Date of Award

January 2020

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Jane K. Dixon


There is vast literature indicating associations of food insecurity with concerning health outcomes, and clinic and community settings now regularly partner to address food insecurity as it is assessed. However, there is scarce health terminology to use in the care of patients experiencing food insecurity. This presents challenges as clinicians seek to define food insecurity as a risk for their patients, order interventions to address it, and study the effect of interventions in individual and population settings. Furthermore, there is no published food insecurity diagnostic criteria to employ as clinicians listen to the histories of their patients and try to support them in being well. This project endeavored to complete three aims: apply for ICD-10-CM terminology for food insecurity and related health concerns, apply for SNOMED CT terminology for key interventions, and forge initial considerations for a food insecurity diagnostic criteria. The author initially proceeded independently, but their efforts soon became embedded in the national consensus social determinant of health (SDOH) data initiative, the Gravity Project. The author served as one of two food insecurity subject matter experts. The Gravity Project worked collaboratively with data standard organizations to identify a comprehensive data set of 24 screening tools, six goals of care, eight diagnoses, and 109 interventions. In tandem, the author worked with key national content experts to develop diagnostic criteria considerations and a pathway for criteria development.


This is an Open Access Thesis.

Open Access

This Article is Open Access