Montez Kimberly, Brown Callie L, Garg Arvin, Rhodes Scott D, Song Eunyoung Y, Taxter Alysha J, Skelton Joseph A, Albertini Laurie W, Palakshappa Deepak
Department of Pediatrics, Wake Forest University Health Sciences, Winston-Salem, NC, 27157, USA.
Departments of Pediatrics and Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem, NC, 27157, USA.
BMC Pediatr. 2021 Aug 27;21(1):364. doi: 10.1186/s12887-021-02829-3.
Healthcare organizations are increasingly screening and addressing food insecurity (FI); yet, limited data exists from clinic-based settings on how FI rates change over time. The objective of this study was to evaluate household FI trends over a two-year period at a clinic that implemented a FI screening and referral program.
In this retrospective cohort study, data were extracted for all visits at one academic primary care clinic for all children aged 0-18 years whose parents/guardians had been screened for FI at least once between February 1, 2018 to February 28, 2019 (Year 1) and screened at least once between March 1, 2019 to February 28, 2020 (Year 2). Bivariate analyses tested for differences in FI and demographics using chi-square tests. Mixed effects logistic regression was used to assess change in FI between Years 1 and 2 with random intercept for participants controlling for covariates. The interaction between year and all covariates was evaluated to determine differences in FI change by demographics.
Of 6182 patients seen in Year 1, 3691 (59.7%) were seen at least once in Year 2 and included in this study. In Year 1, 19.6% of participants reported household FI, compared to 14.1% in Year 2. Of those with FI in Year 1, 40% had FI in Year 2. Of those with food security in Year 1, 92.3% continued with food security in Year 2. Compared to Hispanic/Latinx participants, African American/Black (OR: 3.53, 95% CI: 2.33, 5.34; p < 0.001) and White (OR: 1.88, 95% CI: 1.06, 3.36; p = 0.03) participants had higher odds of reporting FI. African American/Black participants had the largest decrease in FI between Years 1 and 2 (- 7.9, 95% CI: - 11.7, - 4.1%; p < 0.0001).
Because FI is transitional, particularly for racial/ethnic minorities, screening repeatedly can identify families situationally experiencing FI.
医疗保健机构越来越多地对粮食不安全状况（FI）进行筛查和应对；然而，基于诊所环境中关于FI发生率随时间如何变化的数据有限。本研究的目的是评估在一家实施了FI筛查和转诊计划的诊所中，家庭FI在两年期间的趋势。
在这项回顾性队列研究中，提取了一家学术初级保健诊所中所有0至18岁儿童的就诊数据，这些儿童的父母/监护人在2018年2月1日至2019年2月28日（第1年）期间至少接受过一次FI筛查，并且在2019年3月1日至2020年2月28日（第2年）期间至少接受过一次筛查。使用卡方检验进行双变量分析，以检验FI和人口统计学特征的差异。混合效应逻辑回归用于评估第1年和第2年之间FI的变化，并对控制协变量的参与者使用随机截距。评估年份与所有协变量之间的相互作用，以确定不同人口统计学特征在FI变化方面的差异。
在第1年就诊的6182名患者中，3691名（59.7%）在第2年至少就诊过一次并纳入本研究。在第1年，19.6%的参与者报告家庭存在FI，而在第2年这一比例为14.1%。在第1年存在FI的参与者中，40%在第2年仍有FI。在第1年粮食安全的参与者中，92.3%在第2年继续保持粮食安全。与西班牙裔/拉丁裔参与者相比，非裔美国人/黑人（比值比：[OR] 3.53，95%置信区间：[CI] 2.33，5.34；p < 0.001）和白人（OR：1.88，95% CI：1.06，3.36；p = 0.03）参与者报告FI的几率更高。非裔美国人/黑人参与者在第1年和第2年之间FI的下降幅度最大（-7.9%（95% CI：-11.7%，-4.1%）；p < 0.0001）。
由于FI具有过渡性，尤其是对少数种族/族裔而言，反复筛查可以识别出处于FI状况的家庭。
