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Tuesday March 28, 2023 - 09:10 to 10:10

Room: Hill Country CD

407.1 Implementing food insecurity screening in a pediatric kidney transplant clinic

Mary H. Borst, United States

Nephrology Fellow
Pediatric Nephrology
Emory University / Children's Healthcare of Atlanta

Abstract

Implementing food insecurity screening in a pediatric kidney transplant clinic

Mary Borst1, Rouba Garro1, Roshan George1.

1Pediatric Nephrology, Emory University and Children's Healthcare of Atlanta , Atlanta, GA, United States

Introduction: Food insecurity—the limited or uncertain access to enough food—is a critical child health issue impacting millions of families in the United States and across the world and has significant negative physical and mental health effects on children and their families.1  The American Academy of Pediatrics recommends using a two question Hunger Vital SignTM screening tool, developed and validated by Children’s HealthWatch, to be used in routine medical care as an efficient way to screen for food insecurity.2,3 Children with transplant are often closely followed by their transplant team, giving the transplant team an opportunity to identify patients at risk for food insecurity and connect families with available federal and local resources. We aim to incorporate universal food insecurity screening in our kidney transplant clinic.
Methods: We implemented a pilot project to screen patients in a large, academic pediatric kidney transplant clinic in the US, utilizing the Hunger Vital Sign.TM Input was obtained from multidisciplinary team members (including renal nutritionists, nurses, social workers, and providers) prior to implementation, and team members were educated about the health impacts of food insecurity, the screening process, and available food resources.  Patients were given a written, two question Hunger Vital SignTM survey during the intake process at the start of the visit and completed surveys were collected at the time of triage. Providers were notified of positive results to facilitate further discussion with families. All patients were provided with a food resource handout and information on how to apply for federal food programs and find local food assistance.
Results: Since screening implementation, 97 patients have been approached resulting in 75 completed questionnaires (77%).  A positive screen for food insecurity was identified in 22 patients (29.3%). We plan to continue to screen the entire cohort of pediatric kidney transplant patients at our center, optimize screening process, and implement targeted interventions to address food insecurity.
Conclusion: Our pilot project shows a high prevalence of food insecurity in children with kidney transplant. Screening for food insecurity can be readily implemented using the Hunger Vital SignTM screening tool as part of routine care with the goal to identify and support families experiencing food insecurity. Further work is needed to determine the impact of screening and resource referral on access to food.

References:

[1] Thomas MMC, Miller DP, Morrissey TW. Food Insecurity and Child Health. Pediatrics. 2019;144(4): e20190397
[2] Hager, E. R., Quigg, A. M., Black, M. M., Coleman, S. M., Heeren, T., Rose-Jacobs, R., Cook, J. T., Ettinger de Cuba, S. E., Casey, P. H., Chilton, M., Cutts, D. B., Meyers A. F., Frank, D. A. (2010). Development and Validity of a 2-Item Screen to Identify Families at Risk for Food Insecurity. Pediatrics, 126(1), 26-32. doi:10.1542/peds.2009-3146
[3] COUNCIL ON COMMUNITY PEDIATRICS, COMMITTEE ON NUTRITION, Benjamin A. Gitterman, Lance A. Chilton, William H. Cotton, James H. Duffee, Patricia Flanagan, Virginia A. Keane, Scott D. Krugman, Alice A. Kuo, Julie M. Linton, Carla D. McKelvey, Gonzalo J. Paz-Soldan, Stephen R. Daniels, Steven A. Abrams, Mark R. Corkins, Sarah D. de Ferranti, Neville H. Golden, Sheela N. Magge, Sarah Jane Schwarzenberg; Promoting Food Security for All Children. Pediatrics November 2015; 136 (5): e1431–e1438. 10.1542/peds.2015-3301

Presentations by Mary H. Borst

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