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Roncarolo F, Mercille G, Riva M, Pérez E, Blanchet R, Carabali M, Sylvestre MP, Potvin L. The Pathways study: a cohort study of new food-aid users in rural, semi urban, and urban areas of Quebec, Canada. BMC Public Health 2023; 23:1607. [PMID: 37612709 PMCID: PMC10463898 DOI: 10.1186/s12889-023-16393-1] [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: 11/24/2022] [Accepted: 07/26/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND While considerable research has been conducted on household food insecurity (HFI), little research has examined the effects of food donation programs on users' living conditions. The Pathways study was established to investigate the long-term effects of food donation programs on food insecurity as well as other critical outcomes, such as diet, health, and social support. Herein, we describe the design of the Pathways Study and the participants' characteristics at baseline. METHODS The Pathways study is a prospective cohort study of 1001 food-aid users in Quebec (Canada). We recruited newly registered users of food donation programs from 106 community-based food-aid organizations that partnered with the study. Baseline data were collected through face-to-face interviews from September 2018 to January 2020, with planned follow-up interviews at 12 and 24 months after enrollment. Household food insecurity, diet, food competencies, food shopping behaviors, perceived food environment, health status, social support and isolation, sociodemographic characteristics, housing conditions, negative life events, and the impacts of COVID-19 were assessed with validated questionnaires. RESULTS The cohort included 1001 participants living in rural (n = 181), semi-urban (n = 250), and urban areas (n = 570). Overall, household food insecurity was reported as severe among 46.2% and moderate in 36.9% of participants. Severe household food insecurity was more prevalent in rural (51.4%) and urban (47.8%) areas compared to semi-urban (39%) areas. Overall, 76.1% of participants reported an annual income below C$20,000. Half (52%) had low education levels (high school or lower), 22.0% lived in single-parent households, and 52.1% lived alone. Most (62.9%) experienced at least one major financial crisis in the preceding year. CONCLUSIONS Results show that newly registered users of food donation programs often have low-income and severe food insecurity, with major differences across geographical locations. The Pathways study is the first study designed to follow, over a 2-year period, a cohort of newly registered users of food donation programs and to quantify their trajectories of service use. Findings from the Pathways study might help adapt the community response to the strategies used by food-insecure households to feed themselves.
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Affiliation(s)
- Federico Roncarolo
- Centre de Recherche en Santé Publique (CReSP), CIUSSS du Centre-Sud-de-L'Ile-de-Montréal et Université de Montréal, Montréal, QC, H3C 3J7, Canada
- Chaire de Recherche du Canada Approches Communautaires et Inégalités de Santé, Université de Montréal, Montréal, QC, Canada
| | - Geneviève Mercille
- Centre de Recherche en Santé Publique (CReSP), CIUSSS du Centre-Sud-de-L'Ile-de-Montréal et Université de Montréal, Montréal, QC, H3C 3J7, Canada
- Department of Nutrition, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Mylene Riva
- Department of Geography, McGill University, Canada Research Chair in Housing, Community and Health, Montréal, QC, Canada
| | - Elsury Pérez
- Centre de Recherche en Santé Publique (CReSP), CIUSSS du Centre-Sud-de-L'Ile-de-Montréal et Université de Montréal, Montréal, QC, H3C 3J7, Canada
- Chaire de Recherche du Canada Approches Communautaires et Inégalités de Santé, Université de Montréal, Montréal, QC, Canada
- Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal, Montréal, QC, Canada
| | - Rosanne Blanchet
- Centre de Recherche en Santé Publique (CReSP), CIUSSS du Centre-Sud-de-L'Ile-de-Montréal et Université de Montréal, Montréal, QC, H3C 3J7, Canada
- Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal, Montréal, QC, Canada
| | - Mabel Carabali
- Centre de Recherche en Santé Publique (CReSP), CIUSSS du Centre-Sud-de-L'Ile-de-Montréal et Université de Montréal, Montréal, QC, H3C 3J7, Canada
- Department of Epidemiology, Biostatistics, & Occupational Health, McGill University, Montréal, QC, Canada
| | - Marie-Pierre Sylvestre
- Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche du CHUM, Montréal, QC, Canada
| | - Louise Potvin
- Centre de Recherche en Santé Publique (CReSP), CIUSSS du Centre-Sud-de-L'Ile-de-Montréal et Université de Montréal, Montréal, QC, H3C 3J7, Canada.
- Chaire de Recherche du Canada Approches Communautaires et Inégalités de Santé, Université de Montréal, Montréal, QC, Canada.
- Department of Social and Preventive Medicine, École de Santé Publique, Université de Montréal, Montréal, QC, Canada.
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Easton C, Oudshoorn A, Smith-Carrier T, Forchuk C, Marshall CA. The experience of food insecurity during and following homelessness in high-income countries: A systematic review and meta-aggregation. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3384-e3405. [PMID: 35869792 DOI: 10.1111/hsc.13939] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/30/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
Homelessness is a pervasive challenge caused by poverty which continues to grow in economically developed countries, posing significant health impacts (Fazel et al., Lancet, 384: 1529-1540, 2014). While food security related to poverty and low income has been investigated, this review specifically explores the experience of food security during and following homelessness. Given the fact that the health of individuals who experience homelessness is known to be poor and the importance of nutrition, this is a necessary contribution. Informed by a health equity lens, this review synthesises the findings and quality of the literature regarding experiences of food security during and following homelessness in high-income countries. We used the Joanna Briggs Institute methodology, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Qualitative studies published to date were obtained from six databases. We conducted a meta-aggregation of existing qualitative findings. Twenty-four studies on 462 participants were included in the review. Through meta-aggregation four themes were created: (1) imposed food options as a determinant of health out of my control; (2) obtaining food for survival despite stigma or other consequences; (3) situated within a system that maintains food insecurity; and (4) surviving hardships. Persons during and following homelessness in high-income countries face multiple challenges when securing food while situated in an oppressive system that lacks choice. Despite this, persons who have experienced homelessness demonstrate resilience by finding ways to meet their basic needs in the face of imposed barriers. Implications for research, policy and practice are offered.
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Affiliation(s)
- Corinna Easton
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Abe Oudshoorn
- School of Nursing, Western University, London, Ontario, Canada
| | - Tracy Smith-Carrier
- School of Humanitarian Studies, Royal Roads University, Victoria, British Columbia, Canada
| | - Cheryl Forchuk
- School of Nursing, Western University, London, Ontario, Canada
| | - Carrie Anne Marshall
- Social Justice in Mental Health Research Lab, School of Occupational Therapy, Western University, London, Ontario, Canada
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Roncarolo F, Bisset S, Potvin L. Short-Term Effects of Traditional and Alternative Community Interventions to Address Food Insecurity. PLoS One 2016; 11:e0150250. [PMID: 26974826 PMCID: PMC4790888 DOI: 10.1371/journal.pone.0150250] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 02/11/2016] [Indexed: 11/18/2022] Open
Abstract
Background Despite the effects of food insecurity on health are well documented, clear governmental policies to face food insecurity do not exist in western countries. In Canada, interventions to face food insecurity are developed at the community level and can be categorized into two basic strategies: those providing an immediate response to the need for food, defined “traditional” and those targeting the improvement of participants’ social cohesion, capabilities and management of their own nutrition, defined “alternative”. Objective The objective of this study was to evaluate the effects of food insecurity interventions on food security status and perceived health of participants. Design This was a longitudinal multilevel study implemented in Montreal, Quebec, Canada. Participants were recruited in a two-stage cluster sampling frame. Clustering units were community organizations working on food insecurity; units of analysis were participants in community food security interventions. A total of 450 participants were interviewed at the beginning and after 9 months of participation in traditional or alternative food security interventions. Food security and perceived health were investigated as dependent variables. Differences overtime were assessed through multilevel regression models. Results Participants in traditional interventions lowered their food insecurity at follow-up. Decreases among participants in alternative interventions were not statistically significant. Participants in traditional interventions also improved physical (B coefficient 3.00, CI 95% 0.42–5.59) and mental health (B coefficient 6.25, CI 95% 4.15–8.35). Conclusions Our results challenge the widely held view suggesting the ineffectiveness of traditional interventions in the short term. Although effects may be intervention-dependent, food banks decreased food insecurity and, in so doing, positively affected perceived health. Although study findings demonstrate that food banks offer short term reprise from the effects of food insecurity, the question as to whether food banks are the most appropriate solution to food insecurity still needs to be addressed.
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Affiliation(s)
- Federico Roncarolo
- Public Health Research Institute, University of Montreal (IRSPUM), Montreal, Quebec, Canada
- Public Health School, University of Montreal, Montreal, Quebec, Canada
- Canada Research Chair in Community approaches and health inequalities, University of Montreal, Montreal, Quebec, Canada
- * E-mail:
| | - Sherri Bisset
- Agence de la santé et de services sociaux de la Montérégie, Quebec, Canada
| | - Louise Potvin
- Public Health Research Institute, University of Montreal (IRSPUM), Montreal, Quebec, Canada
- Public Health School, University of Montreal, Montreal, Quebec, Canada
- Canada Research Chair in Community approaches and health inequalities, University of Montreal, Montreal, Quebec, Canada
- Lea Roback Research Centre, Montreal Public Health Directorate, Montreal, Quebec, Canada
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