Social Determinants of Health in Maternity Care: A Quality Improvement Project for Food Insecurity Screening and Health Care Provider Referral.
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ABSTRACT:
SUBMITTER: Fitzhugh CD
PROVIDER: S-EPMC8665789 | biostudies-literature | 2021
REPOSITORIES: biostudies-literature
Publications
Social Determinants of Health in Maternity Care: A Quality Improvement Project for Food Insecurity Screening and Health Care Provider Referral.
Fitzhugh Chelsea D CD Pearsall Marina Stranieri MS Tully Kristin P KP Stuebe Alison M AM
Health equity 20210914 1
<b>Purpose:</b> This quality improvement project evaluated implementation of social determinants of health screening and referral for food insecurity. <b>Methods:</b> Four obstetric providers used study-developed resources to screen and refer English-speaking patients (<i>n</i>=14) during clinic visits. Providers and patients completed post-visit questionnaires. Provider feedback informed improvements to the intervention approach for consecutive study shifts. <b>Results:</b> Providers and patien ...[more]
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Project description:IntroductionThe complex humanitarian emergency that Venezuela has been going through for several years has deteriorated the quality of life of its citizens, deepened food insecurity in households and has promoted migratory movements of almost six million people to neighboring countries.ObjectiveTo analyze food security in Venezuelan households to identify the determinant factors that might contribute to the design of evidence-based public policies.Materials and methodsA non-probabilistic survey of national scope was used in 2,041 urban and non-urban households. A descriptive statistical test was performed to analyze demographic variables and the three component indicators of the food security index (FSI): food consumption, economic vulnerability and coping strategies. The FSI was built according to the World Food Program (WFP) methodology, and a segmentation analysis was applied using the Chi-squared Automatic Interaction Detection (CHAID) algorithm to specify the influence of some variables as the best predictor at each level.ResultsOnly 9% of the households presented food security, 69% classified as marginally secure, and 22% presented moderate or severe food insecurity. The food consumption score (FCS) was the variable that best discriminated the level of food security, followed by coping strategies and the percentage of spending on food. Conclusion: Most of the households studied sacrifice their livelihoods to feed themselves and cover the minimum of their nutritional requirements. This needs attention to stop and reverse the deterioration within a framework of respect for the human rights to health and food.
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Project description:ObjectivesTo test the diagnostic accuracy of the American Academy of Pediatrics (AAP) recommended food insecurity screener.MethodsWe conducted prospective diagnostic accuracy studies between July and November 2016 in Chicago, Illinois. We recruited convenience samples of adults from adult and pediatric emergency departments (12-month recall study: n = 188; 30-day recall study: n = 154). A self-administered survey included the 6-item Household Food Security Screen (gold standard), the validated 2-item Hunger Vital Sign (HVS; often, sometimes, never response categories), and the 2-item AAP tool (yes-or-no response categories).ResultsFood insecurity was prevalent (12-month recall group: 46%; 30-day group: 39%). Sensitivity of the AAP tool using 12-month and 30-day recall was, respectively, 76% (95% confidence interval [CI] = 65%, 85%) and 72% (95% CI = 57%, 84%). The HVS sensitivity was significantly higher than the AAP tool (12-month: 94% [95% CI = 86%, 98%; P = .002]; 30-day: 92% [95% CI = 79%, 98%; P = .02]).ConclusionsThe AAP tool missed nearly a quarter of food-insecure adults screened in the hospital; the HVS screening tool was more sensitive. Public health implications. Health care systems adopting food insecurity screening should optimize ease of administration and sensitivity of the screening tool.
| S-EPMC5636681 | biostudies-literature