429 - The Effect of a Pediatric Primary Care Patient Navigator Program on Reducing Food Insecurity

Poster Number: 429
Publication Number: 429.112

Background: The American Academy of Pediatrics recommends routine screening for food insecurity (FI), as roughly 15% of children in the US experience FI. Pediatric primary care offices serve as ideal touchpoints to offer intervention. The effect of active referral with patient navigators (PNs) as a mechanism to address food insecurity has not been fully evaluated.

Objective: To assess whether providing a PN to families with food insecurity reduced food insecurity more than providing a resource list alone.

Design/Methods: We conducted a stepped-wedge cluster randomized trial comparing the effectiveness of providing families with a PN versus a resource list at a single, large, diverse, academic, pediatric primary care facility (Figure 1). Food insecurity was measured at baseline and 3-months using the USDA Household 6-item Food Security Screen (FSS). A screen was considered positive if participants responded ‘yes’ to at least one question. Raw scores ranged from 1-5, with 1 indicating high food security, 2-4 indicating low food security, and 5, very low food security. All participants were provided a list of resources. The intervention group were also contacted by a PN. The primary outcome was the difference between FSS at baseline and 3-months between the two groups. Descriptive statistics characterized the participant sample. An independent t-test was used to determine the effect of the intervention on 3-month follow-up food security levels.

Results: 768 families completed the FSS from December 2022-July 2023 (Table 1). Over the study period, 9.4% (n=29) of participants in the control group, and 3.0% (n=14) in the intervention group screened positive for FI at baseline and completed a 3-month follow-up. Of those at baseline, the mean FSS in the control group was 2.9 (SD=1.5, range 1-5, median=2) and in the intervention group was 3.0 (SD=1.7, range 1-5, median=3), indicating low food security for both groups. At three months, the mean FSS in the control group was 2.2 (SD=2.0, range 0-5, median=2) and in the intervention group was 2.5 (SD=2.1, range 0-5, median=2). The average change in FSS score in the control group was -0.7 (SD=1.9, range -5 to 3) and in the intervention group, -0.5 (SD=2.9, range -5 to 4). This indicated a net increase in food security. However, this finding was not statistically significant (p=.825 ).

Conclusion(s): Both PNs and community resource lists may effective be at improving food insecurity. Lesser impact from PN support may be due to the short follow-up period of this study. Future studies should assess long-term impact of a PN on food insecurity.