Food Insecurity Screening in Primary Care: Patterns During the COVID-19 Pandemic by Encounter Modality.

Area of Science:

• Public Health
• Health Services Research
• Social Determinants of Health

Background:

• Clinical screening for food insecurity is recommended but inconsistently implemented.
• The COVID-19 pandemic impacted healthcare delivery, shifting towards telehealth and altering screening practices.

Purpose of the Study:

• To evaluate food insecurity screening prevalence in telehealth versus in-person encounters.
• To assess changes in screening rates before and after COVID-19 vaccine availability.

Main Methods:

• Cross-sectional analysis of electronic health record data from over 400 community health centers.
• Examined 275,465 first primary care encounters between March 2020 and December 2021.
• Used a multilevel probit model to estimate screening prevalence based on encounter mode and time period.

Main Results:

• Overall food insecurity screening rates were low (9.2% in-person vs. 5.1% telehealth).
• Screening was lower during telehealth encounters compared to in-person encounters.
• Screening rates varied by time period, with higher rates in-person after vaccine availability (11.7% vs. 4.9%).

Conclusions:

• Food insecurity screening in primary care is suboptimal, particularly in telehealth settings and during the early pandemic.
• Telehealth encounters showed lower screening prevalence than in-person visits.
• Further research is necessary to enhance social risk screening methods within telehealth platforms.