Screening for food insecurity in primary care

Introduction: Hunger Free VT (HFVT) is a non-profit organization whose mission is to end the injustice of hunger and malnutrition for all Vermonters. HFVT developed an internet-based Continuing Medical Education (CME) course in order to bring awareness to the issue of food insecurity and enhance medical provider training. The CME course entitled Childhood Hunger in Vermont: The Hidden Impacts on Health, Development, and Wellbeing was started by 59 health care providers in VT but only completed by 4. Objective: Our objective was three-fold – 1) to gain an understanding of why registered users did not complete the course, 2) to investigate patient perspectives and experience on the topic of food insecurity and 3) to develop recommendations for HFVT that will increase participation and completion rates of their CME course. Methods: Our objectives were accomplished through the use of online surveys for registered course users, paper questionnaires for parents in pediatric offices, and a focus group for nurses and physicians. Results: Survey participants found the CME course to be valuable, but lengthy. Focus group participants stated that they would prefer for information about food insecurity screening to be delivered in-person. Findings from the survey, questionnaire, and focus group suggest that few patients are being asked about food insecurity by their healthcare providers. Conclusions: Providers cite length of appointments and sensitivity of the topic as the biggest barriers to screening. Incorporating questions about food insecurity into office intake forms in primary care settings would identify patients who would benefit from available community resources.