Almohamad Maha, Mofleh Dania, Altema-Johnson Daphene, Ahmed Mariam, Fries Joseph, Okpala Munachi, Cohen A Sarah, Hernandez Daphne C, Sharrief Anjail
Center for Health Equity, Department of Epidemiology, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, USA.
Department of Psychiatry & Behavioral Sciences, McGovern Medical School at the University of Texas Health Science Center at Houston, USA.
Heliyon. 2024 Aug 10;10(16):e36142. doi: 10.1016/j.heliyon.2024.e36142. eCollection 2024 Aug 30.
To assess the feasibility of administrating an electronic and paper-based food insecurity screener among patients presenting to a stroke clinic during the study period. We aimed to ensure a consecutive sample for our retrospective analysis and evaluate the prevalence and characteristics of food insecurity in this population.
We conducted a retrospective review of patients with an initial telemedicine or in-person appointment to a stroke outpatient clinic between February 1 and July 31, 2021. Prior to their initial visit, patients were sent an electronic questionnaire to screen for food insecurity using the 2-item Hunger Vital Sign™ and to collect socio-demographic characteristics. Patients who were evaluated in-person were given a paper questionnaire if the electronic version was not completed upon clinic appointment. We collected data on patient demographics, screener completion rates, and the prevalence of food insecurity. The feasibility was evaluated by comparing the amount of missing data between electronic and paper-based screeners.
Among 406 adult stroke survivors, 365 (89.9 %) completed the food insecurity screener, with 234 (64.1 %) completing it electronically and 131 (35.9 %) by paper. Overall, 14.3 % of the stroke patients experienced food insecurity. A higher prevalence of food insecurity was observed among patients who completed paper-based compared to electronic questionnaires (21.4 % vs 10.2 %, p = 0.004). Hispanic patients were more likely to complete paper-based questionnaires (32.1 %) compared to electronic questionnaires (18.0 %, p = 0.011). Patients with a 12 grade education or less were more likely to complete paper-based (49.5 %) vs. electronic questionnaires (36.4 %, p = 0.029). Feasibility was evaluated by comparing the amount of missing data between the screener delivery modalities. A higher percentage of socio-demographic characteristics was missing in the paper-based questionnaires compared to electronic questionnaires (105.3 % vs. 14.11 %).
Sample characteristics differ based on the mode of questionnaire delivery, suggesting that different screening modalities may be necessary to identify patients at the highest risk for food insecurity. Our study provides detailed insights into the feasibility of using electronic and paper-based screeners in a clinical setting, highlighting the importance of considering delivery methods in food insecurity assessments. It is important to note that the Spanish language electronic survey was only available during the last two months of the study, which may affect the findings regarding Hispanic patients' preference for paper surveys.
评估在研究期间向中风诊所就诊患者发放电子和纸质粮食不安全筛查工具的可行性。我们旨在确保为回顾性分析获取连续样本，并评估该人群中粮食不安全的患病率及特征。
我们对2021年2月1日至7月31日期间首次通过远程医疗或亲自到中风门诊就诊的患者进行了回顾性研究。在首次就诊前，向患者发送一份电子问卷，使用两项饥饿生命体征™筛查粮食不安全情况，并收集社会人口学特征。如果在诊所预约时未完成电子版问卷，亲自接受评估的患者会收到一份纸质问卷。我们收集了患者人口统计学数据、筛查工具完成率以及粮食不安全患病率。通过比较电子和纸质筛查工具中缺失数据的数量来评估可行性。
在406名成年中风幸存者中，365名（89.9%）完成了粮食不安全筛查，其中234名（64.1%）通过电子方式完成，131名（35.9%）通过纸质方式完成。总体而言，14.3%的中风患者经历过粮食不安全。与电子问卷相比，完成纸质问卷的患者中粮食不安全患病率更高（21.4%对10.2%，p = 0.004）。与电子问卷（18.0%）相比，西班牙裔患者更有可能完成纸质问卷（32.1%，p = 0.011）。接受12年级及以下教育的患者比电子问卷更有可能完成纸质问卷（49.5%对36.4%，p = 0.029）。通过比较筛查工具发放方式之间缺失数据的数量来评估可行性。与电子问卷相比，纸质问卷中社会人口学特征缺失的百分比更高（105.3%对14.11%）。
样本特征因问卷发放方式而异，这表明可能需要不同的筛查方式来识别粮食不安全风险最高的患者。我们的研究详细深入地探讨了在临床环境中使用电子和纸质筛查工具的可行性，强调了在粮食不安全评估中考虑发放方式的重要性。需要注意的是，西班牙语电子调查仅在研究最后两个月提供，这可能会影响关于西班牙裔患者对纸质调查偏好的研究结果。
