Food Insecurity Screening and Interventions: From Hospital to Home

BACKGROUND Household food insecurity (FI) and caregiver inpatient FI (ie, limited or uncertain access to adequate food during hospitalization) negatively affect children. We aimed to describe outcomes of a hospital-based intervention bundle for household/inpatient FI. METHODS A single-arm prospective clinical trial conducted at a large children’s hospital from March 2021 to March 2022 screened English- and Spanish-speaking caregivers. Caregivers with household and/or inpatient FI received the intervention bundle (complimentary hospital meals, active referral to a community-based organization [CBO] for assistance applying for public benefits and accessing food pantries). Two-week postdischarge follow-up calls were completed with caregivers enrolled in the intervention bundle, and the CBO provided 12-month post-referral outcomes. Statistical analysis described the intervention bundle feasibility (% participants who received interventions), acceptability (participant-rated comfort, helpfulness, and satisfaction), and referral outcomes. RESULTS Of 1000 enrolled caregivers (English-speaking, 75%, Spanish-speaking, 25%), 54% screened positive for household and/or inpatient FI (48% household FI and 46% inpatient FI). 70% of caregivers completed the 2-week follow-up, with median scores of 10/10 comfort with FI screening, 9/10 satisfaction with complimentary trays, and 10/10 satisfaction with CBO. Twelve-month follow-up data demonstrated that the CBO had successfully connected with 62% of referred caregivers. A total of 51% of those who connected applied for Supplemental Nutrition Assistance Program (SNAP), and 86% of those who applied received SNAP benefits within 3 months. CONCLUSIONS FI was highly prevalent in caregivers of hospitalized children. Hospital-based interventions with a CBO successfully reached caregivers and was rated favorably. This work can inform intervention efforts as hospital FI screening programs grow.