300 - Home Plate: Screening for Food Insecurity in a Pediatric Gastroenterology Clinic

Publication Number: 3289.300

Chavonne Kouassi, Golisano Children's Hospital at The University of Rochester Medical Center, Rochester, NY, United States; Caroline A. Mosca, University of Rochester School of Medicine and Dentistry, Penfield, NY, United States; Heather Fleming, Golisano Children's Hospital at The University of Rochester Medical Center, Rochester, NY, United States; Susan Crounse, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States; Jan Schriefer, Golisano Children's Hospital at The University of Rochester Medical Center, Rochester, NY, United States

Background: Adequate nutrition and healthy growth established in the first 1,000 days of a child's life have benefits that will last a lifetime. Food Insecurity (FI) characterized by a household-level economic and social condition of limited or uncertain access to adequate food remains a significant barrier to achieving this goal. Our local population mirrors patterns of FI that exist on a national level including the racial and economic disparities that exist relating to food insecurity. The American Academy of Pediatrics has acknowledged the importance of routine screening, emphasizing normalizing the process and approaching screening in a sensitive and culturally effective manner.

Objective: This quality improvement (QI) initiative aims to increase screening for food insecurity in Pediatric Gastroenterology clinic patients from less than 5% to 85% by February 2026 with an interim goal of 60% by November 2025. The project used the Plan-Do-Study-Act framework with sequential cycles designed to enhance feasibility, workflow integration, and connection of families to appropriate resources.

Design/Methods: A fishbone (Figure 1) and key-driver diagram were developed to systematically identify the barriers to screening for food insecurity for patients and providers. Barriers were categorized into four key areas: procedures, processes, environment and policies. We also created a baseball-themed family-friendly campaign to help promote the initiative and strengthen patient education (Figure 2). Screening was conducted using the validated two-question survey. Based on responses families were provided with information on community resources.

Results: Outcome measures included the proportion of patients who screened positive and negative for food insecurity. Currently, 61% of patients were successfully screened. The median number of patients screened each month was analyzed using a run chart (Figure 3) which allowed for evaluation of screening performance demonstrating month-to-month fluctuations and meaningful changes that may reflect the impact of interventions.

Conclusion(s): The prevalence of food insecurity indicates the need for a greater implementation of screening and connection to resources in our Pediatric Gastroenterology Clinic. In addition to connecting individuals to federal food assistance programs, this QI study has increased the efficiency of connecting individuals to local programs. The multi-layered interventions developed in this project to enhance food insecurity screening provide a framework that can be evaluated, refined, and replicated across other pediatric subspecialty clinics

Increasing Screening for Food Insecurity in Pediatric GI Clinic
Figure 1. Fishbone Diagram

Home P.L.A.T.E. Effort
Figure 2. Baseball-themed, family-friendly campaign to help promote the initiative and strengthen patient education.

Pediatric Gastroenterology Patients Screened for Food Insecurity
Figure 3. Run chart of Pediatric Gastroenterology Food Insecurity Screening