Author affiliations Alicia Cohen is a Research Scientist; James Rudolph is Director; Kali Thomas is a Research Health Science Specialist; Elizabeth Archambault is a Social Worker; David Dosa is Associate Director; all at the VA Health Services Research & Development Center of Innovation in Long Term Services and Supports at the Providence VA Medical Center in Rhode Island; Thomas O’Toole is Senior Medical Advisor, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration in Washington, DC. Megan Bowman is Assistant Chief, Nutrition and Food Services at VA Salt Lake City Health Care System in Utah. Christine Going is Executive Assistant, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration. Michele Heisler is a Research Scientist at the Center for Clinical Management Research, Ann Arbor VA Medical Center in Michigan. Alicia Cohen is an Assistant Professor of Family Medicine and Health Services, Policy and Practice; James Rudolph is Professor of Medicine and Health Services, Policy and Practice; Kali Thomas is an Associate Professor of Health Services, Policy, and Practice; David Dosa is an Associate Professor of Medicine and Health Services, Policy and Practice; Thomas O’Toole is a Professor of Medicine; all at the Warren Alpert Medical School of Brown University and Brown University School of Public Health in Providence, Rhode Island. Michele Heisler is a Professor of Internal Medicine and Health Behavior and Health Education at the University of Michigan Medical School and School of Public Health. Megan Bowman and Christine Going are Co- Chairs, and Alicia Cohen, Kali Thomas, and Thomas O’Toole are members of the Ensuring Veteran Food Security Workgroup. Correspondence: Alicia Cohen (alicia.cohen@va.gov)
Author disclosures Alicia Cohen was supported by an Advanced Health Services Research and Development (HSR&D) postdoctoral fellowship through the VA Office of Academic Affairs. James Rudolph and David Dosa were supported by the VA HSR&D Center of Innovation in Long Term Services and Supports (CIN 13‐419). Kali Thomas was supported by a VA HSR&D Career Development Award (CDA 14-422). Michele Heisler was supported by Grant Number P30DK092926 (MCDTR) from the National Institute of Diabetes and Digestive and Kidney Diseases.
Disclaimer The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the US Government, or any of its agencies.
Although resources vary by regional setting, several key governmental and community-based food assistance programs are summarized in Table 2. Local community partners and online/phone-based directories, such as United Way’s 2-1-1 can help identify additional local resources. For older adults and individuals with disabilities, local Aging and Disability Resources Centers can provide information and assistance connecting to needed resources.69 Finally, there are a number of online resources available for clinicians interested in learning more about the impact of food insecurity on health and tools to use in the clinical setting (Table 3).
Conclusion
The VA has recognized food insecurity as a critical concern for the well-being of our nation’s veterans. Use of the EHR clinical reminder represents a crucial first step toward increasing provider awareness about veteran food insecurity and improving clinical efforts to address food insecurity once identified. Through the reminder, health care teams can connect veterans to needed resources and create both the individual and population-level data necessary to inform VHA and community efforts to address veteran food insecurity. Clinical reminder data are currently being used for local quality improvement efforts and have established the need nationally for formalized partnerships between VHA Social Work Services and Nutrition and Food Services to connect veterans with food and provide them with strategies to best use available food resources.
Moving forward, the Ensuring Veteran Food Security Workgroup continues to work with agencies and organizations across the country to improve food insecure veterans’ access to needed services. In addition to existing VA partnerships with Feeding America for the VPP, memorandums of understanding are currently underway to formalize partnerships with both the Food Research and Action Center (FRAC) and MAZON. Additional research is needed both to formally validate the current food insecurity clinical reminder screening question and to identify best practices and potential models for how to most effectively use VHA-community partnerships to address the unique needs of the veteran population.
Ensuring the food security of our nation’s veterans is essential to VA’s commitment to providing integrated, veteran-centered, whole person care. Toward that goal, VA health care teams are urged to use the clinical reminder and help connect food insecure veterans with relevant resources both within and outside of the VA health care system.
