Food Insecurity Screening Among Families of Children with Diabetes

Vitale, Michele; Gucciardi, Enza; Dorado, Linda; Pais, Vanita; Sidani, Souraya

doi:10.1016/j.jcjd.2018.08.059

Cited by 4 publications

(6 citation statements)

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“…10 -14 Several studies have explored patient perceptions of addressing social needs in clinical settings, 10 ,12-19 related both to specific domains like intimate partner violence 20,21 and to food insecurity 12,13,17 as well as social needs screening more generally. Most participants across studies agreed that health care providers should ask patients about social needs, 10,12,13,16,18,19 though some added qualifications, including concern for privacy regarding sensitive topics. 14 Less research to date has focused on ED patients' views on social needs screening, 10,13,15,16 with very little devoted to housing issues specifically.…”

Section: Importancementioning

confidence: 99%

“…While there is consensus that such social factors are important contributors to health, 9 the most effective ways to identify and address them in health care settings are less clear. The literature cites numerous arguments supporting social needs screening in health care settings but also raises concerns, including patients' fear of judgment by clinicians and the limited time available to address both medical and social issues 10–14 . Several studies have explored patient perceptions of addressing social needs in clinical settings, 10,12–19 related both to specific domains like intimate partner violence 20,21 and to food insecurity 12,13,17 as well as social needs screening more generally.…”

Section: Introductionmentioning

confidence: 99%

“…The literature cites numerous arguments supporting social needs screening in health care settings but also raises concerns, including patients' fear of judgment by clinicians and the limited time available to address both medical and social issues 10–14 . Several studies have explored patient perceptions of addressing social needs in clinical settings, 10,12–19 related both to specific domains like intimate partner violence 20,21 and to food insecurity 12,13,17 as well as social needs screening more generally. Most participants across studies agreed that health care providers should ask patients about social needs, 10,12,13,16,18,19 though some added qualifications, including concern for privacy regarding sensitive topics 14 …”

Section: Introductionmentioning

confidence: 99%

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Patient views on emergency department screening and interventions related to housing

Kelly

Fazio

Padgett³

et al. 2022

Academic Emergency Medicine

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ObjectivesEmergency departments (EDs) serve as a health care "safety net" and may be uniquely suited to screening for and addressing patients' unmet social needs. We aimed to better understand patient perspectives on ED-based screening and interventions related to housing instability, as a step toward improving future efforts. MethodsWe present findings from a qualitative study using in-depth, one-on-one interviews with ED patients who had become homeless in the past 6 months. Qualitative interviewees were asked their thoughts on ED staff asking about and helping to address homelessness and housing issues. Interviews were professionally transcribed verbatim. Multiple coders identified interview text segments focused on ED-based housing screening and intervention, which were then independently analyzed thematically and discussed to reach consensus. Researchers also categorized each participant's overall opinion on ED housing screening and interventions as positive, neutral, or negative. Results Qualitative interviews were conducted with 31 patients. Four themes related to ED-based housing screening and interventions emerged: (1) patients generally welcome ED staff/providers asking about and assisting with their housing situation, with caveats around privacy and respect; (2) ED conversations about housing have potential benefits beyond addressing unmet housing needs; (3) patients may not consider the ED as a site to obtain help with housing; (4) patients' experiences navigating existing housing services can inform best approaches for the ED. Most participants expressed overall positive views of ED staff/providers asking patients about their housing situation. Conclusions How to cite this article: Kelly A, Fazio D, Padgett D, . Patient views on emergency department screening and interventions related to housing.

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Section: Importancementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient views on emergency department screening and interventions related to housing

Kelly

Fazio

Padgett³

et al. 2022

Academic Emergency Medicine

View full text Add to dashboard Cite

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“…1 The first two items of the Household Food Security Survey Module, ("(I/We) worried whether (my/our) food would run out before (I/we) got money to buy more," and "The food that (I/we) bought just didn't last, and (I/we) didn't have money to get more"), are routinely used as screening questions in clinical care. 26,27 A review of 24 food security measures indicates the United States Household Food Security Survey Module is a robust, valid, and reliable (Cronbach's alpha = 0.86-0.93) measurement tool. 1,28,29 The validity for differentiating households was established in Frongillo et al 30 Parents/guardians of SEARCH youth participants (<18 years of age) and participants 18 years of age or older completed the survey.…”

Section: Household Food Insecuritymentioning

confidence: 99%

Household food insecurity is associated with diabetic ketoacidosis but not severe hypoglycemia or glycemic control in youth and young adults with youth‐onset type 2 diabetes

et al. 2022

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Objective: To examine the association between household food insecurity (HFI), glycemic control, severe hypoglycemia and diabetic ketoacidosis (DKA) among youth and young adults (YYA) with youth-onset type 2 diabetes.Research design and methods: This cross-sectional study included 395 YYA with type 2 diabetes from the SEARCH for Diabetes in Youth Study (2015Study ( -2019. HFI was reported by young adult participants or parents of minor participants via the US Household Food Security Survey Module. Glycemic control was assessed by HbA 1c and analyzed as a continuous and categorical variable (optimal: <7.0%, suboptimal: ≥7.0%-9.0%, poor: >9.0%). Acute complications included self-reported severe hypoglycemia or DKA in the last 12 months. Adjusted logistic and linear regression were used for binary and continuous outcomes, respectively.Results: Approximately 31% reported HFI in the past 12 months. Mean HbA 1c among those with HFI was 9.2% compared to 9.5% without HFI. Of those with HFI, 56% had an HbA 1c >9.0% compared to 55% without HFI. Adjusted models showed no associations between HFI and glycemic control. Of those with HFI, 14.4% reported experiencing DKA and 4.7% reported severe hypoglycemia. YYA with HFI had 3.08

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“…44 From this report, it isn't clear if this is for DKA or hypoglycemia, but given that high a prevalence, most would agree that this meets the definition of brittle diabetes. Food and medication insecurity often co-exist, 46 so a child or adult with type 1 diabetes in this situation is particularly challenged.…”

Section: Insulin and Food Insecuritymentioning

confidence: 99%

A new look at brittle diabetes

Hirsch

Gaudiani

2021

Journal of Diabetes and its Complications

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Brittle diabetes" was first used to describe a life "disrupted by episodes of hypoglycemia or hyperglycemia." Early descriptions focused on small case reports of mostly young women with psycho-social instability, recurrent diabetic ketoacidosis, poor patient compliance or maladaptation. We redefine "brittle diabetes" as occurring in four specific life stages each with distinct characteristics and associated conditions resulting in severely erratic glycemic control and poor outcomes. Once identified however these factors can often be reversed or significantly mitigated. The first group includes younger patients with associated psychiatric diseases such as bulimia and depression which require specific therapy and are treatable. A second group includes individuals who have another underlying medical condition resulting in disruption of insulin sensitivity or glucose utilization which must be sought. A third group, the largest we believe, has "geriatric type 1 diabetes" and develops severe glycemic instability due to frailty, chronic renal failure, dementia, vision loss, loss of counterregulation and other diseases of aging which lead to unintentional omission of insulin, insulin dosing errors and increasing insulin sensitivity. The fourth group, now seen around the world, suffers lack of insulin access and associated food insecurity. All four of these groups are described.

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Food Insecurity Screening Among Families of Children with Diabetes

Cited by 4 publications

References 0 publications

Patient views on emergency department screening and interventions related to housing

Patient views on emergency department screening and interventions related to housing

Household food insecurity is associated with diabetic ketoacidosis but not severe hypoglycemia or glycemic control in youth and young adults with youth‐onset type 2 diabetes

A new look at brittle diabetes

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