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{ "pk": 19435, "title": "Food and Housing Insecurity, Resource Allocation, and Follow-up in a Pediatric Emergency Department", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> Food and housing insecurity in childhood is troublingly widespread. Emergency departments (ED) are well positioned to identify and support food- and housing-insecure children and their families. However, there is no consensus regarding the most efficient screening tools or most effective interventions for ED use.</p>\n<p><strong>Objective:</strong> In this cross-sectional study we aimed to investigate the implementation of a food/ housing insecurity screening tool and resource referral uptake in a pediatric ED.</p>\n<p><strong>Methods: </strong>During the study period (March 1–December 9, 2021), there were 67,297 ED visits at the study institution, which is a freestanding children’s hospital. Caregivers of patients presenting to the ED were approached for participation in the study; 1,908 families participated (2.8% of all ED visits during the study period) and were screened for food and housing insecurity. Caregiver surveys included demographic, food and housing insecurity, caregiver/patient health status, and healthcare utilization questions. Caregivers who screened positive for food and/or housing insecurity received printed materials with food and/or housing resources. We analyzed data using descriptive statistics, one-way analysis of variance, and the Pearson chi-squared test.</p>\n<p><strong>Results:</strong> A total of 1,908 caregivers were surveyed: 416 (21.8%) screened positive for food and/or housing insecurity. Of those who screened positive, 147/416 completed follow-up surveys. On follow-up, 44 (30.0%) no longer screened positive for food and/or housing insecurity, while 15 (10.2%) reported using at least one resource referral. The most frequently reported referral utilization barrier was loss or reported non-receipt of the referral.</p>\n<p><strong>Conclusion: </strong>This study demonstrates high food- and housing-insecurity rates among families presenting to a pediatric ED, emphasizing the urgency and necessity of screening and intervening in this environment. The food and housing insecurity change between baseline and follow-up reported here and the overall low resource uptake highlights challenges with ED-based screening and intervention efficacy.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "Food Insecurity" }, { "word": "housing instability" }, { "word": "pediatric ED" }, { "word": "social determinants of health" }, { "word": "adverse childhood experiences" } ], "section": "Health Equity", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/6x97n508", "frozenauthors": [ { "first_name": "Raymen", "middle_name": "R.", "last_name": "Assaf", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Orange, California; University of California Irvine, School of Medicine, Department of Pediatrics, Irvine, California", "department": "Emergency Medicine" }, { "first_name": "Chloe", "middle_name": "", "last_name": "Knudsen-Robbins", "name_suffix": "", "institution": "University of Cincinnati College of Medicine, Department of Emergency Medicine, Cincinnati, Ohio", "department": "" }, { "first_name": "Theodore", "middle_name": "", "last_name": "Heyming", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Orange, California; University of California at Irvine, Department of Emergency Medicine, Orange, California", "department": "Emergency Medicine" }, { "first_name": "Kellie", "middle_name": "", "last_name": "Bacon", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Orange, California", "department": "Emergency Medicine" }, { "first_name": "Shelby", "middle_name": "K.", "last_name": "Shelton", "name_suffix": "", "institution": "Children’s Hospital of Orange County, Orange, California", "department": "" }, { "first_name": "Bharath", "middle_name": "", "last_name": "Chakravarthy", "name_suffix": "", "institution": "University of California at Irvine, Department of Emergency Medicine, Orange, California", "department": "Emergency Medicine" }, { "first_name": "Soheil", "middle_name": "", "last_name": "Saadat", "name_suffix": "", "institution": "University of California at Irvine, Department of Emergency Medicine, Orange, California", "department": "" }, { "first_name": "Jason", "middle_name": "A.", "last_name": "Douglas", "name_suffix": "", "institution": "University of California Irvine, Department of Health, Society, & Behavior, Irvine, California", "department": "" }, { "first_name": "Victor", "middle_name": "", "last_name": "Cisneros", "name_suffix": "", "institution": "University of California at Irvine, Department of Emergency Medicine, Orange, California; Eisenhower Health, Department of Emergency Medicine, Rancho Mirage, California", "department": "" } ], "date_submitted": "2024-02-12T23:41:32.626000Z", "date_accepted": "2024-10-19T15:55:02.414000Z", "date_published": "2025-01-15T14:00:00Z", "render_galley": { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/19435/galley/31273/download/" }, "galleys": [ { "label": "Layout", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/19435/galley/31060/download/" }, { "label": "Final Article", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/19435/galley/31273/download/" } ] }