Stenmark Sandra Hoyt, Steiner John F, Marpadga Sanjana, Debor Marydale, Underhill Kathleen, Seligman Hilary
Pediatrician and Physician Lead of Health Equity in Community Benefit for Kaiser Permanente Colorado in Denver (
Senior Investigator in the Institute for Health Research at Kaiser Permanente in Denver, CO (
Perm J. 2018;22:18-093. doi: 10.7812/TPP/18-093.
Traditionally, health care systems have addressed gaps in patients' diet quality with programs that provide dietary counseling and education, without addressing food security. However, health care systems increasingly recognize the need to address food security to effectively support population health and the prevention and management of diet-sensitive chronic illnesses. Numerous health care systems have implemented screening programs to identify food insecurity in their patients and to refer them to community food resources to support food security. This article describes barriers encountered and lessons learned from implementation and expansion of the Kaiser Permanente Colorado's clinical food insecurity screening and referral program, which operates in collaboration with a statewide organization (Hunger Free Colorado) to manage clinic-to-community referrals. The immediate goals of clinical screening interventions described in this article are to identify households experiencing food insecurity, to connect them to sustainable (federal) and emergency (community-based) food resources, to alleviate food insecurity, and to improve dietary quality. Additional goals are to improve health outcomes, to decrease health care utilization, to improve patient satisfaction, and to better engage patients in their care.
传统上,医疗保健系统通过提供饮食咨询和教育的项目来解决患者饮食质量方面的差距,而未涉及食品安全问题。然而,医疗保健系统越来越认识到,为有效支持民众健康以及预防和管理饮食敏感型慢性病,有必要解决食品安全问题。许多医疗保健系统已实施筛查项目,以识别患者中的粮食不安全状况,并将他们转介至社区粮食资源处,以支持食品安全。本文描述了科罗拉多州凯撒医疗集团临床粮食不安全筛查及转介项目在实施和扩展过程中遇到的障碍及吸取的经验教训,该项目与一个全州性组织(科罗拉多无饥饿组织)合作,负责管理从诊所到社区的转介工作。本文所述临床筛查干预措施的近期目标是识别面临粮食不安全状况的家庭,将他们与可持续(联邦)和应急(社区)粮食资源联系起来,缓解粮食不安全状况,并改善饮食质量。其他目标包括改善健康结果、减少医疗保健利用率、提高患者满意度,以及更好地让患者参与自身护理。