P2B303: Addressing Food Insecurity in Pediatric Primary Care: A Quality Improvement Project to Screen, Connect, and Advocate

Purpose/Objectives: The American Academy of Pediatrics recommends that clinicians follow 3 steps to address food insecurity: screen and identify, connect, and advocate. However, many pediatricians do not feel well equipped to do so and often struggle to screen and refer patients to community resources. This quality improvement project integrates clinician education, EHR tools, a text campaign, and a robust web-based resource list to help guide pediatricians in the highest quality of care in the recognition of food insecurity, connection to resources, and advocacy.

Design/Methods: To improve awareness of food insecurity and its health and behavioral impacts and to seamlessly screen and connect through tools integrated into the Epic electronic health record, all clinicians at CPCMG, a 28-site single-specialty pediatrics practice in San Diego and Riverside Counties, were invited to participate in the food insecurity initiative, which is approved to 25 points of MOC part 4 credit. All participating clinicians receive quarterly 1-hour training on the food insecurity initiative, community resources, and advocacy opportunities. To improve identification of food insecurity and connecting patients to resources, every patient who screens positive on the Hunger Vital Sign based on patient-answered questionnaire given at well checks, nutrition or behavioral health specific visits, or other times when the Hunger Vital sign is used, receive a text message with a link to CPCMG Food and Nutrition Resources health hub page available in English and Spanish. Each month participating clinicians receive a report of their patients who received the text campaign. To improve connecting patients to resources, patients who screen positive may be referred to CPCMG’s Virtual Teaching Kitchen for coaching and supports for cooking on a healthy budget. Patients who receive the text campaign are sent a follow up survey to assess whether the resources were helpful and utilized.

Results: The project is ongoing with preliminary results as follows: 23 clinicians enrolled in the MOC program and attended food insecurity educational sessions. On average, group-wide 3000 patients had a positive food insecurity screen per month, with 12 of 28 sites having more than 100 positive screens per month; 1400 patients received the text campaign per month with 176 clicks and a click through rate of 12.2%. Virtual teaching kitchen uptake has been slow with 2 participants completed the sessions to date. Response rate to patient follow up surveys was low.

Conclusion/Discussion: Integrating clinician education, EHR tools, a text campaign, and robust web-based resources can help clinicians improve food insecurity screening, connection to resources, and advocacy. More strategies are needed to further assess how and whether patients connect to community resources.