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Frank M, Daniel L, Hays CN, Shanahan ME, Naumann RB, McNaughton Reyes HL, Austin AE. Association of Food Insecurity With Multiple Forms of Interpersonal and Self-Directed Violence: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:828-845. [PMID: 37009984 PMCID: PMC10666476 DOI: 10.1177/15248380231165689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Economic stress, broadly defined, is associated with an increased likelihood of multiple forms of violence. Food insecurity is a distinct economic stressor and material hardship that is amenable to programmatic and policy intervention. To inform intervention and identify gaps in the current evidence base, we conducted a systematic review to synthesize and critically evaluate the existing literature regarding the association between food insecurity and five forms of interpersonal and self-directed violence: intimate partner violence (IPV), suicidality, peer violence and bullying, youth dating violence, and child maltreatment, in high-income countries. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and searched six electronic databases from their start date through February of 2022. We included studies that examined food insecurity as the exposure and an outcome measure of IPV, suicide, suicidality, peer violence, bullying, youth dating violence, or child maltreatment; were peer-reviewed and published in English; reported quantitative data; and took place in a high-income country. We identified 20 relevant studies. Nineteen studies found that food insecurity was associated with an increased likelihood of these forms of violence. Results highlight the potential for programs and policies that address food insecurity to function as primary prevention strategies for multiple forms of violence and underscore the importance of trauma-informed approaches in organizations providing food assistance. Additional theory-driven research with validated measures of food insecurity and clearly established temporality between measures of food insecurity and violence is needed to strengthen the existing evidence base.
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Affiliation(s)
- Madeline Frank
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Leah Daniel
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Caroline N. Hays
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | - Anna E. Austin
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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McClain AC, Johnson CM, DiRado-Owens C, Dickin KL. How do Latina/o Parents Interpret and Respond to the US Household Food Security Survey Module? A Qualitative Cognitive Interviewing Study. J Acad Nutr Diet 2023; 123:S25-S45. [PMID: 37730305 PMCID: PMC10581700 DOI: 10.1016/j.jand.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The US Latino/a population disproportionately lives in poverty and experiences household food insecurity, especially households with children. The Household Food Security Survey Module (FSSM) was originally developed among rural White women. Despite wide use in English and Spanish, how well the FSSM captures the food insecurity experiences of Latino/a households is not well known. OBJECTIVE This study explored how Latino/a caregivers understood, interpreted, and perceived FSSM items and responses, and how well quantitative FSSM responses captured their reported food insecurity experiences. DESIGN Trained researchers conducted in-depth cognitive interviews in a qualitative study. PARTICIPANTS AND SETTING Interviews were conducted between October 2021 and August 2022 with Latino/a adults (N = 62) experiencing food insecurity while caring for a child (aged 18 years or younger) in the same household, and living in California, New York, or Texas. STATISTICAL ANALYSIS PERFORMED Qualitative analysis using iterative summaries for data reduction focused on item interpretation, response patterns, and cross-cutting themes. RESULTS Participants generally understood FSSM items as intended. The most salient findings were themes that applied across multiple FSSM items rather than wording issues with specific items. Underreporting of food insecurity was linked to nonaffirmative ("never") responses to items referencing not having enough money for food while describing reliance on nonmonetary resources (eg, food assistance or food pantries); emotional sensitivity to discussing food insecurity, particularly as it related to children; stigma and emotions related to skipping meals; and limited response options that participants believed did not reflect their experiences. These issues influenced multiple items, impeding ease of responding and leading to inaccurate responses in English- and Spanish-language versions. CONCLUSIONS Assessing coping strategies and providing more acceptable response options could enhance FSSM validity. Considering emic perspectives of Latino/a caregivers and how food access experiences differ from quantitative survey measures of food security could strengthen policy and programs.
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Affiliation(s)
- Amanda C McClain
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California.
| | - Cassandra M Johnson
- School of Family and Consumer Sciences, Texas State University, San Marcos, Texas
| | | | - Katherine L Dickin
- Department of Public and Ecosystem Health, Cornell University, Ithaca, New York
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Gomez H, DiTosto JD, Niznik CM, Yee LM. Understanding Food Security as a Social Determinant of Diabetes-Related Health during Pregnancy. Am J Perinatol 2023; 40:825-832. [PMID: 34839467 PMCID: PMC9142759 DOI: 10.1055/s-0041-1740194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Gestational and pregestational diabetes during pregnancy are substantial and growing public health issues. Low-income individuals and individuals who identify as racial and ethnic minorities are disproportionately affected. Food security, which is defined as the degree to which individuals have capacity to access and obtain food, is at the center of nutritional resources and decisions for individuals with diabetes. While increasingly recognized as an important mediator of health disparities in the United States, food insecurity is understudied during pregnancy and specifically among pregnant individuals with diabetes, for whom the impact of food-related resources may be even greater. Previous research has suggested that food insecurity is associated with type 2 diabetes mellitus diagnoses and disease exacerbation in the general adult population. An emerging body of research has suggested that food insecurity during pregnancy is associated with gestational diabetes mellitus diagnoses and adverse diabetes-related outcomes. Additionally, food insecurity during pregnancy may be associated with adverse maternal and neonatal outcomes. Future research and clinical work should aim to further examine these relationships and subsequently develop evidence-based interventions to improve diabetes-related outcomes among pregnant individuals with food insecurity. The purpose of this article is to offer a working definition of food security, briefly review issues of food insecurity and diabetes, summarize research on food insecurity and diabetes-related pregnancy health, and discuss clinical recommendations and areas for future investigation. KEY POINTS: · Research on food insecurity and diabetes-related health is limited.. · The impact of food security on diabetes management and obstetric outcomes is likely significant.. · Future work to evaluate perinatal food security screening is warranted..
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Affiliation(s)
- Helen Gomez
- Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, Delaware
| | - Julia D. DiTosto
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Charlotte M. Niznik
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lynn M. Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Ezzeddin N, Eini-Zinab H, Kalantari N, Ahmadi M, Beheshti Z. Fear of COVID-19 Higher among Food-Insecure Households: A Model-Based Study, Mediated by Perceived Stress among Iranian Populations. IRANIAN JOURNAL OF PSYCHIATRY 2022; 17:401-410. [PMID: 36817807 PMCID: PMC9922359 DOI: 10.18502/ijps.v17i4.10689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/29/2022] [Accepted: 08/23/2022] [Indexed: 11/24/2022]
Abstract
Objective: The COVID-19 pandemic is a crisis accompanied by multiple psychological consequences (including fear of COVID-19) and threatens the food security status of millions of people. This study aimed to examine the association between fear of COVID-19 and food insecurity, mediated by perceived stress. Method : This cross-sectional study was conducted among 2871 Iranian participants (18-80 years), recruited through the Social Media during the COVID-19 epidemic. The demographic and socio-economic information questionnaire, Household Food Insecurity Access Scale (HFIAS), COVID-19 fear scale (FCV-19S), Cohen's Perceived Stress Scale (PSS-14) and Perceived Social Support Questionnaire (MSPSS) were used in data gathering. Descriptive and analytical analyses were done using SPSS 22.0 and Amos 22.0 was used for structural equation modeling (SES). Results: Food insecurity has significant positive direct and indirect (mediated by perceived stress) correlations with fear of COVID-19 (P < 0.05). It was also shown that perceived social support could negatively relate to fear of COVID-19 through the pathways of food security status or perceived stress (P < 0.05). Among women, the presence of a child under 5 had a significant direct association with fear of COVID-19 (P < 0.05). Conclusion: Food insecurity was associated with more perceived fear of COVID-19 among the studied population. The crisis caused by COVID-19 highlights the need to increase social resilience through developing and implementing appropriate strategies to prevent and mitigate social costs (whether physical, psychological, or nutritional).
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Affiliation(s)
- Neda Ezzeddin
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naser Kalantari
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Corresponding Author: Address: Shahid Farahzadi Boulvard, Shahid Hafezi Street (Western Arghavan), Ghods Town (West), Tehran, Iran, Postal Code: 1981619573. Tel: 98-21 22077424, Fax: 98-21 22360660,
| | - Mohammad Ahmadi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Beheshti
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Escobar M, Mendez AD, Encinas MR, Villagomez S, Wojcicki JM. High food insecurity in Latinx families and associated COVID-19 infection in the Greater Bay Area, California. BMC Nutr 2021; 7:23. [PMID: 34112257 PMCID: PMC8192129 DOI: 10.1186/s40795-021-00419-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Food insecurity impacts nearly one-in-four Latinx households in the United States and has been exacerbated by the novel coronavirus or COVID-19 pandemic. METHODS We examined the impact of COVID-19 on household and child food security in three preexisting, longitudinal, Latinx urban cohorts in the San Francisco Bay Area (N = 375 households, 1875 individuals). Households were initially recruited during pregnancy and postpartum at Zuckerberg San Francisco General Hospital (ZSFG) and UCSF Benioff prior to the COVID-19 pandemic. For this COVID-19 sub-study, participants responded to a 15-min telephonic interview. Participants answered 18 questions from the US Food Security Food Module (US HFSSM) and questions on types of food consumption, housing and employment status, and history of COVID-19 infection as per community or hospital-based testing. Food security and insecurity levels were compared with prior year metrics. RESULTS We found low levels of household food security in Latinx families (by cohort: 29.2%; 34.2%; 60.0%) and child food security (56.9%, 54.1%, 78.0%) with differences between cohorts explained by self-reported levels of education and employment status. Food security levels were much lower than those reported previously in two cohorts where data had been recorded from prior years. Reported history of COVID-19 infection in households was 4.8% (95% Confidence Interval (CI); 1.5-14.3%); 7.2% (95%CI, 3.6-13.9%) and 3.5% (95%CI, 1.7-7.2%) by cohort and was associated with food insecurity in the two larger cohorts (p = 0.03; p = 0.01 respectively). CONCLUSIONS Latinx families in the Bay Area with children are experiencing a sharp rise in food insecurity levels during the COVID-19 epidemic. Food insecurity, similar to other indices of poverty, is associated with increased risk for COVID-19 infection. Comprehensive interventions are needed to address food insecurity in Latinx populations and further studies are needed to better assess independent associations between household food insecurity, poor nutritional health and risk of COVID-19 infection.
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Affiliation(s)
- Milagro Escobar
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, 550 16th Street, 5th Floor, San Francisco, CA, 94158-0136, USA
| | - Andrea DeCastro Mendez
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, 550 16th Street, 5th Floor, San Francisco, CA, 94158-0136, USA
| | - Maria Romero Encinas
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, 550 16th Street, 5th Floor, San Francisco, CA, 94158-0136, USA
| | - Sofia Villagomez
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, 550 16th Street, 5th Floor, San Francisco, CA, 94158-0136, USA
| | - Janet M Wojcicki
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of California, 550 16th Street, 5th Floor, San Francisco, CA, 94158-0136, USA.
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Hojaji E, Aghajani M, Zavoshy R, Noroozi M, Jahanihashemi H, Ezzeddin N. Household food insecurity associations with pregnancy hypertension, diabetes mellitus and infant birth anthropometric measures: a cross-sectional study of Iranian mothers. Hypertens Pregnancy 2021; 40:109-117. [PMID: 33476216 DOI: 10.1080/10641955.2021.1874010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: The purpose of this study was to determine the associations between food insecurity on pregnancy and its outcomes.Materials and methods: This cross-sectional study was carried out on 700 Iranian mothers. Household socioeconomic status, prenatal information and household food security status were assessed using questionnaires. Data analysis was applied by SPSS version 22.Results: The results of the study showed a significant association between food insecurity with gestational diabetes mellitus. The results also showed a significant association between birth weight, and height with pregnancy-induced hypertension.Conclusion: food insecure women should be recognized, and receive appropriate training and assistance.
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Affiliation(s)
- Elham Hojaji
- Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran.,Department of Human Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mobina Aghajani
- Gastrointestinal and Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran.,Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran
| | - Rosa Zavoshy
- Department of Human Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mostafa Noroozi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Hassan Jahanihashemi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Neda Ezzeddin
- Department of Community Nutrition, Faculty of Nutrition science and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Weiser SD, Sheira LA, Palar K, Kushel M, Wilson TE, Adedimeji A, Merenstein D, Cohen M, Turan JM, Metsch L, Adimora AA, Ofotokun I, Wentz E, Tien PC, Frongillo EA. Mechanisms from Food Insecurity to Worse HIV Treatment Outcomes in US Women Living with HIV. AIDS Patient Care STDS 2020; 34:425-435. [PMID: 32941054 DOI: 10.1089/apc.2020.0009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Food insecurity (FI) contributes to HIV-related morbidity and mortality, but the mechanisms whereby FI negatively impacts HIV health are untested. We tested the hypothesis that FI leads to poor HIV clinical outcomes through nutritional, mental health, and behavioral paths. We analyzed data from Women's Interagency HIV Study (WIHS) among 1803 women living with HIV (WLWH) (8225 person-visits) collected from 2013 to 2015 biannually from nine sites across the United States participating in the WIHS. FI was measured with the US Household Food Security Survey Module. Outcomes included HIV viral nonsuppression, CD4 cell counts, and physical health status (PHS). We used longitudinal logistic and linear regression models with random effects to examine associations adjusting for covariates and path analysis to test nutritional, mental health, and behavioral paths. Increasing severity of FI was associated with unsuppressed viral load, lower CD4 counts, and worse PHS (all p < 0.05). Report of FI 6 months earlier was independently associated with most outcomes after adjusting for concurrent FI. For viral nonsuppression, the nutritional and behavioral paths accounted for 2.09% and 30.66% of the total effect, with the mental health path operating via serial mediation through the behavioral path. For CD4 count, the mental health and behavioral paths accounted for 15.21% and 17.0% of the total effect, respectively. For PHS, depressive symptoms accounted for 60.2% of the total effect. In conclusion, FI is associated with poor health among WLWH through different paths depending on the outcome. Interventions should target FI and its behavioral and mental health mechanisms to improve HIV outcomes.
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Affiliation(s)
- Sheri D. Weiser
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Lila A. Sheira
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Kartika Palar
- Division of HIV, Infectious Disease and Global Medicine, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Margot Kushel
- Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Tracey E. Wilson
- Department of Community Health Sciences, State University of New York Downstate Medical Center, School of Public Health, Brooklyn, New York, USA
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Dan Merenstein
- Department of Family Medicine, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Mardge Cohen
- Department of Medicine, Stroger Hospital, Chicago, Illinois, USA
| | - Janet M. Turan
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lisa Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Adaora A. Adimora
- School of Medicine and UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ighovwerha Ofotokun
- Division of Infectious Diseases, Department of Medicine, Emory University, Grady Healthcare System, Atlanta, Georgia, USA
| | - Eryka Wentz
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Phyllis C. Tien
- Department of Medicine, University of California, San Francisco and Medical Service, Department of Veteran Affairs Medical Center, San Francisco, California, USA
| | - Edward A. Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
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Quintanilha M, Mayan MJ, Jarman M, Bell RC. Prevalence and experiences of food insecurity among immigrant women connected to perinatal programs at a community-based organization in Edmonton, Canada. INTERNATIONAL JOURNAL OF MIGRATION HEALTH AND SOCIAL CARE 2019. [DOI: 10.1108/ijmhsc-09-2018-0064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to investigate the prevalence of household food insecurity among immigrant women connected to perinatal programs offered through a community-based organization in Edmonton, and to explore their experiences in coping with food insecurity.Design/methodology/approachThis study utilized a mixed methods research design. A community-based participatory research approach was used to engage health workers who were connected to immigrant women and families through the Multicultural Health Brokers Cooperative in Edmonton. Through the health workers a sample of 213 immigrant women connected to their perinatal programs completed the Household Food Security Survey. Following the survey, 17 women completed semi-structured interviews which were analyzed using content analysis.FindingsThe vast majority of women (94 percent (n=199)) lived in food insecure households, and 53 percent (n=112) in severely food insecure. In semi-structured interviews, women specifically described not having enough money to buy vegetables, fruit and meat, and perceiving a lack of control over foods they ate and offered to their families.Practical implicationsThis study highlights the need for support to be provided to immigrant families for acquiring healthy food in Canada.Originality/valueThe mixed methods design with a decent sample of often underrepresented research participants highlights an area in need of further research and greater support.
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Ezzeddin N, Jahanihashemi H, Zavoshy R, Noroozi M. The Prevalence of Postpartum Depression and Its Association with Food Insecurity among Mothers Referring to Community Health Centers. IRANIAN JOURNAL OF PSYCHIATRY 2018; 13:280-287. [PMID: 30627202 PMCID: PMC6320385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/25/2018] [Accepted: 07/01/2018] [Indexed: 11/18/2022]
Abstract
Objective: Postpartum depression (PPD) is a condition which may compromise both maternal and neonatal health. The present study was conducted to determine the prevalence of PPD and its association with demographic, socioeconomic, obstetric, and household food security status. Method : This cross sectional study was conducted in community health centers in west of Tehran. A total of 325 women were selected by stratified sampling method from community health centers. A sociodemographic questionnaire, USDA 18-item questionnaire, and Edinburgh Postnatal Depression Scale (EPDS) questionnaire were used for data collection. Data were analyzed using both descriptive and analytic analyses, such as chi-squared test and logistic regression in SPSS 22. Results: The prevalence of PPD and food insecurity among the studied population was 35.4% and 34.2%, respectively. The results of this study revealed a significant association among PPD and food insecurity (OR = 6.690, CI = 3.118-14.353, p<0.001), the levels of economic satisfaction (OR = 3.419, CI = 1.241-9.420, P = 0.017), pregnancy loss (OR = 1.899, CI = 1.006-3.582, p = 0.048), and pregnancy complications (OR = 1.853, CI = 1.083-3.170, P = 0.024). Conclusion: Based on the results of this study, household food insecurity may predispose mothers to PPD. Moreover, it was observed that mothers with poor economic satisfaction were more likely to be depressed. Histories of pregnancy loss and pregnancy complications were other risk factors for PPD.
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Affiliation(s)
- Neda Ezzeddin
- Department of Community Nutrition, School of Nutrition Science and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Jahanihashemi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Roza Zavoshy
- Department of Nutrition, Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mostafa Noroozi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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Ohly H, Crossland N, Dykes F, Lowe N, Moran VH. A realist qualitative study to explore how low-income pregnant women use Healthy Start food vouchers. MATERNAL AND CHILD NUTRITION 2018; 15:e12632. [PMID: 29956890 DOI: 10.1111/mcn.12632] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/09/2018] [Accepted: 05/15/2018] [Indexed: 11/30/2022]
Abstract
Healthy Start is the UK government's food voucher programme for low-income pregnant women and young children. It was introduced in 2006, but the impact of the programme on nutritional outcomes remains understudied. This study sought to explore potential outcomes of the Healthy Start programme (including intended and unintended outcomes) and develop explanations for how and why these outcomes might occur. A realist review preceded this study, in which programme theories were developed and tested using existing evidence. This qualitative study aimed to further refine and consolidate the programme theories from the realist review while remaining open to new and emerging theories (or hypotheses) about how low-income pregnant women use Healthy Start vouchers. Semistructured interviews were conducted with 11 low-income women from North West England, who received Healthy Start vouchers during pregnancy. A realist logic of analysis was applied to generate clear and transparent linkages between outcomes and explanations. The findings suggested that some women used the vouchers to improve their diets during pregnancy (intended outcome), whereas some women were diverted towards alternative or unintended outcomes. Women's circumstances, values, beliefs, and motivations influenced how they perceived and responded to the vouchers. This paper presents four evidence-based programme theories to explain four contrasting (and potentially overlapping) outcomes: dietary improvements (theory refined from review), shared benefits (new theory), financial assistance (theory refined from review), and stockpiling formula (new theory). It considers how the Healthy Start programme could be improved, to increase the possibilities for low-income women to experience the intended outcome of dietary improvements.
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Affiliation(s)
- Heather Ohly
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Nicola Crossland
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Fiona Dykes
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Nicola Lowe
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Victoria Hall Moran
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
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Di Noia J, Monica D, Cullen KW, Pérez-Escamilla R, Gray HL, Sikorskii A. Differences in Fruit and Vegetable Intake by Race/Ethnicity and by Hispanic Origin and Nativity Among Women in the Special Supplemental Nutrition Program for Women, Infants, and Children, 2015. Prev Chronic Dis 2016; 13:E115. [PMID: 27560723 PMCID: PMC5003529 DOI: 10.5888/pcd13.160130] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction The objective of this exploratory study was to determine whether fruit and vegetable consumption differed by race/ethnicity, by origin and nativity among Hispanics, and by language preference (as an indicator of acculturation) among foreign-born Hispanics. Methods We recruited 723 women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and orally administered a questionnaire containing demographic items, validated measures of food security status and social desirability trait, and the Behavioral Risk Factor Surveillance System fruit and vegetable module. Differences in intakes of 100% fruit juice, fruit, cooked or canned beans, and dark green, orange-colored, and other vegetables were assessed by using analysis of covariance with Bonferroni post hoc tests. Analyses were controlled for age, pregnancy status, breastfeeding status, food security status, educational attainment, and social desirability trait. Results The frequency of vegetable intake differed by race/ethnicity (cooked or canned beans were consumed more often among Hispanic than non-Hispanic black and non-Hispanic white or other participants, orange-colored vegetables were consumed more often among Hispanics than non-Hispanic black participants, and other vegetables were consumed more often among non-Hispanic white or other than among non-Hispanic black and Hispanic participants), origin (other vegetables were consumed more often among Columbian and other Hispanics than Dominican participants) and nativity (orange-colored vegetables were consumed more often among foreign-born than US-born Hispanics). Fruit and vegetable intake did not differ by language preference among foreign-born Hispanics. Conclusion Differences in fruit and vegetable consumption among WIC participants by race/ethnicity and by Hispanic origin and nativity may have implications for WIC nutrition policies and nutrition education efforts.
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Affiliation(s)
- Jennifer Di Noia
- Department of Sociology, William Paterson University, 300 Pompton Rd, Wayne, NJ 07470.
| | | | - Karen Weber Cullen
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
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Gross RS, Mendelsohn AL, Gross M, Scheinmann R, Messito MJ. Material Hardship and Internal Locus of Control Over the Prevention of Child Obesity in Low-Income Hispanic Pregnant Women. Acad Pediatr 2016; 16:468-474. [PMID: 26861931 PMCID: PMC4931974 DOI: 10.1016/j.acap.2016.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 12/31/2015] [Accepted: 02/02/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine the relations between household material hardships and having a low internal locus of control over the prevention of child obesity in low-income Hispanic pregnant women. METHODS We performed a cross-sectional analysis of baseline data collected during a third trimester prenatal visit from women participating in the Starting Early Study, a randomized controlled trial to test the efficacy of a primary care-based family-centered early child obesity prevention intervention. Using multiple logistic regression analyses, we determined whether 4 domains of material hardship (food insecurity, difficulty paying bills, housing disrepair, neighborhood stress), considered individually and also cumulatively, were associated with having a low internal locus of control over the prevention of child obesity. RESULTS The sample included 559 low-income Hispanic pregnant women, with 60% having experienced at least 1 hardship. Food insecurity was independently associated with a low internal locus of control over the prevention of child obesity (adjusted odds ratio, 2.38; 95% confidence interval, 1.50-3.77), controlling for other hardships and confounders. Experiencing a greater number of material hardships was associated in a dose-dependent relationship with an increased odds of having a low internal locus of control. CONCLUSIONS Prenatal material hardships, in particular food insecurity, were associated with having a lower prenatal internal locus of control over the prevention of child obesity. Longitudinal follow-up of this cohort is needed to determine how relations between material hardships and having a low internal locus of control will ultimately affect infant feeding practices and child weight trajectories.
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Affiliation(s)
- Rachel S. Gross
- Department of Pediatrics, Albert Einstein College of Medicine, Children’s Hospital at Montefiore, 3444 Kossuth Avenue, Bronx, New York, USA, 10467.
| | - Alan L. Mendelsohn
- Division of Developmental - Behavioral Pediatrics, New York University School of Medicine and Bellevue Hospital Center, 550 First Avenue, New York, New York, USA, 10016.
| | - Michelle Gross
- Division of General Pediatrics, New York University School of Medicine and Bellevue Hospital Center, 550 First Avenue, New York, New York, USA, 10016.
| | - Roberta Scheinmann
- Research and Evaluation Unit, Public Health Solutions, 40 Worth Street, 5thFloor, New York, New York, USA 10013.
| | - Mary Jo Messito
- Division of General Pediatrics, New York University School of Medicine and Bellevue Hospital Center, 550 First Avenue, New York, New York, USA, 10016.
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Gebremeskel F, Dibaba Y, Admassu B. Timing of first antenatal care attendance and associated factors among pregnant women in Arba Minch Town and Arba Minch District, Gamo Gofa Zone, south Ethiopia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2015; 2015:971506. [PMID: 26543485 PMCID: PMC4620253 DOI: 10.1155/2015/971506] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/27/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the timing of first antenatal care attendance and associated factors among pregnant women in Arba Minch Town and Arba Minch District, south Ethiopia. METHOD Facility based cross-sectional study employing both quantitative and qualitative methods was conducted from February to March, 2014, in Arba Minch Town and Arba Minch District. Data were collected from 409 pregnant women attending antenatal care clinics in nine public health facilities using systematic random sampling. Analysis was done using SPSS version 20. Descriptive statistics and binary and multiple logistic regression analysis were done. RESULTS The mean (SD±) age of the respondents was 26 ± 5.5 years. The mean gestational age at first antenatal care attendance was 5 ± 1.5 months. This study indicated that pregnant women with low monthly income (AOR = 4.9, CI: 1.71, 14.08), women who did not receive advise on when to start ANC (AOR = 3, CI: 1.48, 6.24), women with household food insecurity (AOR = 4.66, CI: 1.007, 21.59) and women with unplanned pregnancy (AOR = 4.49, CI: 2.16, 9.35) had higher odds of late antenatal care attendance compared with their counterparts. CONCLUSIONS The study showed that majority of the pregnant women attended late for first antenatal care. Hence, providing health education on the timing of antenatal care is important.
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Affiliation(s)
- Feleke Gebremeskel
- College of Medicine and Health Sciences, Arba Minch University, P.O. Box 021, Arba Minch, Ethiopia
| | - Yohannes Dibaba
- College of Health Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Bitiya Admassu
- College of Health Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
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Lyles CR, Nord M, Chou J, Kwan CML, Seligman HK. The San Francisco Chinese Food Security Module: Validation of a Translation of the US Household Food Security Survey Module. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2015. [DOI: 10.1080/19320248.2014.962776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Measuring food and nutrition security: tools and considerations for use among people living with HIV. AIDS Behav 2014; 18 Suppl 5:S490-504. [PMID: 24297517 DOI: 10.1007/s10461-013-0669-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
As an increasing number of countries implement integrated food and nutrition security (FNS) and HIV programs, global stakeholders need clarity on how to best measure FNS at the individual and household level. This paper reviews prominent FNS measurement tools, and describes considerations for interpretation in the context of HIV. There exist a range of FNS measurement tools and many have been adapted for use in HIV-endemic settings. Considerations in selecting appropriate tools include sub-types (food sufficiency, dietary diversity and food safety); scope/level of application; and available resources. Tools need to reflect both the needs of PLHIV and affected households and FNS program objectives. Generalized food sufficiency and dietary diversity tools may provide adequate measures of FNS in PLHIV for programmatic applications. Food consumption measurement tools provide further data for clinical or research applications. Measurement of food safety is an important, but underdeveloped aspect of assessment, especially for PLHIV.
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Development of a conceptually equivalent Chinese-language translation of the US Household Food Security Survey Module for Chinese immigrants to the USA. Public Health Nutr 2014; 18:242-50. [PMID: 24642365 DOI: 10.1017/s1368980014000160] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To develop a conceptually equivalent Chinese-language translation of the eighteen-item US Household Food Security Survey Module. DESIGN In the current qualitative study, we (i) highlight methodological challenges which arise in developing survey instruments that will be used to make comparisons across language groups and (ii) describe the development of a Chinese-language translation of the US Household Food Security Survey Module, called the San Francisco Chinese Food Security Module. SETTING Community sites in San Francisco, CA, USA. SUBJECTS We conducted cognitive interviews with twenty-two community members recruited from community sites hosting food pantries and with five professionals recruited from clinical settings. RESULTS Development of conceptually equivalent surveys can be difficult. We highlight challenges related to dialect, education, literacy (e.g. preferences for more or less formal phrasing), English words and phrases for which there is no Chinese language equivalent (e.g. 'balanced meals' and 'eat less than you felt you should') and response formats. We selected final translations to maximize: (i) consistency of the Chinese translation with the intent of the English version; (ii) clarity; and (iii) similarities in understanding across dialects and literacy levels. CONCLUSIONS Survey translation is essential for conducting research in many communities. The challenges encountered illustrate how literal translations can affect the conceptual equivalence of survey items across languages. Cognitive interview methods should be routinely used for survey translation when such non-equivalence is suspected, such as in surveys addressing highly culturally bound behaviours such as diet and eating behaviours. Literally translated surveys lacking conceptual equivalence may magnify or obscure important health inequalities.
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An examination of prenatal and postpartum depressive symptoms among women served by urban community health centers. Arch Womens Ment Health 2014; 17:27-40. [PMID: 24037098 DOI: 10.1007/s00737-013-0378-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 08/27/2013] [Indexed: 10/26/2022]
Abstract
We characterized depressive symptoms in the prenatal and/or postpartum periods and examined associated risk factors among 594 women who received care at community health care centers. Women were screened with comprehensive risk assessments, which included the Patient Health Questionnaire-9 depression screen, during pregnancy and at least 4 weeks after delivery. Fifteen percent had depressive symptoms in the prenatal period only; 6 % in the postpartum period only, and 8 % had depressive symptoms in both periods. Risk markers varied for women who reported depressive symptoms at one period only compared with those who reported persistent depressive symptoms. Age (25 years versus younger), having experienced abuse, not living with the infant's father, and cigarette smoking were associated with depressive symptoms at both periods; being US-born, lacking social support, and experiencing food insecurity were associated with reporting symptoms only in the prenatal period, and lack of phone access was associated with risk only in the postpartum period. Our findings confirm the importance of repeated screenings for depressive symptoms during the perinatal period. The variability in risk markers associated with periods of reported depressive symptoms may reflect their varying associations with persistence, new onset, or recovery from depressive symptoms.
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de Toledo Vianna RP, Hromi-Fiedler AJ, Segall-Correa AM, Pérez-Escamilla R. Household food insecurity in small municipalities in Northeastern Brazil: a validation study. Food Secur 2012. [DOI: 10.1007/s12571-012-0181-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hromi-Fiedler A, Bermúdez-Millán A, Segura-Pérez S, Pérez-Escamilla R. Household food insecurity is associated with depressive symptoms among low-income pregnant Latinas. MATERNAL AND CHILD NUTRITION 2010; 7:421-30. [PMID: 20735732 DOI: 10.1111/j.1740-8709.2010.00266.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Latinas experience high rates of poverty, household food insecurity and prenatal depression. To date, only one USA study has examined the relationship between household food insecurity and prenatal depression, yet it focused primarily on non-Latina white and non-Latina black populations. Therefore, this study examined the independent association of household food insecurity with depressive symptoms among low-income pregnant Latinas. This cross-sectional study included 135 low income pregnant Latinas living in Hartford, Connecticut. Women were assessed at enrolment for household food security during pregnancy using an adapted and validated version of the US Household Food Security Survey Module. Prenatal depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. A cut-off of ≥21 was used to indicate elevated levels of prenatal depressive symptoms (EPDS). Multivariate backwards stepwise logistic regression was used to identify risk factors for EPDS. Almost one third of participants had EPDS. Women who were food insecure were more likely to experience EPDS compared to food secure women (OR = 2.59; 95% CI = 1.03-6.52). Being primiparous, experiencing heartburn and reporting poor/fair health during pregnancy, as well as having a history of depression were also independent risk factors for experiencing EPDS. Findings from this study suggest the importance of assessing household food insecurity when evaluating depression risk among pregnant Latinas.
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Affiliation(s)
- Amber Hromi-Fiedler
- Connecticut Center for Eliminating Health Disparities among Latinos, University of Connecticut, Roy E Jones Building, Unit 4017, 3624 Horsebarn Road Extension, Storrs, Connecticut 06269-4017, USA.
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Hromi-Fiedler A, Bermúdez-Millán A, Melgar-Quiñonez H, Pérez-Escamilla R. Psychometric Properties of an Adapted Version of the U.S. Household Food Security Survey Module for Assessing Food Insecurity Among Low-Income Pregnant Latinas. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2009; 4:81-94. [PMID: 20046913 PMCID: PMC2748343 DOI: 10.1080/19320240802706866] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examined the internal validity of an adapted version of the U.S. Household Food Security Survey Module administered to a sample of 241 pregnant Latinas. Single-parameter logistic (Rasch) measurement model was used to assess the psychometric properties of the adapted module. Two of 14 questions examined did not fit within the acceptable range (0.70-1.30). The severity level of 12 of the 14 questions was similar across two time periods, before pregnancy and the past month of pregnancy. These findings suggest the adapted module is valid for use among pregnant Latinas, yet some items might not be applicable during pregnancy.
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Affiliation(s)
- Amber Hromi-Fiedler
- Connecticut Center for Eliminating Health Disparities among Latinos
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
| | - Angela Bermúdez-Millán
- Connecticut Center for Eliminating Health Disparities among Latinos
- Hispanic Health Council, Hartford, CT
| | | | - Rafael Pérez-Escamilla
- Connecticut Center for Eliminating Health Disparities among Latinos
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
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