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Diagnostic accuracy of two food insecurity screeners recommended for use in health care settings

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  • Makelarski, J.A.
  • Abramsohn, E.
  • Benjamin, J.H.
  • Du, S.
  • Lindau, S.T.

Abstract

Objectives. To test the diagnostic accuracy of the American Academy of Pediatrics (AAP) recommended food insecurity screener. Methods. We conducted prospective diagnostic accuracy studies between July and November 2016 in Chicago, Illinois. We recruited convenience samples of adults from adult and pediatric emergency departments (12-month recall study: n = 188; 30-day recall study: n = 154). A self-administered survey included the 6-item Household Food Security Screen (gold standard), the validated 2-item Hunger Vital Sign (HVS; often, sometimes, never response categories), and the 2-item AAP tool (yes-or-no response categories). Results. Food insecurity was prevalent (12-month recall group: 46%; 30-day group: 39%). Sensitivity of the AAP tool using 12-month and 30-day recall was, respectively, 76% (95% confidence interval [CI] = 65%, 85%) and 72% (95% CI = 57%, 84%). The HVS sensitivity was significantly higher than the AAP tool (12-month: 94% [95% CI = 86%, 98%; P = .002]; 30-day: 92% [95% CI = 79%, 98%; P = .02]). Conclusions. The AAP tool missed nearly a quarter of food-insecure adults screened in the hospital; the HVS screening tool was more sensitive. Public health implications. Health care systems adopting food insecurity screening should optimize ease of administration and sensitivity of the screening tool.

Suggested Citation

  • Makelarski, J.A. & Abramsohn, E. & Benjamin, J.H. & Du, S. & Lindau, S.T., 2017. "Diagnostic accuracy of two food insecurity screeners recommended for use in health care settings," American Journal of Public Health, American Public Health Association, vol. 107(11), pages 1812-1817.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2017.304033_1
    DOI: 10.2105/AJPH.2017.304033
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    Cited by:

    1. Kathryn M. Janda & Nalini Ranjit & Deborah Salvo & Aida Nielsen & Nika Akhavan & Martha Diaz & Pablo Lemoine & Joy Casnovsky & Alexandra van den Berg, 2021. "A Multi-Pronged Evaluation of a Healthy Food Access Initiative in Central Texas: Study Design, Methods, and Baseline Findings of the FRESH-Austin Evaluation Study," IJERPH, MDPI, vol. 18(20), pages 1-18, October.
    2. Kathryn M. Janda & Nalini Ranjit & Deborah Salvo & Deanna M. Hoelscher & Aida Nielsen & Joy Casnovsky & Alexandra van den Berg, 2022. "Examining Geographic Food Access, Food Insecurity, and Urbanicity among Diverse, Low-Income Participants in Austin, Texas," IJERPH, MDPI, vol. 19(9), pages 1-12, April.
    3. Naomi Nichele Duke, 2021. "Adolescent-Reported Food Insecurity: Correlates of Dietary Intake and School Lunch Behavior," IJERPH, MDPI, vol. 18(12), pages 1-18, June.
    4. Michael F. Royer & Christopher Wharton, 2023. "The FINDING-Food Intervention: A Mixed-Methods Feasibility Study Addressing Food Insecurity," Challenges, MDPI, vol. 14(4), pages 1-18, October.

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