Our Experience Establishing Food Insecurity Screening in the Pediatric Endocrinology Clinic During the Beginning of the COVID-19 Pandemic

Objectives In 2019, food insecurity was estimated to affect approximately one fifth of the Pittsburgh population. Food insecurity may be linked to other barriers affecting the care of children with chronic health conditions including endocrinopathies. We established a systematic, sustainable method of screening to determine the prevalence of food insecurity in our practice. Methods For 12 months, beginning in May 2020, a written version of the validated questionnaire, The Hunger Vital SignTM (Hager et al), was administered during the patient triage process. The results were documented in the EMR. Patients and families with positive screens met with a social worker and received information about local resources. Screening rates and the frequency of positive screens for food insecurity were reviewed weekly. Results The screening rate was 26% in the first month after implementation;screening increased to 80% by the third month of the project, as the clinic visits transitioned from telemedicine to face-toface (Figure 1). The prevalence of food insecurity in our patient population in this year was 3.5%, which was lower than the reported prevalence in the city of 19.4% in 2018 (Feeding America, 2018) and the projected prevalence for the city, 15.4%, for 2020. Forty-one percent of the patients with food insecurity were attending diabetes clinic and 59% were attending endocrinology clinic. Sixteen percent of the families with food insecurity also reported issues with paying rent/utilities and 14% identified transportation as a barrier to attending medical appointments. Thirteen percent identified negative financial repercussions of COVID-19 such as job loss or reduction of work hours. Approximately 8% identified the patient's medical diagnosis and related dietary requirements as factors contributing to food insecurity. Conclusions Ascertaining food insecurity in our clinic provided a valuable tool to identify and address socioeconomic determinants influencing health. Families appreciated the printed materials and verbal education regarding available local resources. This screening method was sustainable, has been incorporated into EMR, and will continue to support our patients' families. Future studies will increase understanding how food insecurity impacts management of chronic pediatric endocrine conditions.

Community-Based Participatory Research During the COVID-19 Crisis: Lessons for Partnership Resiliency

This reflective essay explores how the strengths and even presumed limitations of community-based participatory and action research are critical assets to building and sustaining resilient research partnerships before, during, and after particularly difficult times. After highlighting key concepts from the boundary-spanning and resiliency literatures, we outline how four deep-seated principles of community-based participatory research (CBPR) contribute to building partnership and community resiliency. We draw upon our decades of experience across a wide range of both rural and urban partnerships to share examples of how these concepts were applied in actual research situations during the COVID-19 pandemic to understand how they sustain and strengthen partnerships and community impact. © Journal of Higher Education Outreach and Engagement, Volume 25, Number 3, p. 91, (2021)