Food Insecurity Questions

AAFP Social Needs Screening Tool

Within the past 12 months, you worried that your food would run out before you got money to buy more.
Often true
Sometimes true
Never true

Within the past 12 months, the food you bought just didn’t last and you didn’t have money to get more.
Often true
Sometimes true
Never true

AccessHealth Spartanburg Screening Tool

Have you applied for or do you receive food stamps (SNAP) benefits?
Yes/ No

Accountable Health Communities Health-Related Social Needs Screening Tool

Within the past 12 months, you worried that your food would run out before you got money to buy more.
Often true
Sometimes true
Never true

Within the past 12 months, the food you bought just didn't last and you didn't have money to get more.
Often true
Sometimes true
Never true

ACORN Screening Tool 

Within the past 12 months, you worried whether your food would run out before
you got money to buy more
Often True
Sometimes True
Never True

Within the past 12 months, the food you bought just didn’t last and you didn’t
have money to get more.
Often True
Sometimes True
Never True

Do you need help getting food for this
week?
Yes
No

Arlington Screening Tool

Within the past 12 months, did you worry that your food would run out before you got money to buy more?
Yes/No

Boston Medical Center-Thrive Screening Tool

Within the past 12 months, the food you bought just didn’t last and you didn’t have money to get more.
Often true
Sometimes true
Never true

Within the past 12 months, you worried whether your food would run out before you got money to buy more.
Often true
Sometimes true
Never true

Is this an emergency, do you need food for tonight?
Yes/ No

HealthBegins Upstream Risk Screening Tool

Which of the following describes the amount of food your household has to eat:
Enough to eat
Sometimes not enough to eat
Often not enough to eat

Health Leads Social Needs Screening Toolkit

In the last 12 months, did you ever eat less than you felt you should because there wasn’t enough money for food?
Yes/No

Total Health Assessment Questionnaire for Medicare Members (KP)

Do you eat fewer than two meals a day?
Yes/No

Do you always have enough money to buy the food you need?
Yes/No

North Carolina Medicaid Screening Tool

Within the past 12 months, did you worry that your food would run out before you got money to buy more?
Yes/ No

Within the past 12 months, did the food you bought just not last and you didn’t have money to get more?
Yes/ No

PRAPARE

In the past year, have you or any family members you live with been unable to get any of the following when it was really needed?
Food: Yes/No

Structural Vulnerability Assessment Tool

Do you have adequate nutrition and access to healthy food?

WellRx Toolkit

In the past 2 months, did you or others you live with eat smaller meals or skip meals because you didn’t have money for food?
Yes/No

Kaiser Permanente's Your Current Life Situation

In the past 3 months, did you have trouble paying for any of the following? (Select ALL that apply)
Food

In the past 3 months, how often have you worried that your food would run out before you had money to buy more?
Never
Sometimes
Often
Very often

Optional: Are you easily able to get enough healthy food to eat?
Yes
No

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