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Implementation and evaluation of a quality improvement project to standardize food insecurity screening in a

Eva M Glenn Lecea1, Erica Winnicki2, Aris Oates2

  • 1Department of Pediatrics, University of California, San Francisco, USA. evaglennmd@gmail.com.

Pediatric Nephrology (Berlin, Germany)
|July 8, 2026
PubMed

Insights

Implementing universal food insecurity screening in pediatric nephrology clinics is feasible and acceptable. Clear workflows and defined roles ensure sustainability for this vital screening process.

Area of Science:

  • Pediatric Nephrology
  • Public Health
  • Healthcare Implementation Science

Background:

  • Food insecurity is prevalent in children with kidney disease, potentially exacerbating health issues.
  • Effective screening strategies in pediatric subspecialty settings are not well-documented.

Purpose of the Study:

  • To develop, implement, and evaluate a universal in-person food insecurity screening program in a pediatric nephrology clinic.
  • To assess the feasibility, acceptability, and sustainability of the implemented screening process.

Main Methods:

  • A 16-month study compared an intervention clinic (universal screening) with a control clinic (usual care).
  • Screening was conducted using a two-question tool by medical assistants and licensed vocational nurses.
  • Interrupted time series and difference-in-differences analyses evaluated screening rate changes; RE-AIM framework assessed implementation outcomes.

Main Results:

  • Screening rates in the intervention clinic increased by 33% immediately post-implementation, with a sustained monthly increase.
  • Screening was successfully integrated into clinic workflows, with high caregiver comfort reported.
  • Initial staff discomfort was overcome through workflow refinements, including standardized scripts and dedicated support personnel.

Conclusions:

  • Universal food insecurity screening is a feasible and acceptable intervention in pediatric nephrology settings.
  • Well-defined workflows and roles are crucial for the sustainable implementation of screening.
  • This approach can help identify and address food insecurity in vulnerable pediatric populations.
Abstract

Keywords:
COM-BFood insecurity screeningImplementation sciencePediatric nephrology clinicQuality improvementRE-AIM

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