Implementing Nutrition Security Screening in Clinical Settings:

What are the eligibility criteria for this grant?

To be eligible, applying organizations must be: 1) either a government, non-federal; government, federal; or non-government, not-for-profit healthcare site; 2) provide inpatients or outpatients with health-related treatments from healthcare providers (e.g., doctors, physician assistants, nurse practitioners, etc.); 3) willing to screen for both food and nutrition insecurity and modify existing HRSN screening (if applicable); and 4) willing to use the two-item food security screener commonly referred to as the Hunger Vital Sign and an adapted version of the one-item CNHI Brief Nutrition Security Screener as part of HRSN screening. CNHI and the expert co-design group will work with funded clinical sites to ensure that adapted screening and referral systems still contribute to funded clinical sites meeting quality metrics related to HRSN screening and that any modifications will not impact validity of existing tools.

Preference for clinical sites with existing HRSN screening in place and working with a high percentage of patients at risk of diet-related chronic disease.

What is the duration of the project?

This is an 18-month project (October 2024-March 2026).

What is the funding level and types of support provided during the grant period?

Two selected clinical partner sites will receive a total cost of $25,000 in funding to support their role in assisting with developing, piloting, and assessing a screen and refer protocol for nutrition security screening. See the application for ways CNHI plans to support and collaborate with the clinical sites for conducting this project.

What does the clinical site budget need to include?

The budget for the clinical sites should include staff time for a person to coordinate activities (e.g., work with leadership for approvals, connect with IT to modify screening questions, collaborate with analyst to conduct basic analyses of clinical data); assist CNHI to recruit interviewees and survey respondents; and perform basic analyses of clinical data. The $25,000 does not need to include expenses for travel or incentives (e.g., gift cards), as these expenses will be covered. The maximum award amount is $25,000 and any indirect costs must be included.

How many grants will be awarded?

Two clinical partner sites will be awarded.

Can I submit more than one letter of support from the healthcare clinic and one letter of support from a referral site?

While the online submission form allows you to submit one letter of support from the healthcare clinic and one letter of support from the referral site, you are welcome to send additional letters of support to be reviewed with your application to Shelly at spalmer@centerfornutrition.org. Additional letters of support are completely optional.

How can I ask questions about this grant opportunity?

The research team will host virtual office hours to answer questions about applying for the grant opportunity. Please visit the website to register to attend the office hours.

• August 5 from 1-2 p.m. CT
• August 8 from 10-11 a.m. CT
• August 23 from 11-12 p.m. CT
• August 27 from 2-3 p.m. CT

If you have further questions, please contact Shelly Palmer at spalmer@centerfornutrition.org with additional questions.

Will I be asked to modify my food security screening, or other health-related social needs, in a way that negatively impacts compliance or measurement validity?

No.

Do I have to have a closed loop referral system?

It is likely that this will be needed as part of piloting to fully evaluate the processes of integrating nutrition security referrals into social needs screening and referral systems.

Will I be required to refer patients who screen positive for nutrition insecurity to an external community partner?

No, patients could be referred to internal programs or services as long as they are adequate.

Will I be required to share personally identifiable information outside of my organization?

Ideally, any clinical data analyses will be performed by the awarded organization, in-house, to avoid the need to share health information externally (e.g., to assess the association between screening status and biometrics data such as A1c values). To conduct interviews with patients and to survey patients, patients will need to provide informed consent and supply their contact information. CNHI will ensure all data collection procedures and analyses are reviewed and approved by the University of Nebraska Medical Center IRB.

Do I have to have in-house clinical data analysis capacity?

Ideally, yes, although CNHI can support this activity if needed for sites without capacity or bandwidth.

Am I allowed to sub-contract to support partners work on the project?

Yes, sub-contracts to partners are permitted within the scope and amount of the awarded funds. Sub-contract partners’ time should be no more than 50% of the overall contributed time.

Am I allowed to charge indirect costs?

Grant awards are $25,000 for each selected site. Any indirect costs should be included.

What reporting requirements will I have?

CNHI will lead the outlining and drafting of reports and manuscripts from this work. Awarded organizations will provide input to these deliverables and can serve as co-authors if desired and if willing to meet standard requirements of co-authorship (e.g., contribute to the manuscript vision, writing, reviewing, etc.). All awarded organizations will provide a financial report to detail how grant funds were spent.