{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:03:57Z","timestamp":1783537437492,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Food insecurity (FI) affects more than 18 million households in the United States. Children with celiac disease (CeD) depend exclusively on the gluten\u2010free diet, yet gaps persist in screening for food\u2010insecure households who could benefit from interventions. We developed a system to identify and address barriers to FI screening in a pediatric clinic for CeD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the Model for Improvement, we conducted quality initiatives for eligible households between January 1, 2024 and January 31, 2025. We surveyed the medical team to identify barriers to FI screening and designed a key driver diagram to inform plan\u2010do\u2010study\u2010act cycles. We implemented a (1) validated screening form, (2) clinic flowsheet, (3) educational module, and (4) visual aid in the electronic health records. We measured the process of FI screening and documentation. We tracked outcomes on positive screens for general and gluten\u2010free FI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 100 eligible children, the majority were female (63.0%), other race (55.0%), non\u2010Hispanic (66.0%), and primary English\u2010speakers (80.0%); and 66 received FI screening (66.0%). We identified top team\u2010reported barriers to FI screening: language barriers, lack of FI resources, forgetting, and discomfort with asking questions. Applying the model for Improvement, we improved median FI screening from 0.0% to \u226575.0% within 12 months and sustained screening rates for \u22656 months. The average general and gluten\u2010free FI among screened households was 19.7% and 14.8%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We implemented a systematic framework to address team\u2010reported barriers, helping to increase FI screening for children with CeD. Developing interventions to address FI may improve poor outcomes among food\u2010insecure households.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpn3.70169","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T09:05:08Z","timestamp":1753088708000},"page":"1060-1069","source":"Crossref","is-referenced-by-count":2,"title":["Enhancing food insecurity screening in pediatric celiac disease using a quality improvement framework"],"prefix":"10.1002","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5293-3521","authenticated-orcid":false,"given":"Telly","family":"Cheung","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mala","family":"Setty","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Riray","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharad I.","family":"Wadhwani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namrata","family":"Patel\u2010Sanchez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California, San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"1","article-title":"Household Food Security in the United States in 2023 (report no. 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