Connecting Food Insecure People with Resources in Washington

Hannah Wilson1, Dayana Enriquez1, Genevieve Murstig1, Lexie Jackson, MS, RDN, LD, CDE1,2, Carol DeFrancesco,
MALS, RDN, LD1
OHSU Graduate Program in Human Nutrition1, Clinic in Washington2

A Clinic in Washington Implementation Details Discussion & Recommendations 

The urgent care clinic offers medical care services to include diabetes care management,  Food Security Screener
vision, dental and other services such as medications, lab tests, and immunizations services for • Randomized survey for 11 weeks at the clinic during check-in and collected forms
low income people. The clinic serves those uninsured, underinsured, and in-between
insurance. The clinic is volunteer-driven, with credentialed medical & nursing volunteers
staffing the Urgent Care side.
Background/Significance
• Prevalence of Food Insecurity:  12.3% (15.6 million) of U.S. households during 2016, 12.8% of
Washington households during 2015, 13.2% of Clark County households during 2015.1
• The intersection of food insecurity and healthcare is critical to address. Screening for food
insecurity gives providers the ability to create manageable interventions that include low- •
cost food strategies, medications regimes, and referrals to local resources.2  screening questions, determining food security status, and evaluation forms.
• Food insecurity is consistently found to be linked to poor health outcomes including
diabetes, hypertension, hyperlipidemia, low nutrient intake, and poor mental health status3
• During the needs assessment for our project, conversations with patients, providers, and
administration have identified the presence of food insecure patients at the clinic.
• Food insecurity boxes and bags are used by many community clinics around the nation.
Aim/Objective #1
• Screen patients at the clinic for food insecurity using the verified USDA Six-Item Food
Security Screener.
• The objective of this screener is to identify those patients with food insecurity at the clinic.
Aim/Objective #2
• Provide five emergency food bags and a resource guide that will connect people to food in
their community.
• The objective of the emergency food bags is to serve as pilot project to determine if this
model would be effective at the clinic and/or other similar setting for the purpose of
providing a meal to a patients who are severely food insecure.
• The resource guide provides a list of local resources, such as soup kitchens, food banks and •
food pantries. This handout creates awareness of the available food resources for those who •
are food insecure.
Implementation
Timeline
confidentially.  insecurity. A pitfall to this methodology was its inability to intervene directly at that given
• Analyzed data and utilized this information to create guidelines for staff & volunteer
providers to determine a patient's eligibility to receive an emergency food bag.
• 54 patients completed the screeners.
Emergency Food Bags
• Collected nonperishable nutritious food that were adequate to feed five families of four.
• Prepared five bags that contained food contents, the resource guide, and a small
description explaining the use of the resource guide.
Triage nurses were given an instruction sheet and verbal directions on the food insecurity
• Bags were delivered to the clinic, which initiated the pilot study that lasted for four days.  • The resource guide has the ability to impact a large number of patients at the clinic.
• Evaluations forms and verbal feedback was then acquired and analyzed.
Each meal contained the following:
1 can corn, 1 can tomatoes, 1 can green
beans, 1 can pinto beans, 1 can black bean,
and 1 bag of brown rice (small surplus of
rice)
Kcal Carb Pro Fat Fiber
703 72 g 26 g 11g 25 g
kcal
Figure 2. Contents of the emergency food bag Figure 3.Nutrition information per meal 
 
Food Resource Guide
• Performed a needs assessment to determine what information to include into the guide.
• Gathered contact information, location, and hours for food banks and food pantries within
Washington.
Created a brief description for individuals to understand how to use the guide.  1. Food Insecurity in The United States. http://map.feedingamerica.org/. Accessed
Placed resource guide into emergency food bags.
Screening for Food Insecurity
• The Food Security Screener was successful as a mechanism in identifying clients with food
time of collection. Data can be used by the clinic to apply for additional grant funding that
targets food insecurity. Quantitative data derived from the screeners will help
administrators at the clinic see nutrition as a top priority. 
Resource Guide
• Evaluation forms indicated that resource guides were utilized by clinic staff and provided to
at least three clients during the implementation period.
• Please note that the clinic has been utilizing such distribution of community resources to
clients in need, during 1:1 interaction and/or triage
Informing people websites and contact information for food banks, pantries, and soup
kitchen will allow them to stay updated on the most current information. 
Emergency Food Bags
• All 5 bags were used within 3 days of implementation.
• Staff indicated that they wanted to see the Emergency Food Bag program continue.
• The emergency food bags served as an informative pilot run.
• Staff used previous knowledge of clients as per earlier visits to the clinic to determine
eligibility, and/or identifying clients’ food insecurity during 1:1 interaction during triage
and/or upon discharge. Literature concurs that universal screening for food insecurity is the
first step to initiating an intervention.2 Training providers to ask screener questions is
critical to implementation.4
Acknowledgements
We would like to thank Carol DeFrancesco, MALS, RDN, LD; Lexie Jackson, MS RDN, LD, CDE;
Laura Zeigen, MA, MLIS, MPH, AHIP; staff and volunteers at the clinic for their support and
guidance.
References
November 28, 2017.
2. Gucciardi E, Vahabi M, Norris N, Del Monte JP, Farnum C. The Intersection between Food
Insecurity and Diabetes: A Review. Current nutrition reports. 2014;3(4):324-332.
3. Gundersen C, Seligman HK. Food insecurity and health outcomes. Economists' Voice.
2017;14(1).
4. Barnidge E, LaBarge G, Krupsky K, Arthur J. Screening for Food Insecurity in Pediatric
Clinical Settings: Opportunities and Barriers. .Journal of community health.2017;42(1):
51-57.

Date Activity

8/27/17- 11/26/17 Information Gathering and Demographics

11/27/17 Proposal Presentation

12/8/17 USDA Six-Item Food Security Screener Implementation

2/1-18-2/19/18 Resource Research

2/14/18 Data analysis from the USDA Six-Item Food Security Data

2/27/18 Food Bag and Resource Guide Implementation

Figure 4.  Instructions attached for the Figure 5. 1st page of the 4-page resource
3/9/18 Solicit and evaluate Feedback food resource guide guide 
       
Figure 1. Project Timeline