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Assessment of Food Insecurity Screening Practices in Pediatric Kidney Transplant Care Across IROC Centers

Eva Glenn Lecea1, Erica Winnicki1, Aris Oates1

  • 1Department of Pediatrics, Division of Nephrology, University of California, San Francisco, California, USA.

Pediatric Transplantation
|October 28, 2025
PubMed

Insights

Over half of pediatric kidney transplant centers screen for food insecurity (FI). Barriers like staff shortages persist, but interventions such as social work referrals are common. Standardized screening and resources can improve care.

Area of Science:

  • Pediatric Nephrology
  • Public Health
  • Health Equity

Background:

  • Food insecurity (FI) is a significant social determinant of health impacting chronic disease outcomes.
  • FI affects up to 20% of pediatric kidney transplant (KT) recipients, necessitating targeted screening and management.
  • The Improving Renal Outcomes Collaborative (IROC) initiated an assessment of FI practices in pediatric KT centers.

Purpose of the Study:

  • To evaluate the prevalence of FI screening and management practices within IROC centers.
  • To identify barriers to FI screening and interventions utilized by pediatric KT centers.
  • To inform strategies for improving FI care and health equity in this vulnerable population.

Main Methods:

  • A cross-sectional survey using REDCap was distributed to 43 IROC centers in July 2024.
  • The survey assessed FI screening prevalence, screening methods, identified barriers, and intervention strategies.
  • Data were collected from responding centers to analyze current practices.

Main Results:

  • Twenty IROC centers (47% response rate) participated in the survey.
  • Thirteen centers (65% of respondents) reported routine FI screening, primarily using the Hunger Vital Sign or tailored tools.
  • Common interventions included social work referrals (100%) and dietitian consults (69%); barriers cited were limited staff and uncertainty in managing positive screens.

Conclusions:

  • More than half of surveyed pediatric KT centers actively screen for FI, indicating growing awareness.
  • Persistent workforce and workflow challenges hinder universal screening and comprehensive FI management.
  • Implementing standardized electronic health record (EHR)-based screening and a national food resource toolkit could enhance care and promote health equity for pediatric KT recipients.
Abstract

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