CHOP’s new nutrition screener gives eligible families access to food benefits

06 Jun 2024 --- While many low-income families rely on federally funded programs like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP) for nutritional support, they don’t receive the benefits because of complex enrollment processes. Researchers from the Children’s Hospital of Philadelphia (CHOP) implemented and tested a nutrition screener to improve access to healthy resources for these families.

Federally funded food benefit programs are linked to improved health outcomes and decreased healthcare costs, and nutrition screeners have been proven to help with application and enrollment procedures.                                                    

“The approach we developed may be one important way to normalize social needs assessment and provide families with additional nutrition support,” says Dr. Aditi Vasan, attending physician, division of general pediatrics at CHOP and lead author of the study. 

“To ensure all families in need are able to receive appropriate support, clinics should consider priming caregivers to expect follow-up from a resource navigator, as well as asking about preferred contact methods and incorporating additional outreach approaches like text messaging.”

Promising pilot project
The CHOP nutrition screener consists of a tablet-based questionnaire asking eligible families whether they are interested in receiving help applying for WIC and SNAP or want information about local food banks. The findings of the pilot study about the screener were published in the Annals of Family Medicine.

The questionnaire, issued in English or Spanish to families in their child’s patient portal or the waiting room, included nine questions focused on diet, nutritional risk assessment and interest in food resources.

The researchers prioritized preventative care visits for caregivers of infants aged 0–6 months at two primary care clinics in West Philadelphia. These clinics predominantly serve a non-Hispanic Black, Medicaid-insured and English-speaking population, with 3% of patients speaking Spanish and 2% speaking other languages.   

Caregivers who requested help were called within a week and offered targeted assistance with the benefits enrollment. In the first month of the pilot, 433 families completed the screener and 73 requested nutrition resources — 17 wanted information about local food banks and 56 families requested application support for benefits.The nutrition screener was used to connect 38% of families who requested aid to a benefits program.

Roughly 38% of the families requesting application support were successfully connected to WIC or SNAP, while 55% of the pilot participants could not be reached due to incorrect contact information in the electronic health record or non-responsiveness to calls from the resource navigator. 

Instead of asking caregivers about food resources in the context of a dedicated social needs screener — a widely used approach — the researchers embedded these questions in the context of nutritional assessment.

Testing possibilities
The pilot is the brainchild of researchers from The Possibilities Project and Clinical Futures at CHOP. The project aims to design innovative strategies and implement new ideas that better serve patients. The current study designed and tested a standardized process for linking families to WIC and SNAP during pediatric primary care visits.

The approach may be a way to normalize social needs assessment and provide families with additional support. Due to the large number of families who could not be reached by phone, the researchers suggest that clinics consider asking them about a preferred contact method and incorporate other outreach approaches such as text messaging or providing referrals.  

“Prior studies at CHOP show that 50% of people who are eligible for services like WIC might not actually be taking advantage of them,” says Dr. George Dalembert, associate director of the Center for Health Equity at CHOP and co-author of the study.

Meanwhile, the USDA unveiled its SUN Programs: USDA’s Summer Nutrition Programs for Kids, to improve food and nutrition security during the summer. The programs include grocery benefits and nutritious meal and snack services, providing families with more choices and convenient ways to get summer nutrition support for their children under 18.

In addition, the US government introduced new enhancements to WIC incorporating science-based revisions and recommendations from the National Academies of Science, Engineering and Medicine and the 2020-2025 Dietary Guidelines for Americans.

By Inga de Jong