590 - Food for Salud: Implementing Hospital-wide Food Insecurity Screening at a Free-standing Children's Hospital

Poster Number: 590
Publication Number: 590.411

Alexandra K. Byrne, Nicklaus Children’s Hospital, Miami, FL, United States; Gabriel Cardenas, Nicklaus Children’s Hospital, Miami, FL, United States; Stephen DeGennaro, Nicklaus Children’s Hospital, Palmetto Bay, FL, United States; Odalis Santa, Nicklaus Children’s Hospital, Miami, FL, United States; Joanna E. Perdomo, Nicklaus Children's Hospital / Florida International Univeristy, Miami, FL, United States

Background: Food insecurity (FI) is a national problem experienced by 12.5% of U.S. children and associated with adverse child health outcomes. FI screening is recommended at well child visits, yet is less widely implemented in inpatient settings. Using a multidisciplinary approach, we implemented FI screening and resource referrals for all admitted patients at our free-standing quaternary care children’s hospital, which sees 70% Medicaid-enrolled patients, starting in May 2022.

Objective: Our aims were to (1) characterize the inpatient population experiencing FI, (2) compare characteristics of food insecure vs food secure patients.

Design/Methods: This is a cross-sectional study of patients admitted between May and December 2022. FI screening was performed on every admitted patient using the Hunger Vital Sign, a 2-item validated tool. Families who screened positive were referred to resources. Descriptive statistics were used for baseline demographics.The Chi-squared test and logistic regression were used to determine the association between demographic variables and food insecurity reported as odds ratios, p-values, and 95% CIs.

Results: During the study period, 6,600 unique patients were screened for FI. FI was present in 4.9% (n=326) of patients at baseline (Table 1). Of those who screened positive, higher odds of FI were seen in Black vs Whites patients (OR, 1.5, [95% CI, 1.09-2.06]), Spanish- vs English-speaking patients (OR, 2.31 [95% CI, 1.84-2.89]), and patients enrolled in Medicaid vs non-Medicaid (OR, 4.17 [95% CI 3.0-5.8]) (Table 2). There was a statistically significant difference in the percentage of FI amongst hospital units (p< 0.001), with highest rates of FI seen in the Hematology Oncology unit (Table 2). There is a positive linear relationship between social vulnerability index percentile and odds of food insecurity (OR, 1.02, [95% CI, 1.02-1.03]). In patients who were re-screened during a second admission (n=692), there were no statistically significant differences in changes in food security status (p=0.314).

Conclusion(s): Our program highlights the opportunity to screen for FI in the hospital setting. The percentage of FI disclosure amongst our hospitalized pediatric patients was unexpectedly lower than the national average for U.S. households with children. Our study reveals that Black, Spanish-speaking, and Medicaid-enrolled inpatients had higher odds of experiencing FI. Next steps include implementing electronic screening to allow for more privacy, expanding screening to emergency department and outpatient settings, and creating a closed-loop referral system to track resource utilization.