P3B145: Does Providing Community Resource Lists to Families Experiencing Food Insecurity Reduce Food Insecurity?

Background: The American Academy of Pediatrics recommends routine screening for Social Determinants of Health (SDOH) including food insecurity (FI), as roughly 15% of children in the US experience FI. FI can lead to poor mental and physical health outcomes. Pediatric primary care offices serve as ideal touchpoints to screen for FI and offer intervention. Mechanisms to address FI may include distribution of community resource lists, however the effect of resource lists on reducing FI has not been fully evaluated.

Methods: We conducted a prospective cohort study to assess the effectiveness of providing a resource list on FI at a single, large, diverse, academic, pediatric primary care facility. FI questions included the USDA Household 6-item Food Security Screen (FSS) and were administered at annual well visits. We defined a screen as positive if families being screened answered at least 1 question ‘yes’ and determined a raw score, 1-6, with 0-1 indicating high food security, 2-4 indicating low food security, and 5-6, very low food security level. Each family was provided a list of community resources. At the 1-month time point, the FSS was re-administered. Demographic information was also collected. The study was approved by the Institution’s IRB.

Results: 261 families completed the FSS from December 2022-March 2023. Participants identified as Black (n=94; 36.0%), White (n=32; 12.3%), Asian (n=62; 23.8%), and Other (n=49; 18.8%). 19.9% (n=52) identified as Hispanic or Latino. English was the most common language spoken at home (n= 220; 84.3%), followed by Spanish (n=9; 3.4%). The average age of child for which the screen was administered was 3.7 years (SD=5.1, range 0-22.5, median =1.3). 37 families screened positive for food insecurity at baseline, representing a 14.2% positivity rate. Of those who screened positive, the mean food security status (FSS) across the population was 3.1 (SD=1.4, range 1-5, median=3), indicating low food security. One month follow up was completed by 64.9% of participants (n=24), at which point 62.5% (n=15) screened positive for food insecurity. The mean FSS at one month was 2.5 (SD=2.1, median=3, range 0-5), representing a decrease in FSS and therefore an increase of food security level, although it was not a significant increase. However, among families who completed the follow-up, 11 (45.8%) moved from very low or low food security level at baseline to low or high/marginal food security level.

Conclusion: Rates of families experiencing food insecurity at this pediatric facility were reflective of national rates. Administration of a resource list to families who screened positive for food insecurity was not associated with a change in food security status. Clinically, there was full or partial resolution of food insecurity in roughly half of families who completed follow up.