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APHA Scientific Session and Event Listing

Elizabeth Miller, MD, PhD¹, Katia Canenguez, EdM², Kristin Wieneke, MA², Ron Kleinman, MD³, and Michael Murphy, EdD². (1) Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital, 50 Staniford St., 9th Floor, Boston, MA 02114, (617)726-6992, emiller1@partners.org, (2) Child Psychiatry, Massachusetts General Hospital, Yawkey 6A, Fruit Street, Boston, MA 02114, (3) Pediatric Gastroenterology, Massachusetts General Hospital, Vincent Burnham, 55 Fruit Street, Boston, MA 02114

Recent studies have shown that four percent of US families with children experience hunger and an additional 12 percent are food insecure. Research also shows that hunger and food insecurity are associated with poorer physical health, mental health and academic performance. To identify hungry families and increase food program participation, we created and validated a one-question screen to be administered by front desk staff in pediatric clinics. An on-site hunger outreach worker reviews positive responses, assists with finding and applying for food resources, and provides additional advocacy to support hungry families. We report on the implementation of this screening and intervention program under ‘real world' conditions at two pediatric practices in urban low-income neighborhood health centers. Because screening is voluntary and parents complete only one per family, only about 20% of all scheduled pediatric visits were screened during the first three months of the program. Despite this relatively low rate of screening, more than 1700 families were screened, 166 (10%) screened positive, and 47 completed interventions. Among intervention families, the total number of food programs used increased significantly from 2.1 pre intervention to 2.7 post intervention. Participation improvements were seen in five out of the six food assistance programs with the greatest increase being in Food Stamps where participation jumped from 47 to 88 percent of eligible families. This evaluation demonstrates the feasibility and effectiveness of a screening and outreach program to identify and advocate for hungry families in the pediatric clinical setting.

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