Successes, Challenges, and Considerations for Integrating Referral into Food Insecurity Screening in Pediatric Settings
Successes, Challenges, and Considerations for Integrating Referral into Food Insecurity Screening in Pediatric Settings
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DOI：
10.1353/hpu.2018.0012
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发表时间：
2018-02-01
影响因子：
1.4
通讯作者：
Chilton, Mariana
中科院分区：
文献类型：
--
作者：
Knowles, Molly;Khan, Saba;Chilton, Mariana
粮食不安全，缺乏获得足够食物以积极和健康生活的机会，与儿童健康状况不佳有关。三个儿科诊所对7 284个有5岁以下儿童的家庭进行了两个问题的粮食不安全筛查。1 000多人（1 133人，15.6%）报告粮食不安全，630人（55.6%）被转介到福利获取组织，以获得公共福利和社区资源。本研究通过过程评估、关键知情人访谈和焦点小组对19名护理人员和11名诊所工作人员进行筛查和转诊的有效性进行了评估。使用扎根理论，转录主题编码为筛选和转诊的促进因素和障碍。促进者包括照顾者和工作人员之间的信任，筛选方法的选择，并协助导航福利申请。障碍包括复杂的转诊管理、隐私和耻辱问题，以及护理人员目前的福利登记或不合格。结果表明，综合筛查和转诊同意程序、强有力的沟通和方便的家庭外展非常重要。
Food insecurity, lack of access to enough food for an active and healthy life, is associated with poor child health. Three pediatric clinics implemented a two-question food insecurity screening of 7,284 families with children younger than five years. Over one thousand (1,133, 15.6%) reported food insecurity and 630 (55.6%) were referred to a benefits access organization for connection to public benefits and community resources. This study evaluated the efficacy of screening and referral through process evaluation, key informant interviews, and focus groups with 19 caregivers and 11 clinic staff. Using grounded theory, transcript themes were coded into facilitators and barriers of screening and referral. Facilitators included trust between caregivers and staff, choice of screening methods, and assistance navigating benefits application. Barriers included complex administration of referral, privacy and stigma concerns, and caregivers' current benefit enrollment or ineligibility. Results demonstrate importance of integrated screening and referral consent processes, strong communication, and convenient outreach for families.