Food Insecurity Screening

What is it?

Conducting screening for food insecurity is one way your SBHC can identify students and families that may additional nutrition support. Food insecurity screening can be conducted on its own, or as part of more comprehensive social determinants of health screening.
Universal screening has become more common place in healthcare settings. This is due in part to a growing number of practitioners who believe that addressing food insecurity is critical to their role as a health provider. A recent survey of pediatricians found that 74% were routinely screening patients for food insecurity (more information here).
There are a variety of ways and available tools to implement food insecurity screening (see resources below). This can be a low-cost option to integrate into your center workflow, but it requires staff capacity and training to ensure screening is conducted in a sensitive manner.
Food insecurity screening should never be completed for sake of screening, but should include connecting to referrals and offering appropriate resources as needed. Engaging community or school partners can be critical to ensuring families get connected and enrolled in programs.
Overview of AAP/FRAC Screen and Intervene Toolkit’ by Dr. Kofi Essel

How does it work?

Integrate a food insecurity screening tool into standard screening questionnaires for students and their families, and these can be added to registration packets or completed at routine well-child visits. Consider keeping surveys on paper and content concise, being sure to compensate for: the reading level, language needs, and accessibility needs of the target population.
While many screening tools are used in adult populations, the Hunger Vital Sign has been validated for use with youth.
Some EHR systems already have food insecurity screening questions integrated into the system. This allows for ease of integration into workflows in the center.
More global SDoH screeners may also include questions about food security. A common screening tool used by SBHCs is Rapid Assessment for Adolescent Preventive Services (RAAPS).
The Screen and Intervene toolkit and Food Insecurity Screening Algorithm for Pediatric Patients are comprehensive resources with examples for integrating screening into health center work flows.
Examples from the network:

At Open Door SBHC located in Port Chester Middle School, a template was created in the electronic health record system with the food insecurity screening questions so that they can be added to medical visit documentation. The medical provider and patient care technician were trained to use the template, and began including the screening questions in patient care and making referrals as appropriate.

At MetroHealth System in Cleveland, Ohio, social determinants of health screening is integrated in well child visits. At the school-based health centers that the system operates, this screening is implemented through calling ahead to parents and caregivers, who may not be present during a visit at the center. The health system also utilizes a community resource referral platform (UniteUs) to refer families to resources.