Screening for Adolescent Eating Disorders in a School-Based Health Center using the SCOFF Questionnaire

Abstract

Adolescent eating disorders are increasingly prevalent in the United States. Six percent of all teenagers suffer from eating disorders, which are correlated with a myriad of economic, psychological, as well as healthcare ramifications. Literature reveals there is a lack of screening recommendations, as well as a lack of a single, comprehensive tool that identifies distorted patterns and behaviors of eating for advanced practice nurses within the primary care setting. Therefore, this quality improvement project implemented routine screening using the SCOFF questionnaire to evaluate for the presence of altered eating habits in adolescents seeking care in a school-based health center that had insufficient screening practices. Early detection is essential to prevent complications and improve overall healthcare, particularly in those lacking access to primary care services. Using Leavell and Clark’s mode of prevention as the theoretical framework, this project occurred in three phases. First, an educational meeting with all key stakeholders was conducted during phase one. In phase two, all assenting adolescents seen at the school-based health center during a twelve-week period were screened. Any students who screened positive were referred for additional resources. Data analysis using descriptive statistics occurred in phase three, where data demonstrated that the prevalence of altered eating patterns suggestive of an eating disorder, among underserved adolescents, is significantly higher than the postulated national average. While difficult to know if this data is reproducible, data highlights the ability of the SCOFF questionnaire to detect concerning patterns of eating. Given that, advanced practice nurses in the primary care setting can rely on a single, brief screening tool to evaluate for the presence of concerning dietary habits in adolescents. Keywords: anorexia, bulimia, binge eating disorder, screening, school-based health center, primary care, SCOFF questionnaire