Health care providers' attention to food insecurity in households with children

Objective: To determine the extent to which physicians and nurse practitioners monitor household food insecurity (FI) of families with children, and to examine factors that influence FI monitoring. Method: A 2007 mail survey of family practice and pediatric physicians and nurse practitioners in the Portland, Oregon, region yielded 186 responses. Factor analysis was used to identify barriers to asking about FI. Regression analysis was used to determine whether monitoring of household food status was predicted by those barriers, attentiveness to potential FI indicators, and other variables. Results: Most respondents did not routinely inquire about household FI during clinic visits. However, 88.8% expressed willingness to use a standardized screening question, if available. Monitoring of household food nutritional quality was significantly predicted by one of three identified barriers (providers' time availability). Monitoring of household food sufficiency was predicted by years in practice, attentiveness to FI indicators, and the remaining two identified barriers (inadequate knowledge about FI, discomfort in discussing FI). Conclusion: Routine monitoring of patients' household FI by health care providers is an underutilized strategy for reducing this condition, which poses serious risks to children's health and development. Addressing providers' concerns and introducing standardized screening procedures can increase their monitoring behaviors.