Assaf Raymen R, Knudsen-Robbins Chloe, Heyming Theodore, Bacon Kellie, Shelton Shelby K, Chakravarthy Bharath, Saadat Soheil, Douglas Jason A, Cisneros Victor
Children's Hospital of Orange County, Orange, California.
University of California Irvine, School of Medicine, Department of Pediatrics, Irvine, California.
West J Emerg Med. 2025 Mar;26(2):326-337. doi: 10.5811/westjem.19435.
Food and housing insecurity in childhood is troublingly widespread. Emergency departments (ED) are well positioned to identify and support food- and housing-insecure children and their families. However, there is no consensus regarding the most efficient screening tools or most effective interventions for ED use.
In this cross-sectional study we aimed to investigate the implementation of a food/ housing insecurity screening tool and resource referral uptake in a pediatric ED.
During the study period (March 1-December 9, 2021), there were 67,297 ED visits at the study institution, which is a freestanding children's hospital. Caregivers of patients presenting to the ED were approached for participation in the study; 1,908 families participated (2.8% of all ED visits during the study period) and were screened for food and housing insecurity. Caregiver surveys included demographic, food and housing insecurity, caregiver/patient health status, and healthcare utilization questions. Caregivers who screened positive for food and/or housing insecurity received printed materials with food and/or housing resources. We analyzed data using descriptive statistics, one-way analysis of variance, and the Pearson chi-squared test.
A total of 1,908 caregivers were surveyed: 416 (21.8%) screened positive for food and/or housing insecurity. Of those who screened positive, 147/416 completed follow-up surveys. On follow-up, 44 (30.0%) no longer screened positive for food and/or housing insecurity, while 15 (10.2%) reported using at least one resource referral. The most frequently reported referral utilization barrier was loss or reported non-receipt of the referral.
This study demonstrates high food- and housing-insecurity rates among families presenting to a pediatric ED, emphasizing the urgency and necessity of screening and intervening in this environment. The food and housing insecurity change between baseline and follow-up reported here and the overall low resource uptake highlights challenges with ED-based screening and intervention efficacy.
儿童时期的食品和住房不安全问题普遍存在，令人担忧。急诊科处于识别和支持食品与住房不安全儿童及其家庭的有利位置。然而，对于急诊科使用的最有效筛查工具或最有效干预措施，尚无共识。
在这项横断面研究中，我们旨在调查儿科急诊科食品/住房不安全筛查工具的实施情况以及资源转诊的接受情况。
在研究期间（2021年3月1日至12月9日），研究机构（一家独立的儿童医院）的急诊科有67297次就诊。研究人员邀请到急诊科就诊患者的护理人员参与研究；1908个家庭参与（占研究期间所有急诊科就诊人数的2.8%），并接受了食品和住房不安全筛查。护理人员调查问卷包括人口统计学、食品和住房不安全、护理人员/患者健康状况以及医疗保健利用问题。食品和/或住房不安全筛查呈阳性的护理人员会收到包含食品和/或住房资源的印刷材料。我们使用描述性统计、单因素方差分析和Pearson卡方检验对数据进行了分析。
共对1908名护理人员进行了调查：416人（21.8%）食品和/或住房不安全筛查呈阳性。在筛查呈阳性的人员中，147/416完成了后续调查。在后续调查中，44人（30.0%）食品和/或住房不安全筛查不再呈阳性，而15人（10.2%）报告至少使用了一项资源转诊。最常报告的转诊利用障碍是转诊丢失或报告未收到转诊。
本研究表明，到儿科急诊科就诊的家庭中，食品和住房不安全率很高，强调了在这种环境下进行筛查和干预的紧迫性和必要性。此处报告的基线和随访之间食品和住房不安全情况的变化以及总体资源接受率低凸显了基于急诊科的筛查和干预效果方面的挑战。
