Screening and addressing food insecurity at free clinics: A scoping review

Food insecurity (FI) is highly prevalent amongst patients seeking care at free, student-run health clinics. This study sought to examine the existing literature of food insecurity screenings and interventions at free clinics across the U.S. In this review, we provide the rate of FI screenings, the prevalence of FI, demographic information of patients screened, and interventions and barriers faced by clinics while implementing interventions to improve FI. Studies included in this review needed to implement a FI screening and intervention program in a free clinic within the United States. Additionally, eligible studies could address additional social determinants of health or chronic conditions, but had to include FI screenings and interventions. Due to the inclusion criteria requiring studies to occur in student-run free clinics, of the initial database search of 958 studies, only five were included for analysis. Among the studies, food insecurity was determined by the 6 item US Household Food Security Scale(HFSS), a single question from the USDA food security survey, and a custom 12 item redcap survey. Methods of combating food insecurity included grocery deliveries, in-clinic food pantries, onsite food boxes, aiding patients in accessing SNAP, WIC, and food pantries in the area, and providing referrals to community specific programs who provide food aid. General trends show that implemented FI interventions can range from barrier-informed support to general on-site food pantries. However, our review further showed that the lack of assessment of intervention outcomes limits conclusions on their respective effectiveness. Moving forward, future studies should focus on evaluating implemented programs to improve their broader applicability.