Food Insecurity Screening by an RD in Cystic Fibrosis Clinic Susan Casey, RDN, CD Seattle Children’s Hospital

Presenter Disclosure Susan Casey, RDN, CD There are no relationships to disclose related to this presentation.

What Prompted Our Screening? - 30+ years in CF Clinic, helping families navigate nutrition, many of whom seemed to struggle with providing adequate calories we recommend without adequate funding.

In the Beginning……. Just as a review, I started just asking: “Is there ever a time during the month when your resources to feed yourself or your family ever run short?” This question wasn’t validated. I just kept the numbers in a journal.

What Happened Next…. Decided to use the validated questions from the AAP and the Food Research & Action Center to validate the screening. Within the past 12 months, we worried whether our food would run out before we got money to buy more. Within the past 12 months, the food we bought just didn’t last and we didn’t have money to get more. Answers from which to choose: Often true, Sometimes True, Never True, Don’t know or refused Often true and Sometimes True were considered positive for Food Insecurity.

Progressing on ….. Kept a spreadsheet with the following: Food Insecurity: yes or no BMI percentile or Weight/Length percentile If eligible for the free or reduced breakfast or school lunch If eligible for EBT card (food stamps) If on nutrition supplements If eligible for WIC My two other favorite questions (per clinic request): Is your child able to have access to a restroom at school without restrictions? Does you child have enough time to finish lunch at school?

This is What We Found: 199 patients from 181 encounters across 340 CF clinic encounters Of the 181 households 60 (33%) reported “yes” to Food insecurity 8 of the 181 households who had 2 children in the family with CF reported “yes” to food insecurity (47%)

How This compares….. In Washington State, 12.9% of families report food insecurity. Nationally, 16% of households report food insecurity. Seattle Children’s Hospital CF Center families exceed these numbers significantly.

Families site the following reasons: Higher calorie needs for people with CF means higher grocery bills. (A teenager needing >4000 calories per day every day can stress a food budget in a family with other children.) High co-pays in some instances. Loss of wages for an hourly wage earner to come to clinic for 3 hours and not be able to make up those wages. Commuting to clinic – some can either pay for gas or eat, but not both. Lack of transportation to go to a food bank.

But if you ask the question…….. You have to be able to provide some solutions or access to solutions.

What we’ve done to try to help…… Provide a handout from Seattle Children’s Hospital titled “Food Resources”.

What the handout includes: Information on: How to access the WIC Program. Parent Help: www.parenthelp123.org is multi-lingual and gives out help for food insecurity and health insurance. Fresh Bucks: Most farmers markets will accept EBT cards and the market will match funds up to $10.00. Information is State-wide. EBT Cards for those who qualify. School meals program qualifications. Summer Meals programs

Also Included on the Handout: A lengthy list of foods banks in all counties of Washington State with phone numbers, addresses and operating hours.

My Favorite Sign! www.foodinvasion.org All you need is a computer and a zip code!

What We Also Found….. I needed to call families within 1-2 weeks to follow-up on information we gave them…. “Was any of the information helpful?” “Have you found the food bank and can you get transportation to visit it?” “Did you get an appointment at the WIC office and do you need a WIC form from us?” “Did you find the summer feeding/meal program closest to you?”

Oh Yes – and the Food Pantry! Convincing “people” we needed one on site at the hospital!!! Stay tuned on this one – we’re almost there…… The first clinics to be able to send families are the ones who initially did the screening – CF Clinic and Nephrology! 

Two Quick Stories (if we have time!) 1) December the 23rd……. 2) A family with lots of support who still is food insecure.