Emergency Department Food Insecurity Screening, Food Voucher Distribution and Utilization: A Prospective Cohort Study
Objective: Food insecurity is a prevalent social risk among emergency department (ED) patients. Patients who may benefit from food insecurity resources may be identified via ED-based screening; however, many patients experience difficulty accessing resources after discharge. Co-locating resources in...
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| Language: | English |
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eScholarship Publishing, University of California
2024-09-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/4ns2m3qx |
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| author | Alexander J. Ulintz Seema S. Patel Katherine Anderson Kevin Walters Tyler J. Stepsis Michael S. Lyons Peter S. Pang |
| author_facet | Alexander J. Ulintz Seema S. Patel Katherine Anderson Kevin Walters Tyler J. Stepsis Michael S. Lyons Peter S. Pang |
| author_sort | Alexander J. Ulintz |
| collection | DOAJ |
| description | Objective: Food insecurity is a prevalent social risk among emergency department (ED) patients. Patients who may benefit from food insecurity resources may be identified via ED-based screening; however, many patients experience difficulty accessing resources after discharge. Co-locating resources in or near the ED may improve utilization by patients, but this approach remains largely unstudied. This study characterized the acceptance and use of a food voucher redeemable at a hospital food market for patients who screened positive for food insecurity during their ED visit. Methods: This prospective cohort study, conducted at a single county-funded ED, included consecutive adult patients who presented on weekdays between 8 AM–8 PM from July–October 2022 and consented to research participation. We excluded patients who required resuscitation on arrival or could not provide written informed consent in English. Study participants completed a paper version of the two-question Hunger Vital Sign screening tool, administered by research staff. Participants who screened positive received a uniquely numbered $30 food voucher redeemable at the hospital’s co-located food market. Voucher redemption was quantified through regular evaluation of market receipt records at 30-day intervals. The primary outcome was the proportion of redeemed vouchers. Secondary outcomes included the proportion of participants screening positive for food insecurity, proportion of participants accepting vouchers, and associated descriptive statistics. Results: Of the 396 eligible individuals approached, 377 (95.2%) consented and completed food insecurity screening. Most were middle-aged (median 53 years, interquartile range 30–58 years), 191 were female (50.4%), 242 were Black (63.9%), and 343 were non-Hispanic (91.0%). Of the participants, 228 (60.2%) screened positive for food insecurity and 224 received vouchers (98.2%), of which 86 were redeemed (38.4%) a median of nine days after the ED visit. Conclusion: A high proportion of participants screened positive for food insecurity and accepted food vouchers; however, less than half of all vouchers were redeemed at the co-located food market. These results imply ED food voucher distribution for food insecurity is feasible, but co-location of resources alone may be insufficient in addressing the social risk and alludes to a limited understanding of facilitators and barriers to resource utilization following ED-based social needs screening. |
| format | Article |
| id | doaj-art-475062b791a0484baa13f2d5dbe67d9b |
| institution | OA Journals |
| issn | 1936-900X 1936-9018 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj-art-475062b791a0484baa13f2d5dbe67d9b2025-08-20T02:38:52ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182024-09-0125699399910.5811/westjem.1851318513Emergency Department Food Insecurity Screening, Food Voucher Distribution and Utilization: A Prospective Cohort StudyAlexander J. Ulintz0Seema S. Patel1Katherine Anderson2Kevin Walters3Tyler J. Stepsis4Michael S. Lyons5Peter S. Pang6The Ohio State University College of Medicine, Department of Emergency Medicine, Columbus, OhioIndiana University School of Medicine, Department of Emergency Medicine, Indianapolis, IndianaIndiana University School of Medicine, Department of Emergency Medicine, Indianapolis, IndianaIndiana University School of Medicine, Department of Emergency Medicine, Indianapolis, IndianaIndiana University School of Medicine, Department of Emergency Medicine, Indianapolis, IndianaThe Ohio State University College of Medicine, Department of Emergency Medicine, Columbus, OhioIndiana University School of Medicine, Department of Emergency Medicine, Indianapolis, IndianaObjective: Food insecurity is a prevalent social risk among emergency department (ED) patients. Patients who may benefit from food insecurity resources may be identified via ED-based screening; however, many patients experience difficulty accessing resources after discharge. Co-locating resources in or near the ED may improve utilization by patients, but this approach remains largely unstudied. This study characterized the acceptance and use of a food voucher redeemable at a hospital food market for patients who screened positive for food insecurity during their ED visit. Methods: This prospective cohort study, conducted at a single county-funded ED, included consecutive adult patients who presented on weekdays between 8 AM–8 PM from July–October 2022 and consented to research participation. We excluded patients who required resuscitation on arrival or could not provide written informed consent in English. Study participants completed a paper version of the two-question Hunger Vital Sign screening tool, administered by research staff. Participants who screened positive received a uniquely numbered $30 food voucher redeemable at the hospital’s co-located food market. Voucher redemption was quantified through regular evaluation of market receipt records at 30-day intervals. The primary outcome was the proportion of redeemed vouchers. Secondary outcomes included the proportion of participants screening positive for food insecurity, proportion of participants accepting vouchers, and associated descriptive statistics. Results: Of the 396 eligible individuals approached, 377 (95.2%) consented and completed food insecurity screening. Most were middle-aged (median 53 years, interquartile range 30–58 years), 191 were female (50.4%), 242 were Black (63.9%), and 343 were non-Hispanic (91.0%). Of the participants, 228 (60.2%) screened positive for food insecurity and 224 received vouchers (98.2%), of which 86 were redeemed (38.4%) a median of nine days after the ED visit. Conclusion: A high proportion of participants screened positive for food insecurity and accepted food vouchers; however, less than half of all vouchers were redeemed at the co-located food market. These results imply ED food voucher distribution for food insecurity is feasible, but co-location of resources alone may be insufficient in addressing the social risk and alludes to a limited understanding of facilitators and barriers to resource utilization following ED-based social needs screening.https://escholarship.org/uc/item/4ns2m3qx |
| spellingShingle | Alexander J. Ulintz Seema S. Patel Katherine Anderson Kevin Walters Tyler J. Stepsis Michael S. Lyons Peter S. Pang Emergency Department Food Insecurity Screening, Food Voucher Distribution and Utilization: A Prospective Cohort Study Western Journal of Emergency Medicine |
| title | Emergency Department Food Insecurity Screening, Food Voucher Distribution and Utilization: A Prospective Cohort Study |
| title_full | Emergency Department Food Insecurity Screening, Food Voucher Distribution and Utilization: A Prospective Cohort Study |
| title_fullStr | Emergency Department Food Insecurity Screening, Food Voucher Distribution and Utilization: A Prospective Cohort Study |
| title_full_unstemmed | Emergency Department Food Insecurity Screening, Food Voucher Distribution and Utilization: A Prospective Cohort Study |
| title_short | Emergency Department Food Insecurity Screening, Food Voucher Distribution and Utilization: A Prospective Cohort Study |
| title_sort | emergency department food insecurity screening food voucher distribution and utilization a prospective cohort study |
| url | https://escholarship.org/uc/item/4ns2m3qx |
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