ORIGINAL RESEARCH
Stephanie K. Bunt, PhD; Matthew Traxler, MD; Bridget Zimmerman, PhD; Marcy Rosenbaum, PhD; Sally Heaberlin, MD; Peter F. Cronholm, MD, MSCE; Eliza W. Kinsey, PhD; Kelly Skelly, MD
Corresponding Author: Stephanie K. Bunt, PhD; Department of Family Medicine, University of Iowa
Email: stephanie-bunt@uiowa.edu
DOI: 10.3122/jabfm.2023.230319R1
Keywords: Family Medicine, Food Insecurity, Health Communication, Nutrition Assessment, Screening, Social Determinants of Health, Surveys and Questionnaires
Dates: Submitted: 08-25-2023; Revised: 11-03-2023; Accepted: 11-13-2023
FINAL PUBLICATION: |HTML| |PDF|
PURPOSE: Food insecurity is a hidden epidemic associated with worsening health outcomes affecting 33.8 million people in the U.S. in 2021. Although studies demonstrate the importance of health care clinician assessment of a patient’s food insecurity, little is known about whether Family Medicine clinicians FMC discuss FI with patients and what barriers influence their ability to communicate about FI. This study evaluated FM clinicians’ food insecurity screening practices to evaluate screening disparities and identify barriers that influence the decision to communicate about FI.
METHODS: Data were gathered and analyzed as part of the 2022 Council of Academic Family Medicine’s Educational Research Alliance survey of Family Medicine general membership.
RESULTS: The majority of respondents reported (66.9%) that their practice has a screening system for food insecurity, and most practices used a verbal screen with staff other than the clinician (41%) at specific visits (63.8%). Clinicians reported “rarely or never asking about FI” 40% of the time and only asking “always or frequently” 6.7% of the time. Inadequate time during appointments (44.5%) and other medical issues taking priority (29.4%) were identified as the most common barriers. The lack of resources available in the community was a significant barrier for clinicians who worked in rural areas.
CONCLUSIONS: This survey provides insight into food insecurity screening disparities and identifies obstacles to FMC screening, such as time constraints, lack of resources, and knowledge of available resources. Understanding current communication practices could create opportunities for interventions to identify food insecurity and impact “Food as Medicine.”