Nutrition Month - PEN® eNews 16(3) March 2026

Using Screening Tools to Identify Clients with Financial Constraints: What are Best Practices?

What are the best practices when using screening tools to identify clients with financial constraints accessing health care services (in a health care setting)? What are the facilitators and barriers to using screening tools in a healthcare setting?

When screening a patient / client for food insecurity (FI), clinicians may consider the following:

• disclosing immediately the purpose of screening,
• using private screening methods (e.g. non-verbal form rather than a verbal interview),
• screening in the absence of children,
• being aware that patients/ clients may have negative feelings associated with FI, and
• making FI screening universal and routine.

FI screening may be facilitated by the following factors:

• using non-judgemental communication techniques,
• building a trusting relationship,
• expanding screening to more clinic locations,
• increasing the number of visits where screening occurs
• having clinic assistants do screening and having team-based staffing models, and
• leveraging community partnerships.

The following barriers may hinder FI screening:

• lack of privacy and physical space,
• families having concerns/fear of stigmatization and child protection services
• referrals and feelings of shame/guilt,
• providers having concerns about how to act upon a positive screen due to lack of knowledge on how to assist,
• inappropriateness of completing FI screening at emergency/specialty visits,
• limited clinician capacity/time, and
• inconsistent access to FI screening (e.g. once a year) when programs are facilitated through Electronic Medical Record (EMR) programs.

Remarks

Universal screening is a key part of the recommendation because it reduces stigmatization. It is ideal that the provider communicates with the client that the purpose of screening for food insecurity is to adjust recommendations to an individual's unique needs and experiences for better care. To understand how to prevent harm when having these conversations, see Additional Content: Household Food Insecurity Background and What tools are recommended to screen for financial constraints to determine the risk of household food insecurity in individuals accessing health care services?

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