Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass.
Division of Endocrinology, Department of Medicine, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass.
Acad Pediatr. 2017 Jul;17(5):497-503. doi: 10.1016/j.acap.2016.10.006. Epub 2017 Mar 13.
To describe a clinical approach for food insecurity screening incorporating a menu offering food-assistance referrals, and to examine relationships between food insecurity and referral selection.
Caregivers of 3- to 10-year-old children presenting for well-child care completed a self-administered questionnaire on a laptop computer. Items included the US Household Food Security Survey Module: 6-Item Short Form (food insecurity screen) and a referral menu offering assistance with: 1) finding a food pantry, 2) getting hot meals, 3) applying for Supplemental Nutrition Assistance Program (SNAP), and 4) applying for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Referrals were offered independent of food insecurity status or eligibility. We examined associations between food insecurity and referral selection using multiple logistic regression while adjusting for covariates.
A total of 340 caregivers participated; 106 (31.2%) reported food insecurity, and 107 (31.5%) selected one or more referrals. Forty-nine caregivers (14.4%) reported food insecurity but selected no referrals; 50 caregivers (14.7%) selected one or more referrals but did not report food insecurity; and 57 caregivers (16.8%) both reported food insecurity and selected one or more referrals. After adjustment, caregivers who selected one or more referrals had greater odds of food insecurity compared to caregivers who selected no referrals (adjusted odds ratio 4.0; 95% confidence interval 2.4-7.0).
In this sample, there was incomplete overlap between food insecurity and referral selection. Offering referrals may be a helpful adjunct to standard screening for eliciting family preferences and identifying unmet social needs.
描述一种纳入食品援助转介菜单的食物不安全筛查临床方法，并检验食物不安全与转介选择之间的关系。
3 至 10 岁儿童的照顾者在笔记本电脑上完成自我管理的问卷调查。项目包括美国住户粮食安全调查模块：6 项简短形式（食物不安全筛查）和一个提供援助的转介菜单，包括：1）寻找食品储藏室，2）获得热餐，3）申请补充营养援助计划（SNAP），4）申请特殊补充营养计划妇女、婴儿和儿童（WIC）。转介是独立于食物不安全状况或资格提供的。我们使用多变量逻辑回归检验了食物不安全与转介选择之间的关联，同时调整了协变量。
共有 340 位照顾者参与；106 位（31.2%）报告食物不安全，107 位（31.5%）选择了一个或多个转介。49 位照顾者（14.4%）报告食物不安全但未选择任何转介；50 位照顾者（14.7%）选择了一个或多个转介但未报告食物不安全；57 位照顾者（16.8%）既报告食物不安全又选择了一个或多个转介。调整后，与未选择任何转介的照顾者相比，选择了一个或多个转介的照顾者食物不安全的可能性更大（调整后的优势比 4.0；95%置信区间 2.4-7.0）。
在本样本中，食物不安全与转介选择之间存在不完全重叠。提供转介可能是一种有用的辅助方法，可用于引出家庭偏好并确定未满足的社会需求，以补充标准筛查。
