SLUCare pediatrician

Saint Louis University researchers are tackling hunger in the community by tracking it in a SLU medical clinic, and through training and connecting health advocates to children and families in need of available resources. A $580,000 grant from Missouri Foundation for Health will support this work, including improving screening practices and follow-up care.

In the city of St. Louis, 26 percent of households regularly do not know whether they will be able to feed their family. A 2015 survey of patients at Danis Pediatric Center at SSM Health Cardinal Glennon Children's Hospital found that 57 percent of caregivers experienced some level of household food insecurity.

“A lot of pediatricians and other primary care providers are starting to screen for social determinants, using a standard questionnaire that families fill out in the waiting room, but the challenge with that is a family might fill that out, but what happens next?” principal investigator Ellen K. Barnridge, PhD, said. She is associate professor of behavioral science and health education at Saint Louis University’s College for Public Health and Social Justice.

“It is not just individual things that are happening in one family, but there are actually systems in place that are creating patterns among families,” she said.

The three-year grant will fund researchers, social workers, students and community partners to create, implement and refine a system that will improve screening and follow-up with families struggling with food insecurity, as well as other resource insecurities. SLU students in medicine, public health and social work will be trained as health advocates for the families, sharing information on opportunities for food, banking, training, transportation and social work.

“We need a sustainable way to make connections, and one of the assets that we have at Saint Louis University is our students,” Barnridge said. “And it’s an opportunity for us to think about how we train students to understand the systems that are in place that keep people from reaching their optimal health, and really being able to navigate systems to find resources for things like food and diapers, help with utilities – that we know influence how healthy kids can be.”

Early interventions to provide safety net services have the potential to deter future health problems by providing basic needs and services to families in need, she said. Providing supportive referrals and connections before a family is in crisis can provide long-term stability and health.

“Our hope is that part of what we are doing is changing the culture of the pediatric visit,” Barnridge said.

Children who live in resource-limited households have more cognitive, emotional and physical health challenges throughout their life and face a greater risk of multiple chronic diseases, including obesity, she said. Recommendations from the American Academy of Pediatrics suggest that pediatric clinical settings may create optimal screening opportunities for the identification of household food insecurity.

“Screening alone does not address food insecurity or other resource insecurities,” Barnidge said. “Taking advantage of the fact that most families with children interact with the health care system, we can identify families who may need support and actively link them to community-based resources, increasing the likelihood that families will get the support they need.”

Josh Arthur, M.D., a SLUCare pediatrician in the Danis Center and a co-investigator on the project, said the students working on the project will benefit as much as the community.

“This program is a unique opportunity for SLU students to not only connect families to crucial resources, but also be formed into future practitioners invested in empathetic, evidence-based care for families vulnerable to poor health outcomes,” he said.

SLUCare pediatrician Gene LaBarge, M.D. and professor at Saint Louis University School of Medicine, is also a co-investigator.

Barnridge said that health advocates also are needed to bridge the gap between needs and resources. “Healthcare providers themselves have responsibilities elsewhere, so they can’t be the ones to make that connection,” she said.

The advocates will help families and caregivers complete applications for federal food subsidies, find financial products and debt consolidation opportunities, obtain public transportation vouchers or identify training for parents of young children, among other support opportunities. Health advocates will follow up with families for one year to ensure success.

Operation Food Search, Parents as Teachers, St. Louis Area Diaper Bank, St. Louis Community Credit Union and St. Louis Area Food Bank are the community partners on the project. Operation Food Search will provide emergency meal kits, and the St. Louis Area Diaper Bank will provide diaper packs immediately to families that need them. The partners also will form a community advisory committee of nonprofit service providers.

The goal is to reach 60 families in the first year and, in the long-term, reduce food insecurity among Danis’ 9,000-plus pediatric patients. 

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