Screening and Addressing Food Insecurity at Free Clinics: A Scoping Review

Food insecurity (FI) is highly prevalent amongst patients seeking care at free, student-run health clinics. This study sought to examine the existing literature to examine food insecurity screenings and interventions at free clinics across the U.S. In this review, we provide demographic information and screening statistics of food insecurity interventions, the study's primary aim, and how it relates to the provided FI intervention, barriers that studies identified in implementing FI interventions. Eligible studies needed to implement a FI screening and intervention program in a free clinic within the United States specifically due to the unique nature of the healthcare system. Studies could address additional social determinants of health or chronic conditions, but had to include FI screenings and interventions. Of the initial database search of 958 studies, five were included for analysis. Among the studies, food insecurity was determined by the 6 item HFSS, a one question from the USDA food security survey, and a custom 12 item redcap survey. Methods of combating food insecurity included providing grocery deliveries, utilizing in clinic food pantries, providing onsite food boxes, aiding patients in accessing SNAP, WIC and food pantries in the area, and providing referrals. Few studies examined the effectiveness of implemented interventions. Future studies on implementation of programs targeting food insecurity should focus on an evaluation of the effectiveness of their program, assess the implementation of other FI screening assessments in identifying FI patients and determine the efficacy of implemented FI interventions on various patient health outcomes.