Knowles Molly, Khan Saba, Palakshappa Deepak, Cahill Rachel, Kruger Evelyne, Poserina Bridget G, Koch Brittany, Chilton Mariana
J Health Care Poor Underserved. 2018;29(1):181-191. doi: 10.1353/hpu.2018.0012.
Food insecurity, lack of access to enough food for an active and healthy life, is associated with poor child health. Three pediatric clinics implemented a two-question food insecurity screening of 7,284 families with children younger than five years. Over one thousand (1,133, 15.6%) reported food insecurity and 630 (55.6%) were referred to a benefits access organization for connection to public benefits and community resources. This study evaluated the efficacy of screening and referral through process evaluation, key informant interviews, and focus groups with 19 caregivers and 11 clinic staff. Using grounded theory, transcript themes were coded into facilitators and barriers of screening and referral. Facilitators included trust between caregivers and staff, choice of screening methods, and assistance navigating benefits application. Barriers included complex administration of referral, privacy and stigma concerns, and caregivers' current benefit enrollment or ineligibility. Results demonstrate importance of integrated screening and referral consent processes, strong communication, and convenient outreach for families.
粮食不安全，即无法获得足够的食物以过上积极健康的生活，与儿童健康状况不佳有关。三家儿科诊所对7284名五岁以下儿童的家庭进行了两个问题的粮食不安全筛查。超过一千户家庭（1133户，占15.6%）报告存在粮食不安全问题，其中630户家庭（占55.6%）被转介到一个福利获取组织，以便与公共福利和社区资源建立联系。本研究通过过程评估、关键信息提供者访谈以及与19名照顾者和11名诊所工作人员进行焦点小组讨论，评估了筛查和转介的效果。运用扎根理论，将访谈记录的主题编码为筛查和转介的促进因素和障碍。促进因素包括照顾者与工作人员之间的信任、筛查方法的选择以及申请福利过程中的协助。障碍包括转介管理复杂、隐私和耻辱感问题，以及照顾者目前的福利登记情况或不符合资格的情况。结果表明，综合筛查和转介同意流程、良好的沟通以及为家庭提供便捷的外展服务非常重要。
