Food and Housing Insecurity, Resource Allocation, and Follow-up in a Pediatric Emergency Department

Introduction: 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 effecti...

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Main Authors: Raymen R. Assaf, Chloe Knudsen-Robbins, Theodore Heyming, Kellie Bacon, Shelby K. Shelton, Bharath Chakravarthy, Soheil Saadat, Jason A. Douglas, Victor Cisneros
Format: Article
Language:English
Published: eScholarship Publishing, University of California 2025-01-01
Series:Western Journal of Emergency Medicine
Online Access:https://escholarship.org/uc/item/6x97n508
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author Raymen R. Assaf
Chloe Knudsen-Robbins
Theodore Heyming
Kellie Bacon
Shelby K. Shelton
Bharath Chakravarthy
Soheil Saadat
Jason A. Douglas
Victor Cisneros
author_facet Raymen R. Assaf
Chloe Knudsen-Robbins
Theodore Heyming
Kellie Bacon
Shelby K. Shelton
Bharath Chakravarthy
Soheil Saadat
Jason A. Douglas
Victor Cisneros
author_sort Raymen R. Assaf
collection DOAJ
description Introduction: 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. Objective: 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. Methods: 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. Results: 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. Conclusion: 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.
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spelling doaj-art-c6c836100d494a58bdeef1c48252885e2025-08-20T02:54:07ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182025-01-0126232633710.5811/westjem.1943519435Food and Housing Insecurity, Resource Allocation, and Follow-up in a Pediatric Emergency DepartmentRaymen R. Assaf0Chloe Knudsen-Robbins1Theodore Heyming2Kellie Bacon3Shelby K. Shelton4Bharath Chakravarthy5Soheil Saadat6Jason A. Douglas7Victor Cisneros8Children’s Hospital of Orange County, Orange, CaliforniaUniversity of Cincinnati College of Medicine, Department of Emergency Medicine, Cincinnati, OhioChildren’s Hospital of Orange County, Orange, CaliforniaChildren’s Hospital of Orange County, Orange, CaliforniaChildren’s Hospital of Orange County, Orange, CaliforniaUniversity of California at Irvine, Department of Emergency Medicine, Orange, CaliforniaUniversity of California at Irvine, Department of Emergency Medicine, Orange, CaliforniaUniversity of California Irvine, Department of Health, Society, & Behavior, Irvine, CaliforniaUniversity of California at Irvine, Department of Emergency Medicine, Orange, CaliforniaIntroduction: 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. Objective: 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. Methods: 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. Results: 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. Conclusion: 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.https://escholarship.org/uc/item/6x97n508
spellingShingle Raymen R. Assaf
Chloe Knudsen-Robbins
Theodore Heyming
Kellie Bacon
Shelby K. Shelton
Bharath Chakravarthy
Soheil Saadat
Jason A. Douglas
Victor Cisneros
Food and Housing Insecurity, Resource Allocation, and Follow-up in a Pediatric Emergency Department
Western Journal of Emergency Medicine
title Food and Housing Insecurity, Resource Allocation, and Follow-up in a Pediatric Emergency Department
title_full Food and Housing Insecurity, Resource Allocation, and Follow-up in a Pediatric Emergency Department
title_fullStr Food and Housing Insecurity, Resource Allocation, and Follow-up in a Pediatric Emergency Department
title_full_unstemmed Food and Housing Insecurity, Resource Allocation, and Follow-up in a Pediatric Emergency Department
title_short Food and Housing Insecurity, Resource Allocation, and Follow-up in a Pediatric Emergency Department
title_sort food and housing insecurity resource allocation and follow up in a pediatric emergency department
url https://escholarship.org/uc/item/6x97n508
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