Food Insecurity Screening in Pediatric Clinical Settings: A Caregivers' Perspective
Food Insecurity Screening in Pediatric Clinical Settings: A Caregivers' Perspective
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DOI：
10.1007/s10995-019-02785-6
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发表时间：
2020-01-01
影响因子：
2.3
通讯作者：
Arthur, Joshua
中科院分区：
文献类型：
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作者：
Barnidge, Ellen;Krupsky, Kathryn;Arthur, Joshua
粮食不安全（FI）对儿童的学业、社会和身体健康造成严重后果。最近的一项临床建议建议在儿童健康检查时进行FI筛查。虽然FI筛查研究考虑了临床医生的反馈，但对护理人员向卫生保健提供者披露FI的经验知之甚少。我们的论文探讨照顾者的障碍和促进FI披露。方法在密苏里州圣路易斯市的一所儿科诊所候诊室完成影响FI披露的因素调查。在有FI的家庭中，15名护理人员参加了定性访谈。护理人员被问及与卫生保健提供者讨论FI的经历。我们计算了调查回复的频率，并使用主题内容分析分析了访谈数据。结果护理人员强调了耻辱感、对孩子被带走的恐惧和羞耻感是FI披露的障碍。照顾者认为，较强的人际交往能力、开放的肢体语言和同理心有助于在人际层面上披露信息。提供者发起的对话，在儿童在场时考虑FI披露，以及诊所内FI讨论的正常化被描述为鼓励在组织层面披露FI的方法。作为对FI披露的回应，护理人员希望提供者提供资源，包括转介到基于社区的资源，而不仅仅是食物。我们的研究从护理者的角度确定了医疗机构中FI筛查的考虑因素，涵盖了社会生态模型。为了成功筛查和解决FI问题，多方面的卫生保健干预措施应在考虑到多种社会需求的情况下，在多个层面上解决障碍并促进促进因素。
Objectives Food insecurity (FI) has serious academic, social, and physical health consequences for children. A recent clinical recommendation suggests FI screening during child well visits. While FI screening research has considered clinician feedback, little is known about caregivers' experience of disclosing FI to health care providers. Our paper explores caregivers' barriers and facilitators to FI disclosure. Methods A survey on factors influencing FI disclosure was completed in a pediatric clinic waiting room in St. Louis, MO. Among households with FI, 15 caregivers participated in a qualitative interview. Caregivers were asked about experiences discussing FI with health care providers. We calculated frequencies for survey responses and analyzed interview data using thematic content analysis. Results Caregivers highlighted stigma, fear of child being taken away, and shame as barriers to FI disclosure. Caregivers identified strong interpersonal skills, open body language, and empathy as facilitators to disclosure at the interpersonal level. Provider initiated conversations, consideration of FI disclosure in the presence of a child, and normalization of FI discussions within the clinic were described as ways to encourage FI disclosure at the organizational level. In response to FI disclosure, caregivers would like providers to offer resources including referrals to community-based resources extending beyond food. Conclusions for Practice Our study identifies considerations for FI screening in health care settings, spanning the social-ecological model, from the perspective of caregivers. To successfully screen and address FI, multifaceted health care interventions should address barriers and promote facilitators across multiple levels and in consideration of multiple social needs.