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Clay LA, Koyratty N, Rogus S, Colón-Ramos U, Hossan A, Josephson A, Neff R, Zack RM, Bliss S, Niles MT. A Mixed-Methods Approach to the Development of a Disaster Food Security Framework. J Acad Nutr Diet 2023; 123:S46-S58. [PMID: 37730306 DOI: 10.1016/j.jand.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 04/07/2023] [Accepted: 05/01/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Limited research on food systems and food insecurity (FI) following disasters finds contextual differences in post-disaster food systems that shape dimensions of FI. Measurement limitations make it difficult to address FI and develop effective practices for disaster-affected communities. OBJECTIVE To develop, validate, and test a Disaster Food Security Framework (DFSF). DESIGN Mixed-methods approach was used, including in-depth interviews to understand lived experiences during disasters; expert panel input to validate DFSF designed using responses from in-depth interviews; and quantitative testing of robustness of DFSF using the coronavirus disease 2019 pandemic as a disaster example. PARTICIPANTS AND SETTING The in-depth interviews included participants from Vermont (n = 5), North Carolina (n = 3), and Oklahoma (n = 2) who had been living in those states during Hurricane Irene (2011), Hurricane Florence (2018), the Moore tornadoes (2013), and coronavirus disease 2019 pandemic (2020). The expert panel consisted of researchers and practitioners from different US geographical regions and food-related disciplines (n = 18). For the quantitative testing survey, data from 4 US states (New York, New Mexico, Vermont, and Maryland; n = 3,228) from the National Food Access and COVID Research Team was used. MAIN OUTCOME MEASURES The outcomes from the in-depth interviews were dimensions of disaster FI, those from the expert panel was a content validity ratio, and those from the quantitative testing was the number of items and components to be included. ANALYSES PERFORMED Inductive and deductive reasoning were using when reporting on the in-depth interviews and expert panel results, including frequencies. The quantitative testing was conducted using multiple correspondence analysis. RESULTS The in-depth interviews revealed four dimensions of FI: availability (supply and donation), accessibility (economic, physical, and social), acceptability (preference and health), and agency (infrastructure and self-efficacy). The panel of experts reported high content validity for the DFSF and its dimensions (content validity ratio >0.42), thus giving higher credibility to the DFSF. Multiple correspondence analysis performed on 25 food-related variables identified one component with 13 indicators representing three of the four dimensions: availability, acceptability, and accessibility, but not agency.
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Affiliation(s)
- Lauren A Clay
- Department of Emergency Health Services, University of Maryland, Baltimore County, Baltimore, Maryland.
| | - Nadia Koyratty
- Department of Emergency Health Services, University of Maryland, Baltimore County, Baltimore, Maryland
| | - Stephanie Rogus
- Department of Family and Consumer Sciences, New Mexico State University, Las Cruces, New Mexico
| | | | - Azmal Hossan
- Department of Sociology, Colorado State University, Fort Collins, Colorado
| | - Anna Josephson
- Department of Agricultural and Economic Resources, University of Arizona, Phoenix, AZ
| | - Roni Neff
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rachel M Zack
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Sam Bliss
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, Vermont
| | - Meredith T Niles
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, Vermont
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Niles MT, Beavers AW, Clay LA, Dougan MM, Pignotti GA, Rogus S, Savoie-Roskos MR, Schattman RE, Zack RM, Acciai F, Allegro D, Belarmino EH, Bertmann F, Biehl E, Birk N, Bishop-Royse J, Bozlak C, Bradley B, Brenton BP, Buszkiewicz J, Cavaliere BN, Cho Y, Clark EM, Coakley K, Coffin-Schmitt J, Collier SM, Coombs C, Dressel A, Drewnowski A, Evans T, Feingold BJ, Fiechtner L, Fiorella KJ, Funderburk K, Gadhoke P, Gonzales-Pacheco D, Safi AG, Gu S, Hanson KL, Harley A, Harper K, Hosler AS, Ismach A, Josephson A, Laestadius L, LeBlanc H, Lewis LR, Litton MM, Martin KS, Martin S, Martinelli S, Mazzeo J, Merrill SC, Neff R, Nguyen E, Ohri-Vachaspati P, Orbe A, Otten JJ, Parmer S, Pemberton S, Qusair ZAA, Rivkina V, Robinson J, Rose CM, Sadeghzadeh S, Sivaramakrishnan B, Arroyo MT, Voorhees M, Yerxa K. A Multi-Site Analysis of the Prevalence of Food Insecurity in the United States, before and during the COVID-19 Pandemic. Curr Dev Nutr 2021; 5:nzab135. [PMID: 34934898 PMCID: PMC8677520 DOI: 10.1093/cdn/nzab135] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/21/2021] [Accepted: 10/29/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support and identify long-term impacts and needs. OBJECTIVE The National Food Access and COVID research Team (NFACT) was formed to assess food security over different US study sites throughout the pandemic, using common instruments and measurements. This study presents results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. METHODS A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA 6-item module. Food security prevalence was analyzed using ANOVA by sampling method to assess statistically significant differences. RESULTS Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, compared with before the pandemic. In nearly all study sites, there is a higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but a statistically higher prevalence of food insecurity among high-risk compared with convenience surveys. CONCLUSIONS This comprehensive study demonstrates a higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to the survey implementation method.
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Affiliation(s)
- Meredith T Niles
- Department of Nutrition and Food Sciences, Gund Institute for Environment, University of Vermont, Burlington, VT
| | - Alyssa W Beavers
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI
| | - Lauren A Clay
- Health Administration & Public Health Department, D'Youville College, Buffalo, NY
| | - Marcelle M Dougan
- Department of Public Health and Recreation, San José State University, San José, CA
| | - Giselle A Pignotti
- Department of Nutrition, Food Science, and Packaging, San José State University, San José, CA
| | - Stephanie Rogus
- Department of Family and Consumer Sciences, New Mexico State University, Las Cruces, NM
| | | | | | - Rachel M Zack
- Business and Data Analytics, The Greater Boston Food Bank, Boston, MA
| | - Francesco Acciai
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | - Deanne Allegro
- Department of Kinesiology, Auburn University at Montgomery, Montgomery, AL
| | - Emily H Belarmino
- Department of Nutrition and Food Sciences, Gund Institute for Environment, University of Vermont,
Burlington, VT
| | - Farryl Bertmann
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, VT
| | - Erin Biehl
- Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore, MD
| | - Nick Birk
- Business and Data Analytics, The Greater Boston Food Bank, Boston, MA
| | - Jessica Bishop-Royse
- Faculty Scholarship Collaborative, College of Liberal Arts and Social Sciences, DePaul University, Chicago, IL
| | - Christine Bozlak
- Health Policy, Management, and Behavior, University at Albany- State University of New York, Rensselaer, NY
| | - Brianna Bradley
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | | | | | - Brittney N Cavaliere
- Institute for Hunger Research & Solutions, Connecticut Food Bank/Foodshare, Bloomfield, CT
| | - Young Cho
- Joseph J Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Eric M Clark
- Department of Plant and Soil Science, University of Vermont, Burlington, VT
| | - Kathryn Coakley
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM
| | | | - Sarah M Collier
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
| | - Casey Coombs
- Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT
| | - Anne Dressel
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Adam Drewnowski
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Tom Evans
- School of Geography, Development and Environment, University of Arizona, Tucson, AZ
| | - Beth J Feingold
- Department of Environmental Health Sciences, University at Albany- State University of New York, Rensselaer, NY
| | - Lauren Fiechtner
- Department of Gastroenterology and Nutrition, MassGeneral Hospital for Children, Boston, MA
| | - Kathryn J Fiorella
- Department of Population Medicine and Diagnostic Sciences and Master of Public Health Program, Cornell University, Ithaca, NY
| | - Katie Funderburk
- Alabama Cooperative Extension System, Auburn University, Auburn, AL
| | - Preety Gadhoke
- Department of Pharmacy Administration and Public Health, College of Pharmacy and Health Sciences, St. John's University (at the time of study administration),
Jamaica, NY
| | - Diana Gonzales-Pacheco
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM
| | - Amelia Greiner Safi
- Department of Population Medicine and Diagnostic Sciences and Master of Public Health Program, Cornell University, Ithaca, NY
| | - Sen Gu
- Department of Pharmacy Administration and Public Health, College of Pharmacy and Health Sciences, St. John's University (at the time of study administration),
Jamaica, NY
| | - Karla L Hanson
- Department of Population Medicine and Diagnostic Sciences and Master of Public Health Program, Cornell University, Ithaca, NY
| | - Amy Harley
- Joseph J Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Kaitlyn Harper
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Akiko S Hosler
- Department of Epidemiology and Biostatistics, University at Albany- State University of New York, Rensselaer, NY
| | - Alan Ismach
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
| | - Anna Josephson
- Department of Agricultural and Resource Economics, University of Arizona, Tucson, AZ
| | - Linnea Laestadius
- Joseph J Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Heidi LeBlanc
- Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT
| | - Laura R Lewis
- Community and Economic Development, Washington State University, Port Hadlock, WA
| | - Michelle M Litton
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI
| | - Katie S Martin
- Institute for Hunger Research & Solutions, Connecticut Food Bank/Foodshare, Bloomfield, CT
| | - Shadai Martin
- Department of Family and Consumer Sciences, New Mexico State University, Las Cruces, NM
| | - Sarah Martinelli
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | - John Mazzeo
- Master of Public Health Program, College of Liberal Arts and Social Sciences, DePaul University, Chicago, IL
| | - Scott C Merrill
- Department of Plant and Soil Science, Gund Institute for Environment, University of Vermont, Burlington, VT
| | - Roni Neff
- Department of Environmental Health & Engineering, Bloomberg School of Public Health; Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore, MD
| | - Esther Nguyen
- Center for Public Health Nutrition, University of Washington, Seattle, WA
| | | | - Abigail Orbe
- Institute for Hunger Research & Solutions, Connecticut Food Bank/Foodshare, Bloomfield, CT
| | - Jennifer J Otten
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
| | - Sondra Parmer
- Alabama Cooperative Extension System, Auburn University, Auburn, AL
| | | | - Zain Al Abdeen Qusair
- Master of Public Health Program, College of Liberal Arts and Social Sciences, DePaul University, Chicago, IL
| | - Victoria Rivkina
- Master of Public Health Program, College of Liberal Arts and Social Sciences, DePaul University, Chicago, IL
| | - Joelle Robinson
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Chelsea M Rose
- Department of Epidemiology, University of Washington, Seattle, WA
| | | | | | - Mariana Torres Arroyo
- Department of Environmental Health Sciences, University at Albany- State University of New York, Rensselaer, NY
| | - McKenna Voorhees
- Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT
| | - Kathryn Yerxa
- Cooperative Extension, University of Maine, Orono, ME
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