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Koob C, Stuenkel M, Gagnon RJ, Griffin SF, Sease K. Examining Patient- and Community-Level Factors Associated with Pediatric Mental Healthcare Access Within a Patient Navigation Program. Community Ment Health J 2024; 60:1055-1067. [PMID: 38507129 PMCID: PMC11199227 DOI: 10.1007/s10597-024-01258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/18/2024] [Indexed: 03/22/2024]
Abstract
In 2021, national leaders in the United States declared a "national youth mental health crisis." Still, only 1-in-4 children receive adequate mental healthcare access. Patient Navigator Programs (PNPs) can improve children's referral-to-connection to mental health services. We examined patient- and community-level factors associated with pediatric mental healthcare access. Pediatric Support Services (PSS) is a PNP that triages mental and behavioral health referrals within a large health system in a southeastern state. This study analyzes PSS data from September 2017-March 2023 and Child Opportunity Index 2.0 state-normed zip-code level data to assess social drivers of health estimates. Structural equation modeling was conducted between patient- and community-level factors and connection to mental health services. Overall, 62.7% of children connected to mental health services since PSS' inception. Regardless of SDOH, as children get older, they are more likely to connect with mental health services (β = .053, SE = .010, p < .001). Children with greater number of referral needs are more likely to connect with mental health services (β = .034, SE = .011, p = .002). Further, children who live in communities with higher opportunity levels are more likely to connect with mental health services (β = .016, SE = .008, p = .040), suggesting that children who live in low-income communities experience more barriers to mental healthcare. Social drivers may inform referral practices and tiered navigation support for optimal mental healthcare access among children. Further research should demonstrate the effectiveness of PNPs integrated within healthcare and community-based settings.
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Affiliation(s)
- Caitlin Koob
- Department of Public Health Sciences, Clemson University, 501 Edwards Hall, Clemson, SC, 29634, USA.
- Prisma Health Children's Hospital-Upstate, Greenville, SC, USA.
| | | | - Ryan J Gagnon
- Department of Parks, Recreation, Tourism, and Management, Clemson University, Clemson, SC, USA
| | - Sarah F Griffin
- Department of Public Health Sciences, Clemson University, 501 Edwards Hall, Clemson, SC, 29634, USA
| | - Kerry Sease
- Prisma Health Children's Hospital-Upstate, Greenville, SC, USA
- University of South Carolina School of Medicine Greenville, Greenville, SC, USA
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2
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Krishnamurthy S, Chait JS, Reddy MN, Galli LD, Skelton JA. Food Insecurity and Family Dynamics: A Systematic Review. FAMILY & COMMUNITY HEALTH 2024; 47:219-230. [PMID: 38758024 PMCID: PMC11104509 DOI: 10.1097/fch.0000000000000401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND Undernutrition is related to numerous childhood outcomes. However, little research has investigated the relationship between food insecurity and family dynamics. This systematic review seeks to validate the evidence for a relationship between these 2 factors. METHODS A systematic literature review was conducted in Embase, PubMed, and Scopus. Inclusion criteria include peer-reviewed research articles published during or after 1996 in English, using standardized measures of family function and food insecurity. Exclusion criteria include measurement of parent or child characteristics without assessing household or family characteristics or demographics. Two reviewers independently voted using Covidence, and Alpha agreement was determined at each phase. RESULTS A total of 15 studies were included for data extraction after the initial search being completed in April 2022. All included studies were found to be appropriate in numerous categories for quality assessment. Primary findings from these studies show a potential relationship exists between food insecurity and family dynamics. DISCUSSION The findings in this review suggest that effects of food insecurity expand to various aspects of healthy family functioning. Unhealthy family dynamics in childhood can also expose children to trauma and lead to increased physical and mental health disorders in the future.
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Affiliation(s)
- Sudarshan Krishnamurthy
- Wake Forest University School of Medicine, Winston-Salem, NC
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Joshua S Chait
- Wake Forest University School of Medicine, Winston-Salem, NC
| | - Menaka N Reddy
- Wake Forest University School of Medicine, Winston-Salem, NC
| | - Lucas D Galli
- Wake Forest University School of Medicine, Winston-Salem, NC
| | - Joseph A Skelton
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, NC
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Wetherill MS, Hartwell ML, Williams MB, White KC, Harrist AW, Proffitt S, Bradshaw E. Beyond Groceries: An Analysis of Referral Needs to Address Underlying Causes of Child Hunger among Households Accessing Food Pantries. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:732-748. [PMID: 34469264 PMCID: PMC8739331 DOI: 10.1080/19371918.2021.1943099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Very low food security among children (VLFS-C), often referred to as child hunger, can profoundly hinder child development, family well-being, and community health. Food pantries are important community resources that routinely serve at-risk families. This study investigated the influence of various candidate risk factors for VLFS-C within a food pantry population to inform the development of the "Pantry Assessment Tool against Child Hunger (PATCH)." We collected standardized surveys among a representative sample of households with children accessing food pantry services in Oklahoma (n = 188). Weighted analyses revealed a large majority of households experienced child-level food insecurity (70.6%), with nearly half reporting low food security and nearly one-quarter reporting VLFS-C. We then used logistic regression to identify factors associated with VLFS-C, followed by chi-square automatic interaction detection (CHAID) to assess if, and in what progression, significant risk factors predicted VLFS-C. In unadjusted models, annual household income <$15,000, non-urban residence, lack of health insurance, unstable housing, heavier food pantry reliance, fair or poor adult health, adult anxiety, and adult smoking to reduce hunger pangs were all positively associated with VLFS-C. Receipt of Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and higher social support were protective against VLFS-C. However, in adjusted models, only receipt of WIC remained significant. CHAID analysis revealed that access to insurance best differentiated groups with and without VLFS-C. Informed by these analyses, the PATCH tool may be useful for the development of screening programs to identify and address potential root causes of VLFS-C in pantry settings.
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Affiliation(s)
- Marianna S Wetherill
- Department of Family and Community Medicine, University of Oklahoma-University of Tulsa School of Community Medicine, Tulsa, Oklahoma, USA
- Hudson College of Public Health, Department of Health Promotion Sciences, University of Oklahoma Tulsa Schusterman Center, Tulsa, Oklahoma, USA
| | - Micah L Hartwell
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Mary B Williams
- Department of Family and Community Medicine, University of Oklahoma-University of Tulsa School of Community Medicine, Tulsa, Oklahoma, USA
- Hudson College of Public Health, Department of Biostatistics and Epidemiology, University of Oklahoma Tulsa Schusterman Center, Tulsa, Oklahoma, USA
| | - Kayla C White
- Hudson College of Public Health, Department of Health Promotion Sciences, University of Oklahoma Tulsa Schusterman Center, Tulsa, Oklahoma, USA
| | - Amanda W Harrist
- Department of Human Development and Family Science, Oklahoma State University, Stillwater, Oklahoma, USA
| | | | - Eileen Bradshaw
- Community Food Bank of Eastern Oklahoma, Tulsa, Oklahoma, USA
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Liese AD, Sharpe PA, Bell BA, Hutto B, Stucker J, Wilcox S. Persistence and transience of food insecurity and predictors among residents of two disadvantaged communities in South Carolina. Appetite 2021; 161:105128. [PMID: 33513414 DOI: 10.1016/j.appet.2021.105128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 11/25/2020] [Accepted: 01/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known about patterns of household food insecurity (HFI) across more than two time points in adults in the United States, the frequency predictors of different trajectories. The distinctions between persistent and transient food insecurity trajectories may be crucial to developing effective interventions. OBJECTIVE To characterize dominant trajectories of food security status over three time points between 2013 and 2016 and identify demographic, socioeconomic and health-related predictors of persistent and transient HFI. DESIGN Cohort study in disadvantaged communities in South Carolina. SETTING and subjects: 397 middle-aged participants, predominantly female, African American, living in USDA-designated food deserts. MAIN OUTCOME MEASURE Household food insecurity over time using the 18-item USDA's Household Food Security Survey Module. STATISTICAL ANALYSES PERFORMED Descriptive analyses of food security trajectories and multinomial regression analyses. RESULTS At baseline (2013-2014), 61% of households reported HFI during the previous 12 months, which decreased to 54% in 2015 and to 51% in 2016. Only 27% of households were persistently food secure, 36% experienced transient and 37% persistent food insecurity. Female sex (OR 2.7, 95%CI 1.2-5.9), being married or living with a partner (OR 2.4, 95CI% 1.1-5.3) and fair health status (OR 4.4, 95%CI 2.2-8.8) were associated with increased odds of persistent food insecurity. Fair health was also a significant predictor of transient food insecurity. CONCLUSIONS These findings suggest that future research should focus on persistent versus transient trajectories separately and that tailored interventions may be needed to make progress on alleviating food insecurity among disadvantaged communities.
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Affiliation(s)
- Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.
| | - Patricia A Sharpe
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
| | - Bethany A Bell
- College of Social Work, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
| | - Jessica Stucker
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
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Moving Beyond Giving Free Food: Specific Targeting and Tailoring in Response to Child Food Insecurity. J Acad Nutr Diet 2021; 121:S74-S77. [PMID: 33342528 DOI: 10.1016/j.jand.2020.07.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 12/23/2022]
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Oo K, Stephenson T, Hege A, Brewer D, Gamboa L, Hildesheim L, Serra L, Houlihan J, Koempel A. Addressing Childhood Hunger during the Summer Months: Using Gleaned Produce for Snacks and Interactive Nutrition Education on Food Systems and Healthy Eating. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2020.1744497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Kendra Oo
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Tammy Stephenson
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Amanda Hege
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Dawn Brewer
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Luisyana Gamboa
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Leslie Hildesheim
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Lauren Serra
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Jessica Houlihan
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Annie Koempel
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, Kentucky, USA
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