Implementing Food Insecurity Screening at a Community Health Center

Introduction: The Farm-to-Health Center Initiative aims to reduce rates of food insecurity (FI) at a federally qualified community health center (CHC) by implementing a FI patient screening program and increasing referrals to food assistance programs. The Initiative reflects collaboration among medical students, a CHC, and a hunger-relief farm. FI has been linked to a range of poor health outcomes, yet is often overlooked by healthcare providers. A prior need assessment at this CHC showed 67% were FI; 53% had never been asked about FI.

Approach: We assessed existing resources, compiled a list of local food assistance programs, researched screening models in other clinical settings, and met with CHC patient advocates and WIC staff. We presented the health impacts of FI and screening tools to clinic staff and gathered feedback on the utility of screening. Partnering with a CHC physician, we developed an algorithm for FI screening and referral.

Results: We conferred with relevant CHC committees, learned the importance of listening to CHC staff, the benefit of connecting existing resources, the necessity to learn from other programs doing this work, and the difficulty of adding a new screening tool.

Discussion: Systemic change is a slow process, yet preliminary results show that there is a need for FI screening and both staff and patients identify it as a priority. We are in the process of integrating the screening algorithm into the CHC’s work flow and plan to collect data on the efficacy of screening in increasing referrals to food assistance programs.