The research poster I presented at the Nutrition Resource Centre conference and the Dietitians of Canada conference.

1. • Qualitative interviews were used to assess acceptability and
feasibility.
• Clients were asked about their experience being screened for food
insecurity by their care provider.
• Care providers were asked about their experience incorporating
the screening questions into practice, whether they felt the
screening and care algorithm was useful, and whether it impacted
their interventions or rapport with clients.
Phase 3: Assessing the
Acceptability and Feasibility of
the Screening Initiative
Improving Diabetes Management
for Food Insecure Populations: A
Review.
Thomas, B. & Gucciardi, E. (2016).
Objective: To explore existing
evidence regarding diabetes
management interventions that can
improve diabetes self-management
for food insecure individuals.
Methods: Twenty-three articles that
fit the inclusion criteria were selected
for review. Seven databases were
searched: CINAHL, Cochrane
Database of Systematic Reviews,
Medline, ProQuest Nursing, Scopus,
PsychInfo, and Web Of Science.
Results: Findings are organized
according to the following themes:
screening for food insecurity, nutrition
counseling, improving glycemic
control, improving patient-provider
communication, tailoring interventions
to support diabetes self-management,
and increasing collaboration between
h e a l t h c a r e a n d c o m m u n i t y
organizations.
Conclusion: Screening for food
insecurity and tailoring diabetes
management strategies to meet the
needs of food insecure clients can
improve health outcomes and reduce
health care costs.
Developing an Evidence-based
Food Insecurity Screening and
Care Algorithm
Objectives
1) To develop food insecurity screening questions
and a care algorithm that are evidenced-based
and relevant to a specific practice setting.
2) To pilot the food insecurity screening questions
and care algorithm with clients receiving
diabetes care at South Riverdale Community
Health Centre (SRCHC) in Toronto.
3) To assess the acceptability and feasibility of
implementing the food insecurity screening
initiative.
Adapting the Food Insecurity
Screening Initiative to the Local
Context
1) Feedback From Care Providers
• A meeting with care providers at South Riverdale Community Health Centre
was conducted to seek feedback on the selected food insecurity screening
questions, the proposed care algorithm and the food insecurity posters for
clients.
• Feedback was incorporated to increase acceptance and uptake of the
screening initiative among care providers.
2) Feedback from Clients
• Individual interviews were conducted with clients living with diabetes to
determine if the food insecurity screening questions and care algorithm
recommendations were perceived as helpful and relevant to food insecure
clients.
• Overall, clients agreed that the recommendations were helpful for food
insecure individuals living with diabetes.
• We collected client feedback on the food insecurity posters to ensure they
were appropriate for the target audience.
Phase 2: Implementing the
Screening Initiative
• For a minimum of two weeks, care providers piloted the food
insecurity screening questions and care algorithm with clients
receiving diabetes care at South Riverdale Community Health
Centre.
• Posters about food insecurity were posted in the waiting area to
help reduce client stigma related to food insecurity.
Poster for Clients to Reduce
Stigma of Food Insecurity
Background
• Food insecurity is more prevalent among those
living with diabetes and is associated with poor
diabetes self-management and adverse health
outcomes.
• Food insecure individuals are more likely to
have poor glycemic control, higher rates of
medication non-adherence and more
emergency room visits due to hypoglycemia.
• Numerous studies recommend screening for
food insecurity as a part of routine diabetes
care.
• Knowledge of food insecurity enables care
providers to tailor interventions for food
insecure clients by providing more realistic
dietary recommendations, more appropriate
medication regimens and referrals to other
care providers and community food resources.
Contact Information
Brittany Thomas, RD, MHSc (c)
Email: brittany1.thomas@ryerson.ca
Preliminary Findings
• Clients and care providers support screening for food insecurity.
• Screening for food insecurity elicited important information from
food insecure clients and can strengthen rapport.
• Adding the screening questions to the EMR facilitated use.
• Forgetting, time and logistics were common barriers to screening.
Acknowledgements
A special thank you to Dr. Enza Gucciardi, Sandra Fitzpatrick, Dr.
Souraya Sidani and all of the care providers and clients at DECNET
who participated in this study.
Phase 1: Developing the Screening Initiative
Relevant findings from the systematic literature review and feedback from care providers and clients
were combined to create a food insecurity screening and care algorithm.
Implications for Practice
• Knowledge of food insecurity can help care providers deliver more
realistic and appropriate interventions.
• Tailored interventions can improve diabetes self-management
among food insecure clients and can reduce health care costs.