Connecting Families at Risk for Food Insecurity With Nutrition Assistance Through a Clinical-Community Direct Referral Model.

OBJECTIVE: To assess the feasibility of a clinical-community direct referral model to enroll eligible households in the Supplemental Nutrition Assistance Program (SNAP). METHODS: Pediatric clinics screening for food insecurity (n = 27) invited families experiencing food insecurity to participate in a direct referral to a local organization that assists with SNAP applications. A food stamp specialist telephoned participants to determine SNAP eligibility, assist with the application, and/or provide other supports. Referrals, eligibility determination, enrollment, and estimated benefits were tracked. RESULTS: A total of 486 families were referred to the community partner; 72% (n = 351) were successfully contacted by a food stamp specialist, with 17% (n = 83) applying for SNAP benefits. Another 16% (n = 79) were already enrolled in SNAP but received an additional service. CONCLUSIONS AND IMPLICATIONS: This referral model was feasible and increased the number of families who received nutrition assistance. This approach could be adapted for other health-related social needs.

Motivational interviewing in paediatric residency.

BACKGROUND: Motivational interviewing (MI) is a collaborative, evidence-based, person-centred counselling style for addressing ambivalence about behaviour change. Despite its proven effectiveness, there is little formal instruction of MI in paediatric training programmes. METHODS: Second-year paediatric residents participated in a 4-hour MI workshop, followed by a 1-hour small group review course and hands-on supervision during their Adolescent Medicine rotation. After the MI workshop, and again after their refresher course, we assessed residents' attitudes and skill with written and online surveys, as well as with a modified Helpful Responses Questionnaire (HRQ). RESULTS: Results revealed a statistically significant improvement in residents' confidence in eliciting health behaviour change [t-score(59) = 3.76, p = 0.008]. HRQ scores for all three clinical scenarios improved significantly following the workshop (p < 0.000). Residents most valued the interactive components of the workshop and review course, particularly the practice exercises, videos/video vignettes, feedback and coaching. DISCUSSION: A standardised MI curriculum for paediatric residency training improved residents' confidence in eliciting health behaviour change and use of empathic, reflective language. The curriculum is both feasible and widely accepted by residents, with opportunities for residents to practise MI under supervision during resident training. In conclusion, providing a 4-hour MI workshop for paediatric residents, with reinforcement through a review course and clinical opportunities to practise MI under supervision, improved confidence in eliciting health behaviour change and the use of MI-consistent language. This innovative and time-sensitive effort could serve as a future model for MI training for paediatric residents. There is little formal instruction of MI in paediatric training programmes.