598 - Evaluating Screening Questions and Methods to Increase Families’ Endorsement of Food Insecurity in the Inpatient Setting
Monday, May 1, 2023
9:30 AM – 11:30 AM ET
Poster Number: 598 Publication Number: 598.411
Kerry Tepe, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Katherine Auger, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Hadley Sauers-Ford, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Sonia P. Rodas Marquez, Huntsville Hospital, Huntsville, AL, United States; Rocio D. ATARAMA, Cincinnati Children's Hospital Medical Center, LIBERTY TOWNSHIP, OH, United States
Clinical Research Coordinator Cincinnati Children's Hospital Medical Center Cincinnati, Ohio, United States
Background: Food insecurity (FI) screening in the pediatric inpatient setting often yields lower than expected rates of positivity when considering the area prevalence of FI. Objective: With the goal of mitigating the gap in screening for FI, we aimed to evaluate what combination of question and screening method resulted in a positivity rate that is comparable to our community prevalence (~20%). We also sought to describe FI rates by preferred language, race, ethnicity, and public support received to better understand existing disparities in FI which result from social inequities in certain populations. Design/Methods: We conducted a prospective cross-sectional study that utilized a combination of questions from 3 surveys and 4 screening methods at our urban, freestanding children’s hospital and our satellite site in a suburban community. The survey was composed of questions from U.S. Household Food Security Survey Module: Six-Item Short Form (Six-Item), the Children’s HealthWatch Hunger Vital Sign (HealthWatch), and questions currently utilized by our social workers. A research assistant approached both Spanish and English speaking patients on four inpatient units once weekly, and randomly varied the methods (paper, phone, tablet, and face-to-face) across units. Chi squared analyses were conducted to assess differences in overall positivity. Results: 361 families completed surveys for food insecurity; 19.4% (N=70) endorsed FI (Figure 1). Positivity rates did not differ significantly by method (Table 1). There was a positivity rate of 17.7% for the Six-Item, 16.0% for HealthWatch questions, and 3.1% for the social work questions (Table 1). Combining method and screening questions to determine positivity rate, paper and Six-Item had the highest at 20.9%. Significantly more Spanish speaking families endorsed FI than English speaking families (p< 0.01) (Table 2). More caregivers that self-identified as black and Hispanic ethnicity endorsed FI than those that identified as white or non-Hispanic (Table 2).
Conclusion(s): We found a positivity rate that matched the community rate of FI (20%) using the Six-Item screening questions on paper. Both the Six-Item and HealthWatch questions capture FI more commonly than the local social work questions. We demonstrated significant disparities in FI among our patients. Screening done by a research assistant may provide more accurate endorsement of FI than members of the medical team, though staffing can be challenging. Future work at our institution includes developing a feasible, appropriate food support intervention with families to help after discharge.
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