Evidence map›Paper›PMID 42321957›Full record

ArticleImplementation science communications2026

Roll-Out Implementation Optimization (ROIO) trial to develop and test the implementation of a food security screening and referral process: a study protocol.

Kyung E Rhee, Sarah Hiller-Venegas, Clare Viglione, Michelle A Polich, Jeannie S Huang, Jane J Kim, Mandeep S Bajwa, Michelle Zive, Dawn M Eichen, David R Strong and 2 more

Registry-linked trialAbstract read
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In one paragraph

Article in Implementation science communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06661538 (Addressing Food Insecurity in the Health Care Setting to Promote Health Equity), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06661538 phase2recruitingnot on this map

Addressing Food Insecurity in the Health Care Setting to Promote Health Equity

TypeinterventionalSponsorUniversity of California, San DiegoRan2025 to 2028Enrolled600ConditionsFood InsecurityArmsFood Security Screening & Referral Program
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kyung E RheeDepartment of Pediatrics, University of California San Diego, La Jolla, CA, USA. K1rhee@health.ucsd.edu.
Sarah Hiller-VenegasHerbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA.
Clare ViglioneHerbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA.
Michelle A PolichDepartment of Pediatrics, University of California San Diego, La Jolla, CA, USA.
Jeannie S HuangDepartment of Pediatrics, University of California San Diego, La Jolla, CA, USA.
Jane J KimDepartment of Pediatrics, University of California San Diego, La Jolla, CA, USA.
Mandeep S BajwaDepartment of Pediatrics, University of California San Diego, La Jolla, CA, USA.
Michelle ZiveDepartment of Pediatrics, University of California San Diego, La Jolla, CA, USA.
Dawn M EichenDepartment of Pediatrics, University of California San Diego, La Jolla, CA, USA.
David R StrongHerbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA.
Nicole A Stadnick *Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Lauren Brookman-Frazee *Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.

Funding

Addressing Food Insecurity in the Health Care Setting to Promote Health EquityR01DK140573 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Kyung E Rhee · 2024 to 2026
$1.4M
NIDDK NIH HHS R01 DK140573
6 · The paper itself

Abstract

backgroundFood insecurity (FI) is associated with poorer physical and mental health outcomes, exacerbation of chronic diseases, and decreased access to healthcare. Children experiencing FI face additional risks, including lower psychosocial functioning and reduced academic achievement. Although national initiatives call for integrating nutrition support services into healthcare, clinical workflows for FI screening and referral remain inconsistently implemented and difficult to sustain. The goal of this study is to refine, adapt, and optimize a comprehensive FI screening and referral program, and identify effective implementation strategies for pediatric healthcare systems.

methodsWe will use a RollOut Implementation and Optimization (ROIO) trial design to iteratively implement and refine the implementation strategies for our FI screening and referral program (I-FRESH: Implementing Food Referrals for Equity and Sustained Health) across 4 pediatric clinics. I-FRESH includes: (1) FI screening; (2) assessment of family needs and readiness to access services; (3) referral and navigation support to community nutrition programs; and (4) follow-up to assess fit, utilization, and ongoing needs. The Pragmatic, Robust Implementation and Sustainability Model (PRISM) will guide adaptation and evaluation of contextual determinants, while RE-AIM will guide assessment of outcomes (implementation feasibility and acceptability, fidelity, adoption, reach, effectiveness, and maintenance). We will identify several implementation strategies to increase the likelihood that I-FRESH can be successfully implemented and sustained in a pediatric healthcare system. We will enroll 240 participants and assess preliminary effectiveness on family‑level food security and pediatric nutrition‑related health outcomes (e.g. weight status, blood pressure, lipids, HbA1c, liver function tests). The information gathered in this trial will be utilized in the development of a fully powered Type 2 Hybrid Effectiveness-Implementation Trial that will test the effectiveness of the identified implementation strategies and impact of the FI program on clinical outcomes. DISCUSSION: By integrating PRISM and RE-AIM within an iterative ROIO design, this study will generate a scalable, contextresponsive implementation model for addressing FI in pediatric healthcare settings. Findings will inform sustainable strategies that link families to highquality nutrition support programs and improve nutritionrelated health outcomes for lowincome children.

trial registrationNCT06661538.

Indexed as

Food insecurityNutrition insecurityPediatricsPRISMRE-AIMRoll-Out Implementation and Optimization (ROIO) trial

Identifiers

PMID42321957
PMCPMC13528015

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.