatric medical settings, the uptake of offered food resources after FI identification is not well understood. We aimed to 1) describe utilization of referral and supplemental resources and 2) identify characteristics associated with utilization.
Methods:
We linked hospital screening and Electronic Medical Record data to Hunger Free Colorado (HFC) referral data for patients 0 to 18 years who were screened in the emergency department (ED), inpatient, or outpatient setting from January 2017 to December 2018. Among FI families, we compared patient demographic and clinical variables based on acceptance of HFC referral and connection to a food resource using Pearson's chi-square, Wilcoxon rank sum, and Poisson regression.
Results:
Of 1952 patients with FI, 371 (19%) accepted a referral to HFC and of these 228 (61%) were connected to a food resource. In adjusted analyses, families screened in the ED (adjusted relative risks [aRR] 1.96, confidence interval [CI]: 1.57-2.44) and inpatient (aRR 1.74, CI: 1.20-2.53) settings more often pursued referral to HFC than those screened in Child Health Clinic, while those screened in Special Care Clinic less often pursued referral (aRR 0.24, CI: 0.14-0.41). Families with 3 or more people in the home were more likely to be connected to resources (aRR 2.67, CI: 1.42-5.04).
Conclusions:
Only a small proportion of families with FI identified in a medical setting are ultimately connected to food resources. Higher rates of HFC referral among ED and inpatient families suggest that increased screening efforts in these settings may be warranted.
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