Hunger Vital Sign Explainer Series
Hunger Vital Sign Questions:
“Within the past 12 months we worried whether our food would run out before we got money to buy more.” Often / Sometimes / Never True.
“ Within the past 12 months the food we bought just didn’t last and we didn’t have money to get more.” Often / Sometimes / Never True.
Hager, E. R., Quigg, A. M., Black, M. M., Coleman, S. M., Heeren, T., Rose-Jacobs, R., Cook, J. T., Ettinger de Cuba, S. E., Casey, P. H., Chilton, M., Cutts, D. B., Meyers A. F., Frank, D. A. (2010). Development and Validity of a 2-Item Screen to Identify Families at Risk for Food Insecurity. Pediatrics, 126(1), 26-32. doi:10.1542/peds.2009-3146.
Peer Reviewed Journal Articles:
Original Children’s HealthWatch validation study of the Hunger Vital Sign™ for use among families with young children (2010)
Validation study of the the Hunger Vital Sign™ for use among youth and adolescents (2015)
Validation study of the the Hunger Vital Sign™ for use among adults (2017)
Screening for Food Insecurity: Short-Term Alleviation and Long-Term Prevention (2017)
See also all selected Hunger Vital Sign materials from Children’s HealthWatch.
Creation of the Hunger Vital Sign
Origin of Hunger Vital Sign
Audio & Transcript | Summary of Key Points
Related Materials:
Introduction of the Hunger Vital Sign Tool (2010): Development & Validity of a 2-Item Screen to Identify Families at Risk for Food Insecurity
Screening Tools
Audio & Transcript | Summary of Key Points
Related Materials:
Social Determinants of Health Lexicon (Milbank Quarterly, 2019)
Integrating Social Care Into the Delivery of Health Care (NASEM, 2019)
Creating a Valid Tool
Audio & Transcript | Summary of Key Points
Related Materials:
Research on Impacts of Changing Food Assistance Policies - Food Research & Action Center, Center on Budget & Policy Priorities
Health Impacts of Food Insecurity -National Research.
Creating a Reliable Tool
Audio & Transcript | Summary of Key Points
Related Materials:
Validating Tool For Adolescents and Adults
Effects of changing HVS questions (AJPH, 2017)
Ongoing Research:
Is Hunger Vital Sign Useful?
Audio & Transcript | Summary of Key Points
Related Materials:
American Academy of Pediatrics - Policy Statement
American Academy of Family Physicians - Policy Statement
Summary of Food Insecurity Screening Recommendations - Children’s HealthWatch Organizational Brief
Validity, Reliability, Usefulness As HVS Expands
Audio & Transcript | Summary of Key Points
Related Materials:
Identifying Food Insecurity in Health Care Settings: A Review of the Evidence (SIREN, 2017)
Coding for Food Insecurity (and other societal factors) - American Hospital Association Resource Page
Universal Social Risk Screening Tools (Mathematica / CMMI, 2021)
To Scale or Not to Scale: Social Risk Screening (SIREN, 2021)
Case Studies in Hunger Vital Sign Implementation
Frequently Asked Questions About Implementing Hunger Vital Sign
Vermont Case Study: Interview with Katy Davis at Hunger Free Vermont:
Partnering with Hunger Free Vermont
Audio & Transcript | Summary of Key Points
Conversations About Food Insecurity
Audio & Transcript | Summary of Key Points
The Bigger Picture
Children’s HealthWatch publications:
The Hunger Vital Sign™ policy action brief (2014)
Cultivating Healthy Communities policy action brief (2016)
The Hunger Vital Sign™: Best practices for screening and intervening to alleviate food insecurity white paper (2016)
Case Study #1 — Hennepin County Medical Center
Case Study #2 — Boston Medical Center
Recommended Publications:
Professional Brief: Four Opportunities for Medical and Health Organizations to Address Food Insecurity
Food Is Medicine Massachusetts State Plan Case Study
Food Insecurity and Health: Overcoming Food Insecurity Through Healthcare-Based Interventions
Moving Health Care Upstream’s (MHCU) Policy Learning Lab Compendium of Research & Technical Assistance Memos
NCoP: Food Insecurity Screening, Workflow Design, Multi-Site Expansion, and County-Wide Examples
NCoP: Food Insecurity Screening, Workflow, Compliance, and Measuring Success
Children’s HealthWatch: Identification Requirements at Food Banks
Children’s HealthWatch: Implementing Food Rx Partnerships in Rural Settings
MHCU’s Policy Learning Lab Webinar slide deck and audio/slide recording
Sample toolkits for Screening:
Screen and Intervene: A Toolkit for Pediatricians to Address Food Insecurity (2021 Update) - Food Research and Action Center (FRAC) & American Academy of Pediatricians
Screen & Intervene: Older Adults - Online course offered by FRAC & AARP (2022)
Guide to Implementing Social Risk Screening & Referral (2022) - OCHIN & Kaiser Permanente
Food Insecurity Screening Toolkit (2022) - Feeding America & Humana
Using Health IT to Identify & Support Patients Experiencing Food Insecurity (2021) - HITEQ Center
See also the tools at the UCSF Social Interventions Research & Evaluation Network (SIREN) resource library and report State of the Science on Social Screening in Health Care Settings (2022)
Ongoing Research on Food Insecurity Measurement
Accountable Health Communities Model - Katherine Verlander, CMS Innovation Center
Introduction
Related Materials:
CMS Innovation Center
Audio & Transcript | Summary of Key Points
Related Materials:
Diabetes Prevention Program - Expanded Model (Medicare)
AHC First Evaluation Report (2020)
Accountable Health Communities Model
Audio & Transcript | Summary of Key Points
Related Materials:
Screening Tool Guide & Screening Tool (other languages available)
National Academy of Medicine Article on Creating the Screening Tool
State of the Science for Social Screening in Health Care Settings (SIREN, 2022)
Mathematica AHC Model Implementation Support
Health Affairs 5 Years of the AHC Model (August, 2022)
Evaluating the AHC Model
Audio & Transcript | Summary of Key Points
Related Materials:
25 Years of Food Security Measurement - Conference, April 4, 2022
The Friedman School of Nutrition Science and Policy hosted a virtual conference on food security measurement to recognize 25 years of household food security measurement. The conference featured presentations on research supported by the U.S. Department of Agriculture, in cooperation with Tufts University and the University of Missouri.
Interview with Dr. Ana Poblacion & Richard Sheward
This interview features research into the Validation of an Abbreviated Child and Adult Food Security Scale, presented as part of the April 4th conference.
Papers will appear in a special issue of the Journal of the Academy of Nutrition & Dietetics (JAND).
25 Year of Food Security Measurement - Featured Research:
“Structural Violence and Food Security: Building a Framework to Expand Research and Measurement,” Chelsea Singleton, University of Illinois at Urbana-Champaign and Tulane University
“Personal Food Security,” David Ribar, Georgia State University
“Measuring Food Insecurity in Latino Families: Expanding Understanding of their Experiences Through Exploratory Interviewing and Cognitive Testing,” Amanda McClain, San Diego State University
“Validation of an Abbreviated Child and Adult Food Security Scale (ACAFSS),” Ana Poblacion, Boston University School of Medicine
“Developing a Disaster Food Security Scale,” Lauren Clay, D’Youville College
“Validity Evidence for the Use of the USDA Adult Food Security Survey Module with American Indian and Alaska Native Adults,” Cassandra Nikolaus, Washington State University
Hunger Vital Sign National Community of Practice (NCoP)
Co-convened by Children’s HealthWatch and the Food Research & Action Center (FRAC), the NCoP works to facilitate conversations and collective action among a wide-range of stakeholders interested in addressing food insecurity through a health care lens. The overarching goal and purpose of the NCoP is to rapidly share leading best practices and data on food insecurity screening/intervention activities and strategies to scale what works.
Quarterly virtual meetings facilitate a collaborative forum and a venue where multiple stakeholders gather to disseminate research and best practices, incubate innovative ideas, and most importantly, collaborate in sub-groups to inform and influence large-scale policy and practice change resulting in evidence-based innovations to alleviate food insecurity and improve population health outcomes.
To learn more about the Hunger Vital Sign™National Community of Practice, click here.
To join the Hunger Vital Sign™National Community of Practice, please contact Charlotte.Bruce(at)bmc.org.
Using the Hunger Vital Sign Explainer Series
This Hunger Vital Sign Explainer series highlights work by Children’s HealthWatch and the Hunger Vital Sign National Community of Practice. The original series was created in 2022 to offer training resources for Vermont health care practices interested in food insecurity screening (Vermont project description here). The content is created under a creative commons license to encourage adaptation and use for educational purposes. Please credit Bi-State Primary Care Association for the original production.
Podcast Script and Narration
Interviews, script, and narration by Helen Labun (helen.labun@gmail.com) as part of the Policy in Plainer English podcast series.
Audio Editing and Post-Production Provided By Evergreen Audio
Audio editing and post-production by Evergreen Audio. Evergreen Audio is an independent production company that provides a full range of podcast production services. Find out more at their website.
Funding Source
The original Hunger Vital Sign series was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1,040,000 and as part of another award totaling $189,892; 0% is financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.