Background: An individualized food insecurity protocol is defined as a comprehensive process of screening and set of interventions designed around the specific needs of an individual patient including but not limited to such factors as work schedule, place of living, and forms of identification. The aim of this project is to identify whether an individualized food insecurity protocol reduces food insecurity in the patients seen at the East Harlem Health Outreach Partnership (EHHOP), a student-run, attending-directed free clinic in East Harlem. Methods: Twenty-one patients who had screened positive for food insecurity in the past year were enrolled in the study. Pre- and post-intervention scores based on responses to a modified version of the United States Department of Agriculture’s Six-Item Short Form of the Food Security Survey were recorded, compiled as aggregate data, and compared using the Wilcoxon signed-rank test. Results: The results of this study demonstrate that an individualized protocol was successful in reducing food insecurity (p = 0.005). However, for certain groups, the protocol was not as effective, including patients with poor continuity of care and unstable living conditions. Conclusions: These results showed that the individualized protocol was effective for many but not all participants. Patients may have compounding factors that require additional interventions to supplement this protocol. This protocol is low cost to implement and adaptable to other clinical settings.
Coronavirus disease 2019 (COVID-19) has had a disparate impact on Black and Latinx communities. Even before the COVID-19 pandemic, inaccessibility and distrust of the medical community rooted in historical oppression led to hesitancy about medical interventions. In Boston, COVID-19 vaccination rates of Black and Latinx adolescents lagged behind their white and Asian peers. In response, Boston Medical Center created community vaccine clinic sites across Suffolk County. Pediatric resident physicians subsequently partnered with Boston Medical Center to establish an accompanying education program entitled “Ask-a-Doc” to help improve health literacy and address vaccine hesitancy that focused on Black and Latinx adolescents. In partnership with multidisciplinary stakeholders, including Boston Public School leaders, Ask-a-Doc pediatric resident physicians staffed 46 community vaccine events in 15 zip codes. At these events, 1521 vaccine doses were administered, with most administered to Black and Latinx community members. As of January 1, 2022, 67% of 51 first-year pediatric resident physicians had participated. Ask-A-Doc is an example of a community-based intervention that directly targets health inequities and misinformation and demonstrates that pediatric resident physicians can meaningfully engage in community outreach with sufficient protected time, resources, and institutional support. The resulting connections may lead to greater trust and credibility within systematically oppressed communities.
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