Article Text
Abstract
Background Food insecurity is a determinant of health that undermines the physical and mental wellbeing of individuals across all life stages. Given the importance of the preconception and antenatal period in positively shaping the health course, there is a public health imperative for clinicians to screen for food insecurity in women of childbearing age and during pregnancy. However, the procedures used in reproductive healthcare settings to identify women experiencing food insecurity have not been summarised. This review sought to synthesise evidence from published studies that describe the procedures implemented by clinicians in healthcare settings to identify food insecurity in pregnant women, or women of reproductive age (15–49 years).
Methods Four databases (Medline Complete, CINAHL, Global Health, Embase) were searched in April 2022 to identify eligible studies. Studies that used tools that were both validated or newly developed and incorporated food insecurity screening as part of a multidomain screening too were included. Studies were excluded if their primary aim was to report prevalence on food insecurity only. Two authors conducted the screening, data extraction, and quality assessment independently. Study quality was determined using the Joanna Briggs Institute Critical Appraisal Checklists.
Results 1075 studies were identified, and after screening at multiple levels, seven studies were included in the review. All studies were conducted in the USA and comprised of women who were pregnant or in the postpartum period; no studies included women in the preconception stage. Four screening tools were identified; two- and six-item tools specifically focused on food insecurity, and a 58-item multidomain tool incorporating four food insecurity items. Methods to implement screening varied across studies. Two studies explored patient or clinician acceptance of screening, and three papers described subsequent processes that supported food-insecure patients once identified.
Conclusion Few published studies have investigated optimal screening tools and their implementation within reproductive health care settings to address food insecurity for this priority population group. Further research is required to determine preferable screening methods from the perspectives of patients and clinicians, and appropriate supports for this priority population group once food insecurity is identified.