Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, ML 7035, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA,
J Community Health. 2013 Dec;38(6):1182-7. doi: 10.1007/s10900-013-9731-8.
Despite evidence that food insecurity negatively impacts child health, health care providers play little role in addressing the issue. To inform potential primary care interventions, we sought to assess a range of challenges faced by food insecure (FI) families coming to an urban, pediatric primary care setting. A cross-sectional study was performed at a hospital-based, urban, academic pediatric primary care clinic that serves as a medical home for approximately 15,000 patients with 35,000 annual visits. Subjects included a convenience sample of caregivers of children presenting for either well child or ill care over a 4 months period in 2012. A self-administered survey assessed household food security status, shopping habits, transportation access, budgeting priorities, and perceptions about nutrition access in one's community. Bivariate analyses between food security status and these characteristics were performed using Chi square statistics or Fisher's exact test. The survey was completed by 199 caregivers. Approximately 33% of families were FI; 93% received food-related governmental assistance. FI families were more likely to obtain food from a corner/convenience store, utilize food banks, require transportation other than a household car, and prioritize paying bills before purchasing food. FI families perceived less access to healthy, affordable foods within their community. Thus, FI families may face unique barriers to accessing food. Knowledge of these barriers could allow clinicians to tailor in-clinic screening and create family-centered interventions.
尽管有证据表明粮食不安全会对儿童健康产生负面影响,但医疗保健提供者在解决这个问题方面几乎没有发挥作用。为了为潜在的初级保健干预措施提供信息,我们试图评估来到城市儿科初级保健机构的粮食不安全(FI)家庭所面临的一系列挑战。在一家医院为基础的城市学术儿科初级保健诊所进行了一项横断面研究,该诊所作为大约 15000 名患者的医疗之家,每年有 35000 次就诊。研究对象包括在 2012 年的 4 个月期间,因儿童健康或疾病就诊的儿童的护理人员的便利样本。一份自我管理的调查问卷评估了家庭的粮食安全状况、购物习惯、交通状况、预算优先事项以及对所在社区营养获取的看法。使用卡方检验或 Fisher 精确检验对粮食安全状况与这些特征之间的关系进行了双变量分析。199 名护理人员完成了调查。大约 33%的家庭粮食不安全;93%的家庭接受与食品相关的政府援助。粮食不安全的家庭更有可能从街角/便利店购买食物,利用食品银行,需要除家庭汽车以外的交通工具,并且在购买食物之前优先支付账单。粮食不安全的家庭认为在他们的社区中获得健康、负担得起的食物的机会较少。因此,粮食不安全的家庭在获得食物方面可能面临独特的障碍。了解这些障碍可以使临床医生调整门诊筛查并创建以家庭为中心的干预措施。