Child Nutrition Disorders, Hunger
Conditions
Keywords
social determinants of health, food insecurity, screening, pediatrics
Brief summary
This study compares food insecurity disclosure rates in face-to-face interviews versus electronic formats, and explores caregiver preferences regarding screening modality and location, in a large, urban pediatric emergency department. Half of the participants were screened for food insecurity verbally, face-to-face by a research assistant, and half of the participants were screened electronically by a tablet.
Detailed description
Children are disproportionately affected by the rise in poverty rates in the United States, and economic hardships can compromise their development, negatively affect their overall health, and adversely affect their abilities to succeed in school and in life. Food insecurity (FI)-the limited or uncertain availability of nutritionally adequate or safe foods- while strongly associated with poverty, is an independent predictor of poor health outcomes for children. The Emergency Department (ED) of academic medical centers often serves as a point of care entry for impoverished and high-risk families. Although there is a growing interest in the healthcare system's ability to address Social Determinants of Health (SDH), little is known about food insecurity in the pediatric ED. Additionally, there are limited data on how to implement FI screening into practice in a way that maximizes elicitation of social need, while assuring patient and family comfort.
Interventions
OTHERFood Insecurity Screening Tablet
The intervention is the type of screening modality used to identify food insecurity: verbal face-to-face, or tablet-based screening
OTHERFood Insecurity Screening Verbal
The intervention is the type of screening modality used to identify food insecurity: verbal face-to-face, or tablet-based screening
Sponsors
University of Pennsylvania
Children's Hospital of Philadelphia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* English speaking * Adult caregiver accompanying pediatric patient in the Children's Hospital of Philadelphia (CHOP) emergency department
Exclusion criteria
* Patient (child) in critical condition * Patient (child) \>18 years of age * Previously enrolled in study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence of Food Insecurity | 12 months | Affirmative response to either of the two, validated screening questions for food insecurity. Investigators measured food insecurity using the validated two-question Hunger Vital Sign screening tool, with yes/no responses. These two questions are: within the past 12 months we worried whether our food would run out before we got money to buy more and the food we bought just didn't last and we didn't have money to get more. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Preferred Screening Modality | 4 weeks | Report of screening modality preference: verbal, tablet, or no preference |
| Comfort level with screening location | 4 weeks | Report of comfort with screening in the emergency department and in the primary care setting |
Countries
United States
Outcome results
None listed