The AAP Council on Community Pediatrics and Committee on Nutrition appreciate Ms Fong's comments. Her letter serves as a good reminder that these new questions may create some anxiety in our families until they become accustomed to them. We also appreciate the findings from her research that demonstrate that this issue must be handled with sensitivity, to obtain reliable responses from families.
However, we ask many sensitive questions of our families and of our adolescent patients and we have learned both the importance of asking these questions to help families and patients as well as the need to ask them in a nonstigmatizing way. We ask about maternal depression, family violence, adolescent sexuality, and adolescent drug use. We can and need to do the same for questions of food insecurity.
We value the suggestion that when pediatricians implement these screening questions, it is essential to contextualize the questions to attempt to allay this anxiety. Among the vulnerable groups highlighted by Ms Fong, we also recognize that families who are undocumented may be particularly reluctant either to reveal a food insecurity issue or to seek services. As the recommendation to screen for food insecurity is implemented, it may be done through questionnaires, electronic medical records, or verbally. Many health care providers/systems have begun routinely asking their patients about food insecurity and are getting responses, but research to determine optimal ways of obtaining this crucial health-related information and how best to address the families’ needs will be important. We believe now is the time to open this dialog with our patients, and we hope that over time this will increase the trust patients and their families have with their pediatricians.
Conflict of Interest:
- Copyright © 2016 by the American Academy of Pediatrics