Food insecurity in a pandemic from a pediatric cystic fibrosis care center

Introduction: A potential barrier that many people in the cystic fibrosis (CF) community face is the lack of reliable access to affordable, nutritious food Food insecurity is associated with anxiety, depression, stress, low medication adherence and poor disease management People with CF are vulnerable to food insecurity due to the cost of care as well as the need for increased caloric intake One study suggests that the overall rate of food insecurity in the pediatric CF community is as high as 26 3 percent (McDonald CM, et al ICAN 2009) Overall health outcomes improve when families and patients have access to and an adequate supply of nutritious food Prior to the COVID-19 pandemic, Children's Mercy-Kansas City CF Center (CMKC) discussed the need to assess for food insecurity but had not established a standard approach When the pandemic began, the CMKC Team escalated efforts due to concerns for patient and family financial well-being, realizing that the pandemic could result in job loss and school closures with decreased availability of school lunches The Team initiated a standardized process to assess all patients with upcoming clinic appointments and all patients who were considered high risk, which was defined as a BMI <25 percentile or weight-for-length <25 percentile Methods: The Hunger Vital Sign (HVS) is a validated, 2-question tool used to identify households at risk for food insecurity An affirmative answer to either question suggest that food assistance may be necessary Beginning April 20, 2020, the CF clinic social worker (SW) or dietitian (RD) sent the HVS tool in a private message to the family through the electronic medical record using the Cerner Patient Portal If the family was not enrolled in Cerner Patient Portal, a phone call was placed to the family All results of HVS were recorded in a secure electronic database Results: Since April 2020, the HVS has been used to assess 109 families There have been a total of 67 responses, with two positive The families were provided with food resources Additional discussion with known at-risk families suggested that food resources were needed in six households Resources provided to families consisted of Walmart gift cards, Healthwell COVID-19 ancillary fund and food pantry lists Conclusions: The CMKC Team developed a standardized approach to utilizing HVS during the COVID-19 pandemic This ensured that the Team was consistently assessing for food insecurity during the pandemic Despite only having one positive screen to date, this tool has allowed our families to feel comfortable having dialogue regarding financial concerns and food insecurities Families not experiencing financial concerns or food insecurities have provided positive feedback about knowing our Team is “asking tough questions and helping those that need food ” The CMKC Team will continue to use this tool and incorporate it into social work and dietitian annual assessments