Identifying and Addressing Childhood Food Insecurity in Healthcare and Community Settings

This salient resource offers clinicians a comprehensive multi-tiered framework for identifying, addressing, and reducing food insecurity among children and their families. Reinforcing the importance of food insecurity as a key social determinant of health, this monograph reviews the epidemiology and presents in-depth guidelines for screening for food insecurity and hunger. Recommendations for screening in a busy clinical setting as well as the strengths and limitations of widely-used instruments are discussed. The monograph also outlines a variety of clinic-level interventions, potential community-based resources, and opportunities for clinical-community partnerships to improve families' food access and security. Further, contributors provide workable plans for large-scale advocacy through greater engagement with professional and community resources as well as policymakers. The monograph concludes with an outline of the critical steps to implement a food insecurity screening process and the key components to train the next generation of provider-advocates.

Included in the coverage:

• Epidemiology and pathophysiology of food insecurity
• Screening tools and training
• Scope of interventions to address food insecurity
• Creation and evaluation of the impact of food insecurity-focused clinical-community partnerships on patients and populations
• Development of an action plan to fight food insecurity

Identifying and Addressing Childhood Food Insecurity in Healthcare and Community Settings will find an engaged audience among physicians and other clinicians who want to address food insecurity in their healthcare and/or community setting. Institutions that are starting to address social determinants of health, including food insecurity, will find guidance on screening tools, processes and evaluation of impact.

Auteur
Hans B. Kersten, MD, is professor of Pediatrics at Drexel University College of Medicine and medical director of the Grow Clinic at St. Christopher's Hospital for Children in Philadelphia, PA, USA.
Andrew Beck, MD, MPH, is assistant professor of Clinical Pediatrics-Affiliated in the Department of Pediatrics and attending pediatrician in the Divisions of General & Community Pediatrics and Hospital Medicine at University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center in Ohio, USA.
Melissa Klein, MD, MEd, is associate professor of Clinical Pediatrics in the Division of General and Community Pediatrics and co-director of the Masters of Education (MEd) program at University of Cincinnati in Ohio, USA. Dr. Klein also is director of Education Section and director of General Pediatric Master Educator Fellowship at Cincinnati Children's Hospital Medical Center.

Contenu

Chapter 1. Epidemiology and pathophysiology of food insecurity

This chapter will define key terms of relevance to FI. For example, particular focus will be paid to terms that include food security, FI, and hunger. The chapter will then extend to describe the prevalence of FI over the last 5 years and the various sociodemographic and clinical factors associated with FI. Finally, the chapter will review the deleterious effects that FI can have on children and their families with respect to short- and long-term health outcomes. 1. Definitions

a. Hunger

b. Food insecurity

2. Epidemiology

a. National versus local b. Risk factors for higher prevalence

c. Risk factors for FI

3. Pathology

a. Health effects from birth to adulthood

i. Life course and population health outcomes

Chapter 2. Training providers to screen and provide resources to address food insecurity A starting point in action focused on FI relates to identifying the problem as being a relevant piece of clinical care. Indeed, providers must recognize the importance of addressing FI in order to properly address it. This chapter will focus on ways in which FI can be identified, specifically via screening techniques in the clinical setting. The chapter will also explore educational initiatives that have focused on increasing screening rates as well as identification rates. Principles of adult learning theory will be used to discuss different methods to train providers.

1. Screening methods for FI a. Evidence-based screeners

i. 1 versus 2 versus 6 item screen

b. Types of screeners &nbs...