RT Journal Article
SR Electronic
T1 Food Insecurity Screening in Safety-Net Clinics in Los Angeles County: Lessons for Post-Pandemic Planning
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP jabfm.2022.220175R2
DO 10.3122/jabfm.2022.220175R2
A1 Julia I. Caldwell
A1 Alina Palimaru
A1 Deborah A. Cohen
A1 Dipa Shah
A1 Tony Kuo
YR 2023
UL http://www.jabfm.org/content/early/2023/03/03/jabfm.2022.220175R2.abstract
AB Introduction: Food insecurity is a major public health problem in the United States which was exacerbated by the COVID-19 pandemic. We used a multi-method approach to understand barriers and facilitators to implementing food insecurity screening and referrals at safety net health care clinics in Los Angeles County before the pandemic.Methods: In 2018, we surveyed 1013 adult patients across eleven safety-net clinic waiting rooms in Los Angeles County. Descriptive statistics were generated to characterize food insecurity status, attitudes toward receiving food assistance, and use of public assistance programs. Twelve interviews with clinic staff explored effective and sustainable approaches to food insecurity screening and referral.Results: Patients welcomed the opportunity to access food assistance in the clinic setting; 45% preferred discussing food issues directly with the doctor. Missed opportunities to screen for food insecurity and refer patients to food assistance were identified at the clinic level. Barriers to these opportunities included: competing demands on staff and clinic resources, difficulty establishing referral pathways, and doubts surrounding data.Discussion: Integrating food insecurity assessment in clinical settings requires infrastructure support, staff training, clinic buy-in, and more coordination and oversight from local government, health center entities, and public health agencies.