ArticleBMC public health2022
An embedded multiple case study: using CFIR to map clinical food security screening constructs for the development of primary care practice guidelines.
Article in BMC public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- The Paradoxes of Social Care: Reframing Apparent Conflicts.Annals of family medicine · 2026Pooled it
- Food Insecurity Screening and Intervention Strategies in Pediatric Primary Care Practices: A Mixed Methods Study.Academic pediatrics · 2026Article
- Evaluating the use of the consolidated framework for implementation research in primary care settings: a systematic review.Implementation science communications · 2026Review
- Implementation science in nutrition practice: A review of the Consolidated Framework for Implementation Research.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2025Review
- Article
- Using concept mapping to co-create implementation strategies to address maternal-child food insecurity during the first 1000 days of life.Maternal & child nutrition · 2025Article
- Food Insecurity Screening in High-Income Countries, Tool Validity, and Implementation: A Scoping Review.Nutrients · 2024Article
- Characteristics of hospital and health system initiatives to address social determinants of health in the United States: a scoping review of the peer-reviewed literature.Frontiers in public health · 2024Article
- A global scoping review of adaptations in nurturing care interventions during the COVID-19 pandemic.Frontiers in public health · 2024Article
- Gaining stakeholder perspectives to shape a produce prescription program to improve maternal and birth outcomes: a qualitative study.Frontiers in public health · 2024Article
- Looking Back, Looking Forward: A Study Protocol for a Mixed-Methods Multiple-Case Study to Examine Improvement Sustainability of Large-Scale Initiatives in Tertiary Hospitals.Healthcare (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFood insecurity (FI), the limited access to healthy food to live an active and healthy life, is a social determinant of health linked to poor dietary health and difficulty with disease management in the United States (U.S.). Healthcare experts support the adoption of validated screening tools within primary care practice to identify and connect FI patients to healthy and affordable food resources. Yet, a lack of standard practices limits uptake. The purpose of this study was to understand program processes and outcomes of primary care focused FI screening initiatives that may guide wide-scale program implementation.
methodsThis was an embedded multiple case study of two primary care-focused initiatives implemented in two diverse health systems in Chicago and Suburban Cook County that routinely screened patients for FI and referred them to onsite food assistance programs. The Consolidated Framework for Implementation Research and an iterative process were used to collect/analyze qualitative data through semi-structured interviews with N = 19 healthcare staff. Intended program activities, outcomes, actors, implementation barriers/facilitators and overarching implementation themes were identified as a part of a cross-case analysis.
resultsPrograms outcomes included: the number of patients screened, identified as FI and that participated in the onsite food assistance program. Study participants reported limited internal resources as implementation barriers for program activities. The implementation climate that leveraged the strength of community collaborations and aligned internal, implementation climate were critical facilitators that contributed to the flexibility of program activities that were tailored to fill gaps in resources and meet patient and clinician needs.
conclusionHighly adaptable programs and the healthcare context enhanced implementation feasibility across settings. These characteristics can support program uptake in other settings, but should be used with caution to preserve program fidelity. A foundational model for the development and testing of standard clinical practice was the product of this study.
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