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识别心脏病学诊所中的粮食不安全问题并为家庭提供资源。

Identifying Food Insecurity in Cardiology Clinic and Connecting Families to Resources.

机构信息

Norton Children's Hospital and School of Medicine, University of Louisville, Louisville, Kentucky.

University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

出版信息

Pediatrics. 2022 May 1;149(5). doi: 10.1542/peds.2020-011718.

Abstract

BACKGROUND

Food insecurity (FI) increases children's risk for illness and developmental and behavioral problems, which are ongoing concerns for congenital heart disease (CHD) patients. In 2020, 14.8% of households with children suffered from FI. The Hunger Vital Signs (HVS) asks 2 questions to assess FI. The global aim of the project is to implement HVS and connect FI families to resources.

METHODS

Stakeholders identified 6 critical drivers in implementing FI screening at an outpatient cardiology clinic and conducted plan-do-study-act (PDSA) cycles to implement HVS. Over the 13-month study period, time series analyses were performed to assess our process measure (FI screening) and outcome measure (connection of FI families to resources). Demographics and severity of CHD were analyzed for FI families.

RESULTS

Screening rates increased from 0% to >85%, screening 5064 families. Process evaluations revealed roadblocks including screening discomfort. FI families were more likely to identify as Black or multiple or other ethnicity. Severe CHD patients were at higher risk for FI (n = 106, odds ratio [OR] 1.67 [1.21-2.29], P = .002). Face-to-face meetings with social work and community partnerships reduced loss to follow-up and our ability to offer all FI families individualized FI resources.

CONCLUSION

HVS screening can be implemented in a cardiology clinic to improve identification of FI families. A written tool can combat screening discomfort and improve identification of FI families. Children with severe CHD may be at increased risk for FI. A multidisciplinary team and community partnerships can improve individualized resource distribution.

摘要

背景

食物不安全(FI)增加了儿童患病、发育和行为问题的风险,这是先天性心脏病(CHD)患者持续关注的问题。2020 年,有 14.8%的儿童家庭遭受 FI。饥饿生命体征(HVS)通过询问 2 个问题来评估 FI。该项目的全球目标是实施 HVS 并将 FI 家庭与资源联系起来。

方法

利益相关者确定了在门诊心脏病学诊所实施 FI 筛查的 6 个关键驱动因素,并进行了计划-执行-研究-行动(PDSA)循环以实施 HVS。在 13 个月的研究期间,进行了时间序列分析,以评估我们的过程测量(FI 筛查)和结果测量(将 FI 家庭与资源联系起来)。对 FI 家庭的人口统计学和 CHD 严重程度进行了分析。

结果

筛查率从 0%增加到>85%,筛查了 5064 个家庭。过程评估显示存在障碍,包括筛查不适。FI 家庭更有可能认为自己是黑人或多种族或其他种族。严重 CHD 患者 FI 的风险更高(n=106,优势比[OR]1.67[1.21-2.29],P=0.002)。与社会工作和社区伙伴关系的面对面会议减少了失访,并使我们能够为所有 FI 家庭提供个性化的 FI 资源。

结论

HVS 筛查可以在心脏病学诊所实施,以提高 FI 家庭的识别率。书面工具可以减少筛查不适并提高 FI 家庭的识别率。患有严重 CHD 的儿童可能面临更高的 FI 风险。多学科团队和社区伙伴关系可以改善个性化资源分配。

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