From the Department of Family Medicine, University of Iowa, Iowa City, IA (SKB, MR, KS); Department of Family Medicine, University of Minnesota, Minneapolis, MN (MT); Department of Biostatistics, University of Iowa, Iowa City, IA (BZ); University of Iowa Carver College of Medicine, Iowa City, IA (SH); Department of Family Medicine and Community Health, Center for Public Health, Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA (PFC, EWK).
J Am Board Fam Med. 2024 Mar-Apr;37(2):196-205. doi: 10.3122/jabfm.2023.230319R1.
Food insecurity (FI) is a hidden epidemic associated with worsening health outcomes affecting 33.8 million people in the US in 2021. Although studies demonstrate the importance of health care clinician assessment of a patient's food insecurity, little is known about whether Family Medicine clinicians (FMC) discuss FI with patients and what barriers influence their ability to communicate about FI. This study evaluated FM clinicians' food insecurity screening practices to evaluate screening disparities and identify barriers that influence the decision to communicate about FI.
Data were gathered and analyzed as part of the 2022 Council of Academic Family Medicine's Educational Research Alliance survey of Family Medicine general membership.
The majority of respondents reported (66.9%) that their practice has a screening system for food insecurity, and most practices used a verbal screen with staff other than the clinician (41%) at specific visits (63.8%). Clinicians reported "rarely or never asking about FI" 40% of the time and only asking "always or frequently" 6.7% of the time. Inadequate time during appointments (44.5%) and other medical issues taking priority (29.4%) were identified as the most common barriers. The lack of resources available in the community was a significant barrier for clinicians who worked in rural areas.
This survey provides insight into food insecurity screening disparities and identifies obstacles to FMC screening, such as time constraints, lack of resources, and knowledge of available resources. Understanding current communication practices could create opportunities for interventions to identify food insecurity and impact "Food as Medicine."
食品不安全(FI)是一种隐性流行病,与 2021 年美国 3380 万人健康状况恶化有关。尽管研究表明医疗保健临床医生评估患者食品不安全状况的重要性,但对于家庭医学临床医生(FMC)是否与患者讨论 FI 以及哪些障碍影响他们沟通 FI 的能力知之甚少。本研究评估了 FM 临床医生的食品不安全筛查实践,以评估筛查差异并确定影响沟通 FI 决策的障碍。
数据是作为 2022 年学术家庭医学委员会教育研究联盟对家庭医学普通会员的调查的一部分收集和分析的。
大多数受访者报告(66.9%)他们的实践有食品不安全筛查系统,并且大多数实践在特定就诊时使用除临床医生以外的工作人员进行口头筛查(41%)(63.8%)。临床医生报告“很少或从不询问 FI”的时间占 40%,仅“总是或经常”询问的时间占 6.7%。在预约期间时间不足(44.5%)和其他医疗问题优先(29.4%)被确定为最常见的障碍。缺乏社区可用资源是在农村地区工作的临床医生的一个重大障碍。
这项调查提供了对食品不安全筛查差异的深入了解,并确定了 FMC 筛查的障碍,例如时间限制、资源匮乏以及对可用资源的了解。了解当前的沟通实践可以为识别食品不安全和影响“食品即药物”的干预措施创造机会。