Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado (Dr Kelly and Mss Maytag, and Ross); and Evaluation Specialists, Denver, Colorado (Dr Allen).
J Public Health Manag Pract. 2022;28(1):E56-E61. doi: 10.1097/PHH.0000000000001208.
Only 58% of eligible Coloradans are enrolled in the Supplemental Nutrition Assistance Program (SNAP). In recent years, more community-based organizations (CBOs) and health care clinics are incorporating screening for social needs into their workflows.
Seven Colorado-based CBOs and 3 clinics received funding (2016-2018) to screen for food insecurity (FI) and provide SNAP application assistance to their clients and patients.
Funded agencies were required to implement strategies focused on particular populations or settings based on Food Research and Action Center recommendations.
A 5-part care cascade from screening to SNAP enrollment was conceptualized to guide the evaluation. Funded CBOs and clinics were asked to submit de-identified individual-level data to the evaluation team (number and characteristics of individuals screened, screening results, interest in receiving assistance, submitted application, enrolled in SNAP). The purpose of the evaluation was to assess the proportion of individuals CBOs and clinics screen for FI and assist with completing a SNAP application and describe the characteristics of individuals who are not interested in receiving assistance to complete a SNAP application and the characteristics of individuals who enroll in SNAP.
Thirty-five percent of individuals who reported FI participated in the care cascade and enrolled in SNAP. CBOs assisted a greater proportion of food-insecure individuals (55%) than clinics (22%) (P < .001). Males, adults 40 years or older, rural residents, and African Americans were more likely to be interested in receiving assistance, and adults 40 years or older, rural residents, and American Indians/Alaska Natives were more likely to enroll in SNAP.
CBOs were more successful in assisting individuals along the care cascade than clinics. Certain subpopulations are more likely to be interested in receiving assistance and enrolling in SNAP. These findings can be used by public health practitioners to plan interventions to increase enrollment in SNAP.
仅有 58%的符合条件的科罗拉达人加入了补充营养援助计划（SNAP）。近年来，越来越多的社区组织（CBO）和医疗诊所将社会需求筛查纳入其工作流程。
七个科罗拉达州的 CBO 和三个诊所获得了资金（2016-2018 年），以对其客户和患者进行粮食不安全（FI）筛查，并提供 SNAP 申请援助。
根据食品研究与行动中心的建议，为获得资金的机构制定了侧重于特定人群或环境的战略。
从筛查到 SNAP 注册的五个部分护理链被构想出来以指导评估。要求获得资金的 CBO 和诊所向评估小组提交去标识的个人一级数据（筛查人数和特征、筛查结果、申请援助的意愿、提交的申请、注册 SNAP）。评估的目的是评估 CBO 和诊所筛查 FI 并协助完成 SNAP 申请的人数比例，并描述不感兴趣申请 SNAP 援助的个人特征以及注册 SNAP 的个人特征。
报告有 FI 的个人中有 35%参与了护理链并注册 SNAP。CBO 协助了更多的粮食不安全个人（55%），而诊所（22%）（P<.001）。男性、40 岁或以上的成年人、农村居民和非裔美国人更有可能有兴趣获得援助，而 40 岁或以上的成年人、农村居民和美洲印第安人/阿拉斯加原住民更有可能注册 SNAP。
CBO 比诊所更成功地协助个人沿着护理链前进。某些亚人群更有可能有兴趣获得援助并注册 SNAP。这些发现可被公共卫生从业人员用于规划干预措施，以增加 SNAP 的注册人数。
