The core food security module scale measure is valid and reliable when used with Asians and Pacific Islanders

Reliability and validity of a short form household food security scale in a Caribbean community

BACKGROUND

We evaluated the reliability and validity of the short form household food security scale in a different setting from the one in which it was developed.

METHODS

The scale was interview administered to 531 subjects from 286 households in north central Trinidad in Trinidad and Tobago, West Indies. We evaluated the six items by fitting item response theory models to estimate item thresholds, estimating agreement among respondents in the same households and estimating the slope index of income-related inequality (SII) after adjusting for age, sex and ethnicity.

RESULTS

Item-score correlations ranged from 0.52 to 0.79 and Cronbach's alpha was 0.87. Item responses gave within-household correlation coefficients ranging from 0.70 to 0.78. Estimated item thresholds (standard errors) from the Rasch model ranged from -2.027 (0.063) for the 'balanced meal' item to 2.251 (0.116) for the 'hungry' item. The 'balanced meal' item had the lowest threshold in each ethnic group even though there was evidence of differential functioning for this item by ethnicity. Relative thresholds of other items were generally consistent with US data. Estimation of the SII, comparing those at the bottom with those at the top of the income scale, gave relative odds for an affirmative response of 3.77 (95% confidence interval 1.40 to 10.2) for the lowest severity item, and 20.8 (2.67 to 162.5) for highest severity item. Food insecurity was associated with reduced consumption of green vegetables after additionally adjusting for income and education (0.52, 0.28 to 0.96).

CONCLUSIONS

The household food security scale gives reliable and valid responses in this setting. Differing relative item thresholds compared with US data do not require alteration to the cut-points for classification of 'food insecurity without hunger' or 'food insecurity with hunger'. The data provide further evidence that re-evaluation of the 'balanced meal' item is required.

Public versus private food assistance: barriers to participation differ by age and ethnicity

OBJECTIVE

To examine participation in the Food Stamp Program, food pantries, and soup kitchens and to identify reasons food-insecure households choose not to participate.

DESIGN

Cross-sectional retrospective cohort study.

SETTING

In respondents' homes.

PARTICIPANTS

330 randomly selected low-income households (below 185% of poverty).

MAIN OUTCOME MEASURES

Participation in any of 3 public or private food assistance programs and barriers to participation in each program.

ANALYSIS

Chi-square tests of association between program participation and sociodemographic characteristics. Logistic regression tested for associations between program participation and ethnicity and between food security status and household composition while controlling for potential confounding factors.

RESULTS

Controlling for socioeconomic status, Black households are less than half as likely to receive food stamps (odds ratio [OR] = 0.49; P <.02) as Hispanic households. Hispanic households are more likely than non-Hispanic households to say that they feel uncomfortable using food pantries (P <.01). Elderly households are less than half as likely to receive food stamps (OR = 0.44; P =.04) as nonelderly households and are more likely to say that they feel uncomfortable receiving food stamps (P =.05).

CONCLUSIONS AND IMPLICATIONS

Low-income households' perceptions of which programs are socially acceptable differ by race and age. Outreach for food stamps and private food assistance should accommodate these differences so that food-insecure households can benefit from all available food assistance.

Measures of food insecurity/security

ABSTRACT Nutrition education has the potential to play an important role in ensuring food security and improving nutritional status. Therefore, food security is recommended for inclusion in nutrition education evaluation efforts. Considerable progress has been made in developing brief tools that can be used to measure food security at the household level. These tools are reliable in population-based surveys, and some studies have found that measures of food security are associated with nutrient intake. Hence, these tools can be valuable in monitoring, in community needs assessment, and in planning. These tools may also have the potential for use in evaluating nutrition education activities; this potential will be enhanced by research into the capacity of these tools to identify changes within households over time as a result of nutrition education and their sensitivity and reliability in doing so.

An evaluation of the U.S. Department of Agriculture food security measure with generalized linear mixed models

Over the last decade, new information has been developed and collected to measure the extent of food insecurity and hunger in the United States. Common measurement of the phenomenon of hunger and food insecurity has become possible through efforts of the U.S. Department of Agriculture (USDA) to develop a set of survey questions that can be used to obtain estimates of the prevalence and severity of food insecurity. We evaluated the measurement of food insecurity and the effect of household variables on measured food insecurity. The effects of demographic and survey-specific variables on the food insecurity/hunger scale were evaluated using a generalized linear model with mixed effects. Data came from the 1995, 1997 and 1999 Food Security Module of the Current Population Survey. The results generally validated the model currently used by the USDA. In addition, our approach made it possible to consider the effect of demographics and several survey design variables on food security among measurably food-insecure households, as well as interactions between these factors and the food security questions. The analysis of the expanded model with the 1995 data found results similar to those reported based on the Rasch model used by the USDA. Even though the sample size was reduced and a number of screening and questionnaire changes were introduced in 1997 and 1999, the results for those years appear mostly unchanged and confirm the robustness of the scale in measuring food insecurity. There is some evidence that interpretation of questions may vary among different demographic groups.

Food security stakeholders in Hawaii: perceptions of food security monitoring

OBJECTIVE

The purpose of this study was to document Hawai'i's food security stakeholders' perceptions of (1) definitions of food insecurity and hunger, (2) what should be measured, (3) how stakeholders interpret the Core Food Security Module (CFSM) and Face Valid Food Security Measure (FVFSM), and (4) the value of specific items in the CFSM.

DESIGN

Perceptions were gathered through focus groups and interviews.

SUBJECTS

The 43 stakeholders included 19 WIC nutritionists, 10 food pantry providers, 4 Hawaii foodbank board members, 4 social workers, 3 legislators, and 3 homeless food providers. ANALYSIS PERFORMED: Transcripts were analyzed using constant comparative analysis of each question asked, comparisons between groups, and comparisons with the research literature.

RESULTS

Stakeholders desired more detailed information than the CFSM currently yields and also a simple tool to measure the entire range of food insecurity that could be used to "help the needy." Participants favored the FVFSM over the CFSM because "it is more accurate as far as seeing the picture properly."

IMPLICATIONS

A "Simple Food Security Monitoring Tool," which is based on the FVFSM, was created as an alternative tool for local food security monitoring.

Interpretations of the "balanced meal" household food security indicator

The study objective was to quantify interpretations of the term "balanced meals" used in food security status assessments. Telephone interviews included 77 charitable food recipients in Hawaiì. After participants first responded to the question of whether they could afford to eat balanced meals, they next defined what a "balanced meal" meant. Qualitative responses were categorized into common themes. Forty-one (53%) indicated that a balanced meal consisted of at least three food groups.Thirty-one (40%) indicated something other than three food groups; five (6%) had no idea what a "balanced meal" meant. The findings question the validity and reliability of responses to "balanced meal" food security indicators in Hawaiì.

An assessment of various household food security measures in Hawaiì has implications for national food security research and monitoring

The Core Food Security Module (CFSM), the national food security monitoring tool, requires three affirmative responses to categorize households as food insecure. If this tool is unreliable or inaccurate, vulnerable segments of our population may be adversely affected. The objectives of the present study were to assess the credibility of applying the CFSM categorical measure to a population sample from Hawaiì and to assess the concurrent validity of the CFSM, the new face-valid measure and measures adapted from the Radimer/Cornell (RC) measure and Community Childhood Hunger Identification Project. The sample included 1469 respondents gathered through a statewide telephone sample and 144 food pantry recipients. Responses to the 18 CFSM questions were used to create all four measures. The credibility of the CFSM categorical measure was also assessed via comparisons with individual items and with the 1995 national modal CFSM response pattern. Categorical measures were compared across food security prevalence estimates and indices of income and vegetable intake and with the CFSM scale measure. Differences in the modal response pattern between samples affected CFSM categorization. Only 36% of households followed the Hawaiì modal response pattern, and categorization was not consistent with the content of key items. Although 85% of the households were classified as food secure by the CFSM, only 78% were classified as food secure with each of the other food security measures. Concurrent validity of all measures was confirmed. A reassessment of the national CFSM categorical measure appears warranted.