Developing and implementing a food insecurity screening initiative for patients living with diabetes

Objectives: Routine food insecurity screening is recommended in diabetes care to inform more tailored interventions that better support diabetes self-management among food-insecure patients. This pilot study explored the acceptability and feasibility of a food insecurity screening initiative within a diabetes care setting in Toronto.

Methods: A systematic literature review informed the development of a food insecurity screening initiative to help health-care providers tailor diabetes management plans and better support food-insecure patients with type 2 diabetes. Interviews with 10 patients and a focus group with 15 care providers elicited feedback on the relevance and acceptance of the food insecurity screening questions and a care algorithm. Subsequently, 5 care providers at 4 sites implemented the screening initiative over 2 weeks, screening 33 patients. After implementation, 7 patients and 5 care providers were interviewed to assess the acceptability and feasibility of the screening initiative.

Results: Our findings demonstrate that patients are willing to share their experiences of food insecurity, despite the sensitivity of this topic. Screening elicited information about how patients cope with food insecurity and how this affects their ability to self-manage diabetes. Care providers found this information helpful in directing their care and support for patients.

Conclusions: Using a standardized, respectful method of assessing food insecurity can better equip health-care providers to support food-insecure patients with diabetes self-management. Further evaluation of this initiative is needed to determine how food insecurity screening can affect patients' self-management and related health outcomes.