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Rizvi A, Kearns M, Dignam M, Coates A, Sharp MK, Magwood O, Labelle PR, Elmestekawy N, Rossiter S, Al‐Zubaidi AAA, Dewidar O, Idzerda L, Aguilera JMP, Seal H, Little J, Martín AMA, Petkovic J, Jull J, Gergyek L, Ghogomu ET, Shea B, Atance C, Ellingwood H, Pollard C, Mbuagbaw L, Wells GA, Welch V, Kristjansson E. Effects of guaranteed basic income interventions on poverty-related outcomes in high-income countries: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1414. [PMID: 38887375 PMCID: PMC11180702 DOI: 10.1002/cl2.1414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 06/20/2024]
Abstract
Background High-income countries offer social assistance (welfare) programs to help alleviate poverty for people with little or no income. These programs have become increasingly conditional and stringent in recent decades based on the premise that transitioning people from government support to paid work will improve their circumstances. However, many people end up with low-paying and precarious jobs that may cause more poverty because they lose benefits such as housing subsidies and health and dental insurance, while incurring job-related expenses. Conditional assistance programs are also expensive to administer and cause stigma. A guaranteed basic income (GBI) has been proposed as a more effective approach for alleviating poverty, and several experiments have been conducted in high-income countries to investigate whether GBI leads to improved outcomes compared to existing social programs. Objectives The aim of this review was to conduct a synthesis of quantitative evidence on GBI interventions in high-income countries, to compare the effectiveness of various types of GBI versus "usual care" (including existing social assistance programs) in improving poverty-related outcomes. Search Methods Searches of 16 academic databases were conducted in May 2022, using both keywords and database-specific controlled vocabulary, without limits or restrictions on language or date. Sources of gray literature (conference, governmental, and institutional websites) were searched in September 2022. We also searched reference lists of review articles, citations of included articles, and tables of contents of relevant journals in September 2022. Hand searching for recent publications was conducted until December 2022. Selection Criteria We included all quantitative study designs except cross-sectional (at one timepoint), with or without control groups. We included studies in high income countries with any population and with interventions meeting our criteria for GBI: unconditional, with regular payments in cash (not in-kind) that were fixed or predictable in amount. Although two primary outcomes of interest were selected a priori (food insecurity, and poverty level assessed using official, national, or international measures), we did not screen studies on the basis of reported outcomes because it was not possible to define all potentially relevant poverty-related outcomes in advance. Data Collection and Analysis We followed the Campbell Collaboration conduct and reporting guidelines to ensure a rigorous methodology. The risk of bias was assessed across seven domains: confounding, selection, attrition, motivation, implementation, measurement, and analysis/reporting. We conducted meta-analyses where results could be combined; otherwise, we presented the results in tables. We reported effect estimates as standard mean differences (SMDs) if the included studies reported them or provided sufficient data for us to calculate them. To compare the effects of different types of interventions, we developed a GBI typology based on the characteristics of experimental interventions as well as theoretical conceptualizations of GBI. Eligible poverty-related outcomes were classified into categories and sub-categories, to facilitate the synthesis of the individual findings. Because most of the included studies analyzed experiments conducted by other researchers, it was necessary to divide our analysis according to the "experiment" stage (i.e., design, recruitment, intervention, data collection) and the "study" stage (data analysis and reporting of results). Main Results Our searches yielded 24,476 records from databases and 80 from other sources. After screening by title and abstract, the full texts of 294 potentially eligible articles were retrieved and screened, resulting in 27 included studies on 10 experiments. Eight of the experiments were RCTs, one included both an RCT site and a "saturation" site, and one used a repeated cross-sectional design. The duration ranged from one to 5 years. The control groups in all 10 experiments received "usual care" (i.e., no GBI intervention). The total number of participants was unknown because some of the studies did not report exact sample sizes. Of the studies that did, the smallest had 138 participants and the largest had 8019. The risk of bias assessments found "some concerns" for at least one domain in all 27 studies and "high risk" for at least one domain in 25 studies. The risk of bias was assessed as high in 21 studies due to attrition and in 22 studies due to analysis and reporting bias. To compare the interventions, we developed a classification framework of five GBI types, four of which were implemented in the experiments, and one that is used in new experiments now underway. The included studies reported 176 poverty-related outcomes, including one pre-defined primary outcome: food insecurity. The second primary outcome (poverty level assessed using official, national, or international measures) was not reported in any of the included studies. We classified the reported outcomes into seven categories: food insecurity (as a category), economic/material, physical health, psychological/mental health, social, educational, and individual choice/agency. Food insecurity was reported in two studies, both showing improvements (SMD = -0.57, 95% CI: -0.65 to -0.49, and SMD = -0.41, 95% CI: -0.57 to -0.26) which were not pooled because of different study designs. We conducted meta-analyses on four secondary outcomes that were reported in more than one study: subjective financial well-being, self-rated overall physical health, self-rated life satisfaction, and self-rated mental distress. Improvements were reported, except for overall physical health or if the intervention was similar to existing social assistance. The results for the remaining 170 outcomes, each reported in only one study, were summarized in tables by category and subcategory. Adverse effects were reported in some studies, but only for specific subgroups of participants, and not consistently, so these results may have been due to chance. Authors' Conclusions The results of the included studies were difficult to synthesize because of the heterogeneity in the reported outcomes. This was due in part to poverty being multidimensional, so outcomes covered various aspects of life (economic, social, psychological, educational, agency, mental and physical health). Evidence from future studies would be easier to assess if outcomes were measured using more common, validated instruments. Based on our analysis of the included studies, a supplemental type of GBI (provided along with existing programs) may be effective in alleviating poverty-related outcomes. This approach may also be safer than a wholesale reform of existing social assistance approaches, which could have unintended consequences.
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Affiliation(s)
- Anita Rizvi
- School of Psychology, Faculty of Social SciencesUniversity of OttawaOttawaOntarioCanada
| | | | - Michael Dignam
- School of Psychology, Faculty of Social SciencesUniversity of OttawaOttawaOntarioCanada
| | - Alison Coates
- Telfer School of ManagementUniversity of OttawaOttawaOntarioCanada
| | - Melissa K. Sharp
- Department of Public Health & Epidemiology, School of Population HealthRCSI University of Medicine and Health SciencesDublinIreland
| | - Olivia Magwood
- Bruyère Research InstituteOttawaOntarioCanada
- Interdisciplinary School of Health SciencesUniversity of OttawaOttawaOntarioCanada
| | | | - Nour Elmestekawy
- Bruyère Research InstituteOttawaOntarioCanada
- Faculty of Social SciencesUniversity of OttawaOttawaOntarioCanada
| | - Sydney Rossiter
- School of Psychology, Faculty of Social SciencesUniversity of OttawaOttawaOntarioCanada
| | | | - Omar Dewidar
- Bruyère Research InstituteOttawaOntarioCanada
- Temerty School of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Leanne Idzerda
- Centre for Global Health ResearchUniversity of OttawaOttawaOntarioCanada
| | | | - Harshita Seal
- School of Psychology, Faculty of Social SciencesUniversity of OttawaOttawaOntarioCanada
| | - Julian Little
- Department of Epidemiology & Community MedicineUniversity of OttawaOttawaOntarioCanada
| | | | | | - Janet Jull
- School of Rehabilitation TherapyQueen's UniversityKingstonOntarioCanada
| | - Lucas Gergyek
- Department of PsychologyWilfrid Laurier UniversityWaterlooOntarioCanada
| | | | - Beverley Shea
- Department of Epidemiology and Community MedicineUniversity of OttawaOttawaOntarioCanada
| | - Cristina Atance
- School of Psychology, Faculty of Social SciencesUniversity of OttawaOttawaOntarioCanada
| | | | - Christina Pollard
- School of Population HealthCurtin UniversityBentleyWestern AustraliaAustralia
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact (HEI)McMaster UniversityHamiltonOntarioCanada
| | - George A. Wells
- School of Epidemiology and Public HealthUniversity of OttawaOttawaOntarioCanada
| | - Vivian Welch
- Methods Centre, Bruyère Research InstituteOttawaOntarioCanada
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Baxter KA, Kerr J, Nambiar S, Gallegos D, Penny RA, Laws R, Byrne R. A design thinking-led approach to develop a responsive feeding intervention for Australian families vulnerable to food insecurity: Eat, Learn, Grow. Health Expect 2024; 27:e14051. [PMID: 38642335 PMCID: PMC11032130 DOI: 10.1111/hex.14051] [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: 02/25/2024] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Design thinking is an iterative process that innovates solutions through a person-centric approach and is increasingly used across health contexts. The person-centric approach lends itself to working with groups with complex needs. One such group is families experiencing economic hardship, who are vulnerable to food insecurity and face challenges with child feeding. OBJECTIVE This study describes the application of a design thinking framework, utilizing mixed methods, including co-design, to develop a responsive child-feeding intervention for Australian families-'Eat, Learn, Grow'. METHODS Guided by the five stages of design thinking, which comprises empathizing, defining, ideating, prototyping, and testing. We engaged with parents/caregivers of a child aged 6 months to 3 years through co-design workshops (n = 13), direct observation of mealtimes (n = 10), a cross-sectional survey (n = 213) and semistructured interviews (n = 29). Findings across these methods were synthesized using affinity mapping to clarify the intervention parameters. Parent user testing (n = 12) was conducted online with intervention prototypes to determine acceptability and accessibility. A co-design workshop with child health experts (n = 9) was then undertaken to review and co-design content for the final intervention. RESULTS Through the design thinking process, an innovative digital child-feeding intervention was created. This intervention utilized a mobile-first design and consisted of a series of short and interactive modules that used a learning technology tool. The design is based on the concept of microlearning and responds to participants' preferences for visual, brief and plain language information accessed via a mobile phone. User testing sessions with parents and the expert co-design workshop indicated that the intervention was highly acceptable. CONCLUSIONS Design thinking encourages researchers to approach problems creatively and to design health interventions that align with participant needs. Applying mixed methods-including co-design- within this framework allows for a better understanding of user contexts, preferences and priorities, ensuring solutions are more acceptable and likely to be engaged.
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Affiliation(s)
- Kimberley A. Baxter
- Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologyBrisbaneAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveAustralia
| | - Jeremy Kerr
- School of Design, Education and Social Justice, Faculty of Creative IndustriesQueensland University of TechnologyKelvin GroveAustralia
| | - Smita Nambiar
- Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologyBrisbaneAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveAustralia
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologyBrisbaneAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveAustralia
| | - Robyn A. Penny
- Child Health Liaison, Children's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition, Faculty of Health SciencesDeakin UniversityBurwoodAustralia
| | - Rebecca Byrne
- Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologyBrisbaneAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveAustralia
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Ariyo T, Jiang Q. Maternal autonomy and childhood undernutrition: Analysis of 2018 Nigeria demographic and health survey. J Child Health Care 2024; 28:150-165. [PMID: 35713878 DOI: 10.1177/13674935221108011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Existing knowledge of how maternal autonomy relates to child undernutrition in Nigeria is few and limited to children under 24 months old. Nothing is known about how it affects older children. Therefore, this study investigated whether mothers' household autonomy affects children 24-59 months, as do children under 24 months old. We used data from 2018 Nigerian Demographic and Health Survey, which is a nationally representative survey. Samples include 3502 and 5463 children under 24 months and between 24 and 59 months old, respectively. Three anthropometry indexes were used to determine child undernutrition: weight-for-height, height-for-age, and weight-for-age, which indicate wasting, stunting, and underweight, respectively. Three domains of maternal autonomy: decision-making, financial-control, and mobility, were operationalized using responses from mothers. Results from logistic regression analysis show that in unadjusted models, maternal decision-making autonomy and mobility were associated with undernutrition in both samples. After adding covariates, only associations between maternal decision-making autonomy and underweight in children 24-59 months old retained statistical significance. Findings show that gendered social inequalities are linked to differences in child nutritional outcomes. Future studies could investigate how feeding practices mediate associations between maternal autonomy and childhood undernutrition.
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Affiliation(s)
- Tolulope Ariyo
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, China
| | - Quanbao Jiang
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, China
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So JTH, Byrne R, Nambiar S, Gallegos D, Baxter KA. "You just have to spread it thin": Perceptions and feeding experiences of Australian fathers of young children living with disadvantage. Appetite 2024; 194:107197. [PMID: 38182055 DOI: 10.1016/j.appet.2023.107197] [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: 07/13/2023] [Revised: 12/18/2023] [Accepted: 12/24/2023] [Indexed: 01/07/2024]
Abstract
The role of fathers in feeding is an emerging field within child feeding literature. Fathers have unique contributions to make to family mealtimes and child eating behaviours. However, qualitative research on fathers' experiences is limited, especially in the context of disadvantage. This study explored fathers' perceptions of their roles and feeding practices and their lived experience of disadvantage through a symbolic interactionism lens. Twenty-five Australian fathers of children aged six months to five years who experienced socioeconomic disadvantage participated in semi-structured interviews. Five themes were constructed from reflexive thematic analysis: (i) responsibilities for foodwork are based on strengths, opportunities, and values, (ii) negotiating fatherhood identity from a place of tension to acceptance, (iii) struggling with financial and mental strain, and food insecurity, (iv) managing adversity whist prioritising feeding children, and (v) paternal feeding practices are driven by values, adversity, and emotions. The division of foodwork was contingent on family capability and employment, maternal gatekeeping, paternal attitudes and values, and intergenerational, cultural and gender norms around earning and childrearing. Economic, environmental, and emotional stressors triggered changes to fathers' feeding practices, often contradicting their ideals (e.g., providing alternative meals, using rewards and electronic devices, unstructured settings). Fathers described income and food-based strategies to protect children's food intake, which may involve caregivers forgoing meals. These findings provide insight into fathers' feeding experiences through recognising personal, interpersonal, and systemic enablers and barriers. Promoting optimal feeding practices should include targeted feeding support and broader structural interventions to address inequality. Fathers' experiences as they navigate child mealtime interactions within a context of adversity can be used to inform child feeding interventions to improve child health and development.
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Affiliation(s)
- Jeffrey T H So
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham Street, South Brisbane, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, 4059, Australia.
| | - Rebecca Byrne
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham Street, South Brisbane, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, 4059, Australia.
| | - Smita Nambiar
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham Street, South Brisbane, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, 4059, Australia.
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham Street, South Brisbane, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, 4059, Australia.
| | - Kimberley A Baxter
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham Street, South Brisbane, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, 4059, Australia.
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Baxter KA, Nambiar S, Penny R, Gallegos D, Byrne R. Food Insecurity and Feeding Experiences Among Parents of Young Children in Australia: An Exploratory Qualitative Study. J Acad Nutr Diet 2024:S2212-2672(24)00095-9. [PMID: 38428454 DOI: 10.1016/j.jand.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 02/11/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Responsive feeding is a reciprocal process between caregiver and child that is primarily child-led. It is linked to the development of positive eating behaviors and food preferences. There is evidence that household chaos, family dynamics, the quality of mealtime routines, financial hardship, and food insecurity can impact the feeding relationship. OBJECTIVE This study explored factors influencing feeding experiences among Australian parents with young children experiencing financial hardship, including household chaos and food insecurity. DESIGN This qualitative semi-structured interview study was conducted as a component of a larger research program to design and evaluate a parent program to support responsive feeding practices in Australian families experiencing financial hardship and food insecurity. PARTICIPANTS/SETTING Participants were caregivers of a child aged 6 months to 3 years (n = 29), living in Australia, who self-identified as experiencing financial hardship. Interviews were conducted in person and via telephone between August 2021 and January 2022. ANALYSIS Transcripts were analyzed using the Framework Method of thematic analysis. RESULTS Five key themes were generated: family tensions heightened through hardship, making tradeoffs and sacrifices, the unseen mental load, the inescapable impact of COVID-19, and resiliency and being creative. Despite facing multiple hardships and challenges with feeding the family, parents demonstrated resilience and capabilities through creative food resource management and organizational skills. Parents experienced a high mental load through the cognitive and emotional work of planning, adapting, anticipating, and caring for the family's needs through meals and child feeding. CONCLUSIONS Programs to support child feeding need to consider the high mental load families with food insecurity experience and how this can impact parents' capacity. Program content should be contextually sensitive to the experience of food insecurity and consider the constraints inherent in families and communities while building on capabilities and strengths.
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Affiliation(s)
- Kimberley A Baxter
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Australia.
| | - Smita Nambiar
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Australia
| | - Robyn Penny
- Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Australia
| | - Rebecca Byrne
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Australia
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So JTH, Nambiar S, Byrne R, Gallegos D, Baxter KA. Dads at Mealtimes: Associations between Food Security, Household and Work Chaos, and Paternal Feeding Practices among Australian Fathers Living with Disadvantage. Nutrients 2024; 16:205. [PMID: 38257098 PMCID: PMC10820457 DOI: 10.3390/nu16020205] [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: 12/13/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Understanding how fathers engage in feeding while experiencing disadvantage is important for family-focused interventions. A cross-sectional online survey involving 264 Australian fathers was conducted to explore feeding involvement and the relationships between feeding practices, food insecurity, and household and work chaos. Practices related to coercive control, structure, and autonomy support were measured for two age groups (<2 years and 2-5 years). Multivariable linear regression was used to examine the associations for each practice. Three-quarters of the sample were food insecure, impacting adults more than children, and correlated with household chaos. Food insecurity was associated with increased 'persuasive feeding' and 'parent-led feeding' in younger children. Household chaos was positively associated with coercive control practices in both younger and older child groups, with the strongest associations for 'using food to calm' and 'overt restriction', respectively. In older child groups, household chaos was negatively associated with 'offer new foods' and 'repeated presentation of new foods'. Structure practices had no significant relationships with any factors, and work chaos did not predict any feeding practices. These findings emphasize a need for societal and structural support to address food insecurity and household chaos. Tailored strategies are crucial to support fathers in responsive feeding.
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Affiliation(s)
- Jeffrey T. H. So
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD 4101, Australia; (S.N.); (R.B.); (D.G.); (K.A.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Smita Nambiar
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD 4101, Australia; (S.N.); (R.B.); (D.G.); (K.A.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Rebecca Byrne
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD 4101, Australia; (S.N.); (R.B.); (D.G.); (K.A.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD 4101, Australia; (S.N.); (R.B.); (D.G.); (K.A.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Kimberley A. Baxter
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD 4101, Australia; (S.N.); (R.B.); (D.G.); (K.A.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
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Carrillo-Álvarez E. Perspective: Food and Nutrition Insecurity in Europe: Challenges and Opportunities for Dietitians. Adv Nutr 2023; 14:995-1004. [PMID: 37543145 PMCID: PMC10509433 DOI: 10.1016/j.advnut.2023.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/23/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023] Open
Abstract
In recent years, the interest in food and nutrition insecurity in high-income countries has skyrocketed. However, its recognition in Europe is still developing. This perspective summarizes the evidence on food and nutrition insecurity across Europe in terms of prevalence, consequences, and current mitigation strategies, with the aim of outlining the challenges and opportunities for dietitians. Prevalence in the general population ranges between 5% and 20%, with higher rates identified in women, children, older adults, single-parent households, those with low educational attainment, and on low or unstable income and/or employment. In users of food aid, the prevalence of food insecurity is above 70%. Responses to food and nutrition insecurity include welfare policies and food assistance programs at regional and national levels. However, most current strategies are not successful in tackling the structural drivers of food and nutrition insecurity, nor do they guarantee diet quality. Despite limited involvement to-date, dietitians can play an important role in addressing food and nutrition insecurity across Europe. This narrative identifies 4 areas: 1) create awareness of the existence and severity of food and nutrition insecurity, 2) advocate for comprehensive, robust data on the determinants and prevalence, 3) partner with diverse stakeholders, social assistance providers, local authorities, and nongovernmental organizations in a comprehensive, intersectoral, and integrated manner, 4) participate in the development of political instruments and interventions that ensure equitable access to high-quality safe food.
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Affiliation(s)
- Elena Carrillo-Álvarez
- Public Health Specialist Network (ESDN PH), European Federation of Association of Dietetics (EFAD), Europe; Global Research on Wellbeing (GRoW) research group, Blanquerna School of Health Sciences, Universitat Ramon Lull, Barcelona, Spain.
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Nyarko MJ, van Rooyen DR, Ten Ham-Baloyi W. Preventing malnutrition within the first 1000 days of life in under-resourced communities: An integrative literature review. J Child Health Care 2023:13674935231166427. [PMID: 37011277 DOI: 10.1177/13674935231166427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
This integrative review aimed to summarise existing best evidence practice for preventing malnutrition within the First 1000 Days of Life in under-resourced communities. BioMed Central, EBSCOHOST (Academic Search Complete, CINAHL and MEDLINE), Cochrane Library, JSTOR, Science Direct and Scopus were searched as well as Google Scholar and relevant websites for grey literature. Most recent versions of strategies, guidelines, interventions and policies; published in English, focussing on preventing malnutrition in pregnant women and in children less than 2 years old in under-resourced communities, from January 2015 to November 2021 were searched for. Initial searches yielded 119 citations of which 19 studies met inclusion criteria. Johns Hopkins Nursing Evidenced-Based Practice Evidence Rating Scales for appraising research evidence and non-research evidence were used. Extracted data were synthesised using thematic data analysis. Five themes were derived from extracted data: 1. Improving social determinants of health using a multisector approach; 2. Enhancing infant and toddler feeding; 3. Managing healthy nutrition and lifestyle choices in pregnancy; 4. Improving personal and environmental health practices; and 5. Reducing low-birthweight incidence. Further exploration regarding preventing malnutrition in the First 1000 Days in under-resourced communities is required using high-quality studies. Systematic review registration number: H18-HEA-NUR-001 (Nelson Mandela University).
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Affiliation(s)
- Marian Joyce Nyarko
- Faculty of Health Sciences, 56723Nelson Mandela University, Port Elizabeth, South Africa
| | - Dalena Rm van Rooyen
- Faculty of Health Sciences, 56723Nelson Mandela University, Port Elizabeth, South Africa
| | - Wilma Ten Ham-Baloyi
- Faculty of Health Sciences, 56723Nelson Mandela University, Port Elizabeth, South Africa
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Ferguson M, Tonkin E, Brimblecombe J, Lee A, Fredericks B, Cullerton K, Mah CL, Brown C, McMahon E, Chatfield MD, Miles E, Cadet-James Y. Communities Setting the Direction for Their Right to Nutritious, Affordable Food: Co-Design of the Remote Food Security Project in Australian Indigenous Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2936. [PMID: 36833632 PMCID: PMC9957436 DOI: 10.3390/ijerph20042936] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Despite long histories of traditional food security, Indigenous peoples globally are disproportionately exposed to food insecurity. Addressing this imbalance must be a partnership led by Indigenous peoples in accordance with the UN Declaration of the Rights of Indigenous Peoples. We report the co-design process and resulting design of a food security research project in remote Australia and examine how the co-design process considered Indigenous peoples' ways of knowing, being, and doing using the CREATE Tool. Informed by the Research for Impact Tool, together Aboriginal Community Controlled Health Organisation staff, Indigenous and non-Indigenous public health researchers designed the project from 2018-2019, over a series of workshops and through the establishment of research advisory groups. The resulting Remote Food Security Project includes two phases. Phase 1 determines the impact of a healthy food price discount strategy on the diet quality of women and children, and the experience of food (in)security in remote communities in Australia. In Phase 2, community members propose solutions to improve food security and develop a translation plan. Examination with the CREATE Tool showed that employing a co-design process guided by a best practice tool has resulted in a research design that responds to calls for food security in remote Indigenous communities in Australia. The design takes a strengths-based approach consistent with a human rights, social justice, and broader empowerment agenda. Trial registration: The trial included in Phase 1 of this project has been registered with Australian New Zealand Clinical Trials Registry: ACTRN12621000640808.
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Affiliation(s)
- Megan Ferguson
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
- Department of Nutrition, Dietetics and Food, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Emma Tonkin
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Department of Nutrition, Dietetics and Food, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Julie Brimblecombe
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
- Department of Nutrition, Dietetics and Food, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Amanda Lee
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Bronwyn Fredericks
- Office of the Pro-Vice Chancellor (Indigenous Engagement), The University of Queensland, St. Lucia, QLD 4006, Australia
| | - Katherine Cullerton
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Catherine L. Mah
- School of Health Administration, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Clare Brown
- Apunipima Cape York Health Council, Bungalow, QLD 4870, Australia
| | - Emma McMahon
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
- Department of Nutrition, Dietetics and Food, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Mark D. Chatfield
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Eddie Miles
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Yvonne Cadet-James
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Apunipima Cape York Health Council, Bungalow, QLD 4870, Australia
- Indigenous Education and Research Centre, James Cook University, Bungalow, QLD 4870, Australia
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10
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Sabbagh S, Mohammadi-Nasrabadi F, Ravaghi V, Azadi Mood K, Sarraf Shirazi A, Abedi AS, Noorollahian H. Food insecurity and dental caries prevalence in children and adolescents: A systematic review and meta-analysis. Int J Paediatr Dent 2022. [PMID: 36511123 DOI: 10.1111/ipd.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/13/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Food insecurity (FI) is associated with dietary practices, which can act as a risk factor for dental caries. AIM This study aimed to investigate the relationship between FI and dental caries prevalence in children and adolescents. DESIGN MEDLINE (via PubMed), EMBASE, SCOPUS, ISI web of knowledge, Cochrane, and ProQuest Dissertations & Theses Global database (up to April 19, 2022) as well as reference lists were searched. Eligible studies compared dental caries prevalence in food-secure and food-insecure individuals younger than 19 years. Two independent reviewers performed study selection, data extraction, and risk of bias assessment using a modified Newcastle-Ottawa Scale. Meta-analysis was performed, and the pooled odds ratio (OR) was calculated at 95% confidence interval (95% CI). RESULTS Among the 1350 retrieved records, 10 cross-sectional reports were selected for systematic review. Six studies involving 8631 participants were included in the meta-analysis. More than half of the reports were published within the period 2019-2021. All studies except one were judged as low risk of bias. Overall, the prevalence of dental caries was greater among the food-insecure children and adolescents (OR: 2.01, 95% CI: 1.52-2.65, p < .001, I2 : 73.5%). Similarly, all three categories of FI were significantly associated with caries experience (marginal FI: OR: 1.88, 95% CI: 1.56-2.27, p < .001, I2 : 0.0%; low FI: OR: 2.42, 95% CI: 1.42-4.14, p = .001, I2 : 74.4%; very low FI: OR: 2.37, 95% CI: 1.88-3.00, p < .001, I2 : 0.0%). CONCLUSION The results showed a significant association between FI status and dental caries in both childhood and adolescence; however, there was a lack of longitudinal studies for a better understanding of this association. Health policies leading to reduction in FI may also aim to reduce dental caries.
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Affiliation(s)
- Sedigheh Sabbagh
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Mohammadi-Nasrabadi
- Research Department of Food and Nutrition Policy and Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Ravaghi
- School of Dentistry, University of Birmingham, Birmingham, UK
| | | | - Alireza Sarraf Shirazi
- Department of Pediatric Dentistry, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdol-Samad Abedi
- Department of Research Deputy, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homa Noorollahian
- Department of Pediatric Dentistry, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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11
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Rizvi A, Welch V, Gibson M, Labelle PR, Pollard C, Wells GA, Kristjansson E. PROTOCOL: Effects of guaranteed basic income interventions on poverty-related outcomes in high-income countries: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1281. [PMID: 36908842 PMCID: PMC9538708 DOI: 10.1002/cl2.1281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: to appraise and synthesize the available quantitative evidence on GBI interventions in high-income countries, for the purpose of comparing the relative effectiveness of specific forms of GBI for alleviating poverty.
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Affiliation(s)
- Anita Rizvi
- School of Psychology, Faculty of Social SciencesUniversity of OttawaOttawaCanada
| | - Vivian Welch
- Methods CentreBruyère Research InstituteOttawaCanada
| | - Marcia Gibson
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | | | - Christina Pollard
- School of Population Health, Faculty of Health SciencesCurtin UniversityBentleyAustralia
| | - George A. Wells
- School of Epidemiology and Public Health, Faculty of MedicineUniversity of OttawaOttawaCanada
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12
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Lindberg R, Cirone K, Larkin L, Ball K, Laws R, Margerison C. Strategies used by schools to tackle food insecurity and hunger: a qualitative enquiry in 15 Victorian schools. Aust N Z J Public Health 2022; 46:444-449. [PMID: 35679018 DOI: 10.1111/1753-6405.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Food insecurity is a threat to children's development and in Australia 13.5% of households experience food insecurity. Universal school food programs, however, are not provided nationally. Teachers and not-for-profit organisations have instead mobilised to tackle hunger. The strategies used and their effects on students have limited empirical evidence. The aim of this study is to gain perspectives on the causes and consequences of children's food insecurity in schools and describe food security strategies adopted. METHOD One hundred schools in Victoria, which participate in a not-for-profit lunch program provided by Eat Up were invited to take part in the study. Fifteen staff (including school principals and welfare officers) from 15 schools were recruited for semi-structured interviews. Results: There was evidence that children experience adverse quantity, quality, social and psychological impacts of food insecurity whilst in school settings. Participants described employing multiple strategies including free meals (e.g. lunch, breakfast) and food (e.g. parcels) for food insecure students and their families. Conclusions and implications for public health: In our sample, multiple strategies were being employed by schools to reduce food insecurity, but there remains unmet need for additional wide-scale initiatives to address this critical issue and its causes and consequences.
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Affiliation(s)
- Rebecca Lindberg
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria
| | - Kathryn Cirone
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria
| | | | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria
| | - Claire Margerison
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria
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13
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Akbar H, Radclyffe CJT, Santos D, Mopio-Jane M, Gallegos D. "Food Is Our Love Language": Using Talanoa to Conceptualize Food Security for the Māori and Pasifika Diaspora in South-East Queensland, Australia. Nutrients 2022; 14:nu14102020. [PMID: 35631160 PMCID: PMC9143296 DOI: 10.3390/nu14102020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 12/01/2022] Open
Abstract
Queensland is home to the largest diaspora of Māori and Pasifika peoples in Australia. They form an understudied population concerning experiences and challenges of food insecurity. This community co-designed research aims to explore the conceptualization of household food security by Māori and Pasifika peoples living in south-east Queensland. Participatory action research and talanoa were used to collect and analyse forty interviews with leaders representing 22 Māori and Pasifika cultural identities in south-east Queensland. Eight key themes emerged that conceptualise food security as an integral part of the culture and holistic health. These themes included: spirituality, identity, hospitality and reciprocity, stigma and shame, expectations and obligations, physical and mental health and barriers and solutions. Addressing food insecurity for collectivist cultures such as Māori and Pasifika peoples requires embracing food sovereignty approaches for improved food security through the co-design of practical solutions that impact social determinants and strengthen existing networks to produce and distribute affordable and nutritious food.
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Affiliation(s)
- Heena Akbar
- Woolworths Centre for Childhood Nutrition Research, Queensland University of Technology, South Brisbane 4101, Australia; (H.A.); (C.J.T.R.)
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove 4059, Australia
| | - Charles J. T. Radclyffe
- Woolworths Centre for Childhood Nutrition Research, Queensland University of Technology, South Brisbane 4101, Australia; (H.A.); (C.J.T.R.)
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove 4059, Australia
- Pasifika Young Peoples Well-Being Network (PYPWN), School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove 4059, Australia
| | - Daphne Santos
- Good Start Program, Child and Youth Community Health Services, Children’s Health Queensland, South Brisbane 4101, Australia;
| | | | - Danielle Gallegos
- Woolworths Centre for Childhood Nutrition Research, Queensland University of Technology, South Brisbane 4101, Australia; (H.A.); (C.J.T.R.)
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove 4059, Australia
- Correspondence:
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14
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Ha DH, Arora A, Harford J, Luzzi L, Chrisopoulos S, Do LG. Population Impact of Sugar-Sweetened Beverages on Dental Caries and Overweight/Obesity in Australian Children. JDR Clin Trans Res 2022:23800844221091701. [PMID: 35466760 DOI: 10.1177/23800844221091701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
KNOWLEDGE TRANSFER STATEMENT The reported findings greatly consolidated evidence of detrimental effects of sugars intake on child oral health and overweight and obesity, some of the most prevalent chronic conditions in children. Evidence on population impact of sugars intake is directly informative to policy makers and the public about the potential impact of population-based programs targeting sugars intake to prevent dental caries and overweight and obesity.
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Affiliation(s)
- D H Ha
- School of Dentistry, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia.,Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - A Arora
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia.,Health Equity Laboratory, Campbelltown, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia.,Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Westmead, NSW, Australia
| | - J Harford
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - L Luzzi
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - S Chrisopoulos
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - L G Do
- School of Dentistry, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia.,Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
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15
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Moller H, Sincovich A, Gregory T, Smithers L. Breakfast skipping and cognitive and emotional engagement at school: a cross-sectional population-level study. Public Health Nutr 2021; 25:1-10. [PMID: 34911597 PMCID: PMC9991782 DOI: 10.1017/s1368980021004870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Research on the consequences of breakfast skipping among students tends to focus on academic outcomes, rather than student well-being or engagement at school. This study investigated the association between breakfast skipping and cognitive and emotional aspects of school engagement. DESIGN Cross-sectional study using data from a population-level survey of children and adolescents' well-being and engagement at school. Linear regression with adjustment for confounders was used to estimate the effect of breakfast skipping on school engagement. SETTING Government schools (i.e. public schools) in South Australia. PARTICIPANTS The participants were students, Grades 4-12, who completed the Wellbeing and Engagement Collection in 2019. The analysis sample included 61 825 students. RESULTS Approximately 9·6 % of students reported always skipping breakfast, with 35·4 % sometimes skipping and 55·0 % never skipping. In the adjusted linear regression models, children and adolescents who always skipped breakfast reported lower levels of cognitive engagement (β = -0·26 (95 % CI -0·29, -0·25)), engagement with teachers (β = -0·17 (95 % CI -0·18, -0·15)) and school climate (β = -0·17 (95 % CI -0·19, -0·15)) compared with those who never skipped breakfast, after controlling for age, gender, health, sleep, sadness and worries, parental education, socio-economic status and geographical remoteness. CONCLUSION Consistent with our hypothesis, skipping breakfast was associated with lower cognitive and emotional engagement, which could be due to mechanisms such as short-term energy supply and long-term health impacts. Therefore, decreasing the prevalence of breakfast skipping could have a positive impact on school engagement.
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Affiliation(s)
- Hero Moller
- Telethon Kids Institute, University of Western Australia, Level 7, 31 Flinders St., Adelaide, South Australia5000, Australia
| | - Alanna Sincovich
- Telethon Kids Institute, University of Western Australia, Level 7, 31 Flinders St., Adelaide, South Australia5000, Australia
- School of Public Health, University of Adelaide, Level 5, Rundle Mall Plaza, Adelaide, South Australia5000, Australia
| | - Tess Gregory
- Telethon Kids Institute, University of Western Australia, Level 7, 31 Flinders St., Adelaide, South Australia5000, Australia
- School of Public Health, University of Adelaide, Level 5, Rundle Mall Plaza, Adelaide, South Australia5000, Australia
| | - Lisa Smithers
- School of Public Health, University of Adelaide, Level 5, Rundle Mall Plaza, Adelaide, South Australia5000, Australia
- School of Health and Society, University of Wollongong, Wollongong, Australia
- Robinson Research Institute, Norwich Centre, North Adelaide, Australia
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16
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Kleve S, Bennett CJ, Davidson ZE, Kellow NJ, McCaffrey TA, O’Reilly S, Enticott J, Moran LJ, Harrison CL, Teede H, Lim S. Food Insecurity Prevalence, Severity and Determinants in Australian Households during the COVID-19 Pandemic from the Perspective of Women. Nutrients 2021; 13:nu13124262. [PMID: 34959816 PMCID: PMC8706915 DOI: 10.3390/nu13124262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 01/27/2023] Open
Abstract
This study aimed to describe the prevalence, severity and socio-demographic predictors of food insecurity in Australian households during the COVID-19 pandemic in 2020, from the perspective of women. A cross-sectional online survey of Australian (18–50 years) women was conducted. The survey collected demographic information and utilised the 18-item US Department of Agriculture Household Food Security Survey Module and the Kessler Psychological Distress Scale (K10). A multivariable regression was used to identify predictors of food security status. In this cohort (n = 1005), 19.6% were living in households experiencing food insecurity; with 11.8% experiencing low food-security and 7.8% very low food-security. A further 13.7% of households reported marginal food-security. Poor mental health status (K10 score ≥ 20) predicted household food insecurity at all levels. The presence of more than three children in the household was associated with low food-security (OR 6.24, 95% CI: 2.59–15.03). Those who were renting were 2.10 (95% CI: 1.09–4.05) times likely to experience very low food-security than those owning their own home. The COVID-19 pandemic may have contributed to an increased prevalence of household food insecurity. This study supports the need for a range of responses that address mental health, financial, employment and housing support to food security in Australia.
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Affiliation(s)
- Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia; (C.J.B.); (Z.E.D.); (N.J.K.); (T.A.M.)
- Correspondence: ; Tel.: +61-3-9902-4268
| | - Christie J. Bennett
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia; (C.J.B.); (Z.E.D.); (N.J.K.); (T.A.M.)
| | - Zoe E. Davidson
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia; (C.J.B.); (Z.E.D.); (N.J.K.); (T.A.M.)
| | - Nicole J. Kellow
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia; (C.J.B.); (Z.E.D.); (N.J.K.); (T.A.M.)
| | - Tracy A. McCaffrey
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Melbourne, VIC 3168, Australia; (C.J.B.); (Z.E.D.); (N.J.K.); (T.A.M.)
| | - Sharleen O’Reilly
- School of Agriculture and Food Science, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland;
| | - Joanne Enticott
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia; (J.E.); (L.J.M.); (C.L.H.); (H.T.); (S.L.)
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia; (J.E.); (L.J.M.); (C.L.H.); (H.T.); (S.L.)
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia; (J.E.); (L.J.M.); (C.L.H.); (H.T.); (S.L.)
| | - Helena Teede
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia; (J.E.); (L.J.M.); (C.L.H.); (H.T.); (S.L.)
| | - Siew Lim
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia; (J.E.); (L.J.M.); (C.L.H.); (H.T.); (S.L.)
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17
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Teasdale SB, Müller-Stierlin AS, Ruusunen A, Eaton M, Marx W, Firth J. Prevalence of food insecurity in people with major depression, bipolar disorder, and schizophrenia and related psychoses: A systematic review and meta-analysis. Crit Rev Food Sci Nutr 2021:1-18. [PMID: 34783286 DOI: 10.1080/10408398.2021.2002806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
People with severe mental illness (SMI), such as major depression, bipolar disorder, and schizophrenia, experience numerous risk factors that may predispose them to food insecurity; however, the prevalence of food insecurity and its effects on health are under-researched in this population group. This systematic review and meta-analysis aimed to describe the prevalence and correlates of food insecurity in people with SMI. A comprehensive electronic search was conducted up to March 2021. Random effects meta-analysis was employed to determine the prevalence of food insecurity in SMI, and odds ratio (OR) of food insecurity in people with SMI compared to non-psychiatric controls/general population. Twenty-nine unique datasets (31 publications) were included. Prevalence estimate of food insecurity in people with SMI was 40% (95% CI 29-52%, I2 = 99.7%, N = 27). People with SMI were 2.71 (95% CI 1.72-3.25) times more likely to report food insecurity than the comparator group (Z = 11.09, p < 0.001, I2 = 95%, N = 23). The odds of food insecurity in SMI were higher in high/high-middle income countries compared to low/low-middle income countries, likely due to the high food insecurity rates in the general population of lower income countries. There was no difference in food insecurity rates by diagnosis. Food insecurity should be a consideration for health professionals working with community-dwelling people with SMI.
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Affiliation(s)
- Scott B Teasdale
- School of Psychiatry, University of New South Wales and Mindgardens Neuroscience Network, Kensington, Australia
| | - Annabel S Müller-Stierlin
- Department of Psychiatry II, Ulm University, Ulm, Germany
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Anu Ruusunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
- Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, iMPACT - the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Melissa Eaton
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Wolfgang Marx
- Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, iMPACT - the Institute for Mental and Physical Health and Clinical Translation, Geelong, Australia
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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18
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Maia I, Santos AC. Prevalence and determinants of children self-reports of food insecurity: evidence from a Portuguese population-based birth cohort. Food Secur 2021. [DOI: 10.1007/s12571-021-01233-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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19
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Higgins CD, Páez A, Kim G, Wang J. Changes in accessibility to emergency and community food services during COVID-19 and implications for low income populations in Hamilton, Ontario. Soc Sci Med 2021; 291:114442. [PMID: 34655939 PMCID: PMC8506574 DOI: 10.1016/j.socscimed.2021.114442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/01/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022]
Abstract
In this paper we analyze the changes in accessibility to emergency and community food services before and during the COVID-19 pandemic in the City of Hamilton, Ontario. Many of these food services are the last line of support for households facing food insecurity; as such, their relevance cannot be ignored in the midst of the economic upheaval caused by the pandemic. Our analysis is based on the application of balanced floating catchment areas and concentrates on households with lower incomes (<CAD40,000, approximately the Low Income Cutoff Value for a city of Hamilton's size). We find that accessibility was low to begin with in suburban and exurban parts of the city; furthermore, about 14% of locations originally available in Hamilton closed during the pandemic, further reducing accessibility. The impact of closures on the level of service of the remaining facilities, and on accessibility, was disproportionate, with system-wide losses exceeding 39%. Those losses were geographically and demographically uneven. While every part of the city faced a reduction in accessibility, inner suburbs fared worse in terms of loss of accessibility. As well, children (age ≤18) appear to have been impacted the most.
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Affiliation(s)
- Christopher D Higgins
- Department of Geography & Planning, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON, M1C1A4, Canada.
| | - Antonio Páez
- School of Earth, Environment and Society, McMaster University, Hamilton, ON, L8S 4K1, Canada.
| | - Gyoorie Kim
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada.
| | - Jue Wang
- Department of Geography, Geomatics and Environment, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada.
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20
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Kerz A, Bell K, White M, Thompson A, Suter M, McKechnie R, Gallegos D. Development and preliminary validation of a brief household food insecurity screening tool for paediatric health services in Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1538-1549. [PMID: 33170535 DOI: 10.1111/hsc.13219] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/08/2020] [Indexed: 06/11/2023]
Abstract
Children from food insecure households are more likely to have substandard food and nutritional intakes, and experience developmental delays, behaviour issues and increased use of health services. In Australia, screening for household food insecurity (HFI) within health services is not undertaken routinely, limiting opportunities to optimise nutrition and healthcare. This research aimed to (a) identify the prevalence, potential determinants and outcomes of HFI among paediatric outpatients in two Queensland hospitals; and (b) identify questions suitable for screening households at risk of HFI. A cross-sectional survey collected data from caregivers of children attending paediatric appointments at two hospitals in Brisbane, Australia (n = 148). Sociodemographic, health and household-related characteristics were collected, and food security status was assessed using four HFI measures. Chi-square, independent t-tests, ANOVA and logistic regression explored associations between HFI and health-related characteristics. A potential HFI screener was identified based on the most frequently endorsed questions from any HFI measure, and its validity was assessed through calculation of sensitivity and specificity. Prevalence of HFI was 41%, with 16% experiencing very low food security. Households with a child of 'fair/poor' health had 5.59 times greater odds of being food insecure than being food secure, compared to households with a child of 'excellent/good' health (aOR 5.59, 95% CI: 1.3-23.5). HFI was also positively associated with household chaos (p = .006). A combination of two questions was identified as a possible screening tool, with a sensitivity of 96% and a specificity of 90%. This study demonstrated HFI may be highly prevalent in a paediatric outpatient population, which may result in difficulties in being able to follow nutrition prescriptions. A highly sensitive and specific two-question screening tool was identified and may assist practitioners in paediatric healthcare settings in identifying clients who are at risk of HFI.
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Affiliation(s)
- Aria Kerz
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kristie Bell
- Dietetics and Food Services, Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, Australia
| | - Melinda White
- Dietetics and Food Services, Children's Health Queensland Hospital and Health Service, South Brisbane, QLD, Australia
| | - Amy Thompson
- Department of Dietetics and Food Services, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, QLD, Australia
| | - Michelle Suter
- Department of Dietetics and Food Services, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, QLD, Australia
| | - Rebecca McKechnie
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
- Woolworths Centre for Child Nutrition Research, Centre for Children's Health Research, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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21
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Food Insecurity and Child Development: A State-of-the-Art Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178990. [PMID: 34501578 PMCID: PMC8431639 DOI: 10.3390/ijerph18178990] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/22/2021] [Accepted: 08/22/2021] [Indexed: 02/07/2023]
Abstract
Converging research indicates that household food insecurity impedes children from reaching their full physical, cognitive, and psychosocial potential. This state-of-the-art review examines the last decade of research to: (1) describe the impact of the severity and persistence of food insecurity on child development; (2) use a socio-ecological framework to examine significant proximal and distal factors which may interplay; and (3) outline directions for future research. We conducted a systematic review of six databases of published papers from 2011 to June 2021. The search was limited to high-income countries and children aged from birth to 12 years. From 17,457 papers, 17 studies were included in the final review. Transitioning between food security and food insecurity had a significant and lasting effect on academic/cognitive function and behavior (i.e., externalizing), however less clear relationships were seen for psychosocial outcomes and other behaviors examined (i.e., internalizing). There was significant variation in the measurement and thresholds used to define both food insecurity and child development outcomes. Subsequently, comparisons across studies are difficult. Several future recommendations, including incorporation of socio-ecological factors, is provided. In conclusion, this review supports the link between food insecurity and sub-optimal child development; however, there is an imperative to improve and extend current understanding to ameliorate the causes of food insecurity.
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Velardo S, Pollard CM, Shipman J, Booth S. How Do Disadvantaged Children Perceive, Understand and Experience Household Food Insecurity? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4039. [PMID: 33921362 PMCID: PMC8070068 DOI: 10.3390/ijerph18084039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 02/07/2023]
Abstract
Food insecurity is associated with reduced physical, social, and psychological functioning in children. There has been sparse research into child food insecurity that incorporates children's own perspectives, as adults are often interviewed as child proxies. While a nuanced, child-centred understanding of food insecurity is needed to inform effective policy and program responses, little is known about Australian children's firsthand understanding or experience of household food insecurity. This study aimed to fill this gap by inviting preadolescent children's perspectives. Eleven participants aged 10-13 years (seven girls and four boys) took part in the study and were recruited from an Australian charity school holiday camp that targets severely disadvantaged youth. Children took part in individual semi-structured interviews that incorporated drawings and emoji scales. Qualitative interviews were audio recorded, transcribed, and analysed using thematic techniques. Four themes emerged from the data analysis, children had: (i) financial understanding; (ii) awareness of food insecurity and coping mechanisms; (iii) sharing, empathy, and compassion for food insecure families; and (iv) described the nature of 'food' preparation. This study provides a child-centric analysis, demonstrating how children's agency is enacted and constrained in food insecure contexts. This child-derived understanding of food insecurity provides a critical basis from which to build effective approaches to assess and respond to this significant social issue.
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Affiliation(s)
- Stefania Velardo
- College of Education, Psychology & Social Work, Flinders University, GPO Box 2100, Adelaide 5001, Australia
| | - Christina M. Pollard
- School of Public Health, Curtin University, GPO Box U1987, Perth 6845, Australia;
| | - Jessica Shipman
- College of Nursing & Health Sciences, Flinders University, GPO Box 2100, Adelaide 5001, Australia;
| | - Sue Booth
- College of Medicine & Public Health, Flinders University, GPO Box 2100, Adelaide 5001, Australia;
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23
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A structured expert judgement elicitation approach: how can it inform sound intervention decision-making to support household food security? Public Health Nutr 2021; 24:2050-2061. [PMID: 33541466 DOI: 10.1017/s1368980021000525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine structured expert judgement (SEJ) elicitation as a method to provide robust, defensible data for three determinants of household food security (food cost, household disposable income and physical access) for quantifying a proof-of-concept integrating decision support system for food security. DESIGN SEJ elicitation is a validated method for obtaining unavailable data, but its use in household food security in high-income countries is novel. Investigate Discuss Estimate Aggregate (IDEA) elicitation protocol was implemented, including quantitative and qualitative elements. Using specific questions related to three determinants, food security experts were encouraged to Investigate - estimate individual first-round responses to these questions, Discuss - with each other evidence on the reasoning and logic of their estimates, Estimate - second-round responses, following which these judgements were combined using mathematical Aggregation. SETTING Victoria, Australia. PARTICIPANTS Five experts with a range of expertise in the area of household food insecurity participated in the SEJ elicitation process. RESULTS The experts' ability to provide reliable estimates was tested and informed the aggregation of the collection of individual estimates into a single quantity of interest for use in decision support. The results of the quantitative elicitation show the impact of combinations of varying household income, food cost and physical access on household food security status and severity and is supported by the experts reasoning during elicitation. CONCLUSION This research provides insight to the application of SEJ where elicited data can inform and support intervention decision-making specific to household food security, especially where evidence is absent or of poor quality.
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Monteith H, Anderson B, Williams PL. Capacity building and personal empowerment: participatory food costing in Nova Scotia, Canada. Health Promot Int 2020; 35:321-330. [PMID: 30793732 DOI: 10.1093/heapro/daz004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Food insecurity impacts millions of people globally. It has been recognized as a priority and a human right by the United Nations where empowerment of women is identified as a significant goal in addressing food insecurity. In the Maritime Province of Nova Scotia (NS), Canada, more than one in five children live in food insecure households. Since 2002, participatory action research (PAR) has been an integral component of food costing in NS with an aim to support capacity building for food security. Building on earlier research that examined short-term outcomes, and recognizing a lack of research examining outcomes of PAR processes, this study aimed to explore the medium-term individual capacity building processes and outcomes of women involved in Participatory Food Costing (PFC). Findings revealed that capacities were built with respect to interrelated themes of 'awareness, participation, personal development, readiness to change, political impact, influence on others, self-esteem, project growth and project continuity'. In addition, the involvement of these women in PFC resulted in both personal empowerment and food security-related policy change. Involving vulnerable populations through PAR is valuable in influencing health-related policy.
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25
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Prevalence and correlates of food insecurity in community-based individuals with severe mental illness receiving long-acting injectable antipsychotic treatment. Br J Nutr 2020; 124:470-477. [PMID: 32234106 DOI: 10.1017/s0007114520001191] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
People with severe mental illness (SMI) have numerous risk factors that may predispose them to food insecurity (FI); however, the prevalence of FI and its effects on health are under-researched in this population. The present study aimed to describe the prevalence of FI and its relationship to lifestyle factors in people with SMI. This cross-sectional study recruited people with SMI receiving long-acting injectable (LAI) antipsychotic medication from community services at three sites in Sydney, Australia. Assessments were completed on physical health and lifestyle factors. χ2 Tests, independent-samples t tests and binary logistic regression analyses were calculated to examine relationships between lifestyle factors and FI. In total, 233 people completed the assessments: 154 were males (66 %), mean age 44·8 (sd 12·7) years, and the majority (70 %) had a diagnosis of schizophrenia. FI was present in 104 participants (45 %). People with FI were less likely to consume fruits (OR 0·42, 95 % CI 0·24, 0·74, P = 0·003), vegetables (OR 0·39, 95 % CI 0·22, 0·69, P = 0·001) and protein-based foods (OR 0·45, 95 % CI 0·25, 0·83, P = 0·011) at least once daily, engaged in less moderate to vigorous physical activity (min) (OR 0·997, 95 % CI 0·993, 1·000, P = 0·044), and were more likely to smoke (OR 1·89, 95 % CI 1·08, 3·32, P = 0·026). FI is highly prevalent among people with SMI receiving LAI antipsychotic medications. Food-insecure people with SMI engage in less healthy lifestyle behaviours, increasing the risk of future non-communicable disease.
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26
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Household food insecurity and educational outcomes in school-going adolescents in Ghana. Public Health Nutr 2020; 24:1349-1361. [PMID: 32713415 DOI: 10.1017/s1368980020001974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We examined the association of household food insecurity with educational outcomes and explored the moderating effect of gender and school lunch programme. DESIGN The study used a cross-sectional design. Data were collected in 2014 using interviewer-administered questionnaires and school administrative records. We measured household food insecurity using the Household Food Insecurity Access Scale. Educational outcomes referred to knowledge, attitudes and skills that students are expected to obtain while attending school. We obtained sixteen different measures of educational outcomes, ranging from academic grades to beliefs and attitudes towards school and education. Data were analysed using multilevel modelling with covariates at the student and school levels. We conducted moderation tests by adding a two-way interaction between food insecurity and gender, and between food insecurity and school lunch programme. SETTING The study was conducted in 100 schools located in fifty-four districts within Ghana's eight administrative regions in 2014. PARTICIPANTS Participants included 2201 school-going adolescents aged 15-19 years. RESULTS More than 60 % of adolescents were from food-insecure households. Household food insecurity was negatively associated with Math grade and school attendance. Food insecurity was also inversely associated with socio-emotional outcomes, including academic self-efficacy, commitment to school and academic aspirations and expectations. We did not find a moderating effect of gender and school lunch programme. CONCLUSIONS Food insecurity is negatively associated with wide-ranging educational outcomes related to both learning and socio-emotional abilities. Our study supports prior evidence suggesting the importance of food access on both cognitive and non-cognitive educational outcomes.
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27
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Enns A, Rizvi A, Quinn S, Kristjansson E. Experiences of Food Bank Access and Food Insecurity in Ottawa, Canada. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2020.1761502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Aganeta Enns
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Anita Rizvi
- School of Psychology, University of Ottawa, Ottawa, Canada
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Jansen E, Lachman JM, Heinrichs N, Hutchings J, Baban A, Foran HM. Hunger in Vulnerable Families in Southeastern Europe: Associations With Mental Health and Violence. Front Public Health 2020; 8:115. [PMID: 32351924 PMCID: PMC7174726 DOI: 10.3389/fpubh.2020.00115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 03/23/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Hunger can influence healthy development of children and has been shown to be associated with other determinants of child health, such as violence within the family and maternal (mental) health problems. Whilst the majority of research has been conducted in high-income countries with vulnerable populations, less is known about the circumstances in low-and-middle-income countries. This study explored the experience of hunger in vulnerable families in three Southeastern European countries, and simultaneously examined relationships with four sets of risk factors—lack of financial, mental, familial, and social resources. Methods: Families (N = 140) were recruited for a parenting intervention targeting child behavioral problems. Baseline data was collected on hunger, socioeconomic characteristics, mental health and wellbeing, family violence (i.e., child maltreatment and intimate partner violence), and social and emotional support. Univariate and multivariable risk factors of hunger were examined cross-sectionally with regression models. Results: Overall, 31% of families experienced at least one form of hunger in the last month. Worse family functioning, current intimate partner violence, and more instances of child neglect showed univariate associations with family hunger. In hierarchical analysis, five risk factors remained significantly associated with the experience of hunger: lower adult educational, literacy level, emotional support, more children in the household and higher scores on parental depression, anxiety, and stress. Conclusions: Hunger in Southeastern European families, among families with children showing elevated behavioral problems, was associated with more family violence, but specifically poorer mental health and less emotional support above and beyond socio-structural strains. Adapting parenting interventions to support the primary caregiver in getting more access to emotional support may potentially also change hunger and its association with health and violence. However, this hypothetical pathway of change needs explicit testing.
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Affiliation(s)
- Elena Jansen
- Institute of Psychology, Alps-Adria University, Klagenfurt am Woerthersee, Austria
| | - Jamie M Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom.,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Nina Heinrichs
- Department of Psychology, University of Bremen, Bremen, Germany
| | - Judy Hutchings
- School of Psychology, Bangor University, Wales, United Kingdom
| | - Adriana Baban
- Department of Psychology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Heather M Foran
- Institute of Psychology, Alps-Adria University, Klagenfurt am Woerthersee, Austria
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29
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Booth S, Pollard CM. Food insecurity, food crimes and structural violence: an Australian perspective. Aust N Z J Public Health 2020; 44:87-88. [PMID: 32190940 DOI: 10.1111/1753-6405.12977] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sue Booth
- College of Medicine and Public Health, Flinders University, South Australia
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30
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Maia I, Severo M, Santos AC. Application of the mixture item response theory model to the Self-Administered Food Security Survey Module for Children. PLoS One 2020; 15:e0228099. [PMID: 31971981 PMCID: PMC6977726 DOI: 10.1371/journal.pone.0228099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/07/2020] [Indexed: 11/19/2022] Open
Abstract
Background The Self-Administered Food Security Survey Module for Children was developed to assess food insecurity of individual children and has not been used in Portugal. We aimed to apply the mixture item response theory model to the Self-Administered Food Security Survey Module for Children, to assess its reliability and validity, and to estimate the cut-offs of the food security status for Portuguese children. Methods The scale was self-administered to 2132 children of the Generation XXI birth cohort. The internal consistency was assessed using Cronbach’s alpha. We evaluated dimensionality and/or clustering, and Latent Class Analysis, Latent Trait Analysis and Mixture Latent Trait Analysis were tested. The number of classes and/or traits were defined according to the Akaike Information Criterion, Bayesian Information Criterion, Adjusted Bayesian Information Criterion, Vuong-Lo-Mendell-Rubin Likelihood Ratio Test, Bootstrapped Likelihood Ratio Test and Entropy. Construct validity was explored using socio-demographic characteristics. The classification tree was used to define cut-offs to predict cluster membership. Results The best model was a Mixture Latent Trait Analysis with 1 factor and 2 classes (food security and food insecurity), assuming class variant item parameters (for items 1 and 3). Based on the estimated posterior probabilities, the food insecurity prevalence was 17.6%. Cronbach’s alpha was 0.617. A higher proportion of less-educated mothers and low-income households was observed in the food insecurity class. The classification tree showed an accuracy of 100.0% by identifying the food security and food insecurity groups. Conclusion Our results supported that the Self-Administered Food Security Survey Module for Children provides a valid and reliable measure, which allows the identification of food insecurity among Portuguese children.
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Affiliation(s)
- Isabel Maia
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal
- * E-mail:
| | - Milton Severo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
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31
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Food Insecurity and Socioeconomic Disadvantage in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020559. [PMID: 31952327 PMCID: PMC7014009 DOI: 10.3390/ijerph17020559] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 11/16/2022]
Abstract
Research on food insecurity in Australia has typically relied on a single-item measure and finds that approximately 5% of the population experiences food insecurity. This research also finds that demographic characteristics such as household composition and marital status affect levels of food insecurity, independent of income level. The present study examines the prevalence and correlates of food insecurity in a cohort (n = 400) of people experiencing entrenched disadvantage in Perth, Western Australia. Using the US Department of Agriculture Household Food Security Survey Module, we find that food insecurity at the household, adult, and child level is at sharply elevated levels, with 82.8% of the sample reporting household food insecurity, 80.8% and 58.3% experiencing food insecurity among adults and children, respectively. Demographic characteristics do not significantly affect levels of food insecurity, and food insecurity is associated with negative physical and mental health outcomes. Food insecurity is positively correlated with access to food emergency relief services, indicating that these services are being used by those most in need, but do not address the root causes of food insecurity. Policy and practice should focus on increasing stable access to adequate quantities and quality of food and addressing the structural causes of food insecurity.
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32
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Jamaluddine Z, Sahyoun NR, Choufani J, Sassine AJ, Ghattas H. Child-Reported Food Insecurity Is Negatively Associated with Household Food Security, Socioeconomic Status, Diet Diversity, and School Performance among Children Attending UN Relief and Works Agency for Palestine Refugees Schools in Lebanon. J Nutr 2019; 149:2228-2235. [PMID: 31504697 DOI: 10.1093/jn/nxz189] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/29/2019] [Accepted: 07/23/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recent studies have shown that children are able to accurately describe their own experiences of food insecurity; however, few studies have quantified this experience. OBJECTIVES We aimed to develop and validate a child food security scale to be used in Arabic-speaking countries. METHODS As part of the Healthy Kitchens Healthy Children study on food security and nutrition in schools, 14 questions were administered to 5-15-y-old children (n = 1433) attending 4 UN Relief and Works Agency for Palestine refugees schools. We used statistical methods based on Item Response Theory to assess the internal validity of a proposed food security scale using these items. Further validation of the scale was conducted by examining associations with sociodemographic, economic, household food security, and diet diversity variables through logistic regression models adjusted for age, sex, and school of the children. RESULTS A total of 1287 children (89.8%) provided complete responses to the questionnaire. Four items were dropped from the scale because of high infit statistics (>1.3) and high residual correlation with other items. The resulting 10-item scale had acceptable reliability (Cronbach α coefficient = 0.89). Children who reported food insecurity were more likely to be from food-insecure households (OR: 2.3; P < 0.001). Food-insecure children came from households with lower expenditures per capita (OR: 0.80; P = 0.007) and higher household crowding (OR: 1.70; P = 0.001), and had less educated mothers (OR: 0.89; P = 0.009), lower household diet diversity (OR: 0.85; P < 0.001), and lower household consumption of meat (OR: 0.89; P < 0.001) and fruit (OR: 0.95; P = 0.001). Child food insecurity was also associated with higher school absenteeism (OR: 1.64; P = 0.01) and lower academic grades in languages and science (P < 0.05). CONCLUSIONS Child food security was accurately measured through a 10-item scale. This tool is appropriate to assess child food insecurity experience directly with children, and can be used in school-based interventions, where obtaining data from parents may be cumbersome.
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Affiliation(s)
- Zeina Jamaluddine
- Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, USA
| | - Jowel Choufani
- Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon.,International Food Policy Research Institute, Washington, DC, USA
| | - AnnieBelle J Sassine
- Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon
| | - Hala Ghattas
- Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon
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Yii V, Palermo C, Kleve S. Population-based interventions addressing food insecurity in Australia: A systematic scoping review. Nutr Diet 2019; 77:6-18. [PMID: 31593624 DOI: 10.1111/1747-0080.12580] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/09/2019] [Accepted: 07/19/2019] [Indexed: 01/07/2023]
Abstract
AIM Food insecurity (FI) is a critical public health issue in Australia. Population-based interventions aiming to address the socio-ecological determinants of FI are critical for relieving and preventing it. This review aimed to map and summarise the characteristics of population-based interventions addressing household and/or community FI in Australia. METHODS A systematic scoping review was undertaken. Five databases, selected for range and relevance to FI in Australia ("CINAHL plus", "Ovid MEDLINE", "Sociological Abstracts", "Australian Public Affairs Information Service", and "Rural and Remote Health") were searched in May 2018 using the terms and relevant synonyms "FI" and "interventions". In addition a systematic grey literature search using multiple Google searches was undertaken. Data synthesis included categorisation and counting intervention type. Interventions were defined and charted by influence of at least one dimension of food security and impact on the socioeconomic, cultural and environmental conditions. RESULTS A total of 3565 published and grey literature records were identified, with the final 60 records describing 98 interventions. Few national interventions were identified, with approaches predominantly in Victoria, Northern Territory and Tasmania. Determinants related to living and working environments, food availability and food utilisation were most frequently addressed. Interventions addressing the key determinant of FI economic access were limited. A number of interventions did not appear to be associated with rigorous evaluation. CONCLUSIONS While there is evidence of population responses to FI in Australia, the effectiveness of these remains limited. Importantly there is a lack of coordinated and coherent national responses that address the range of FI determinants.
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Affiliation(s)
- Vivien Yii
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
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Bramwell L, Foley W, Shaw T. Putting urban Aboriginal and Torres Strait Islander food insecurity on the agenda. Aust J Prim Health 2019; 23:415-419. [PMID: 29037305 DOI: 10.1071/py17073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/08/2017] [Indexed: 11/23/2022]
Abstract
Food insecurity adversely affects diet quality, physical, mental and social wellbeing and the capacity to act on health advice recommended by primary healthcare providers. In this article, an overview of the neglected issue of food insecurity in urban Aboriginal and Torres Strait Islander communities is provided. Policy and action on food security for urban Aboriginal and Torres Strait Islander people is reviewed, and it is argued that for primary health care to better address food insecurity, an evidence base is needed to understand the experiences of individuals and households and how to work effectively to support food insecure clients.
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Affiliation(s)
- Leigh Bramwell
- Access and Capacity-Building Team, Metro South Health, PO Box 52, Inala, Qld 4077, Australia
| | - Wendy Foley
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Health, Inala, Qld 4077, Australia
| | - Tanya Shaw
- Access and Capacity-Building Team, Metro South Health, PO Box 52, Inala, Qld 4077, Australia
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35
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Lindberg R, McCartan J, Stone A, Gale A, Mika A, Nguyen M, Kleve S. The impact of social enterprise on food insecurity - An Australian case study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:e355-e366. [PMID: 30848546 DOI: 10.1111/hsc.12737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/08/2019] [Accepted: 02/09/2019] [Indexed: 06/09/2023]
Abstract
Like many high-income countries, in Australia there are a range of programmes in place, from social security to food banks, to help address food insecurity. So far, they have been unable to adequately alleviate and prevent this growing nutrition challenge. This paper presents an evaluation of a new type of intervention in the food security landscape, the social enterprise. The Community Grocer is a social enterprise that operates weekly fresh fruit and vegetable markets in Melbourne, Australia. The aim of the study was to examine the market's ability to increase access, use and availability of nutritious food in a socially acceptable way, for low socioeconomic status urban-dwelling individuals. The mixed-method evaluation included: comparative price audits (n = 27) at local (<1 km) stores; analysis of operational data from sample markets (n = 3); customer surveys (n = 91) and customer interviews (n = 12), collected in two phases (Autumn 2017, Summer 2018). The results found common (n = 10) fruit and vegetables cost, on average, approximately 40% less at the social enterprise, than local stores. Over twenty per cent of customers were food insecure and 80% of households were low income. Thirty-four different nationalities shopped at the market, and just over half (54%) shopped there weekly. More than 50 types of vegetables and fruit were available to purchase, varying for cultural preferences and seasonality, which supported variety and choice. Overall, this enterprise promotes food security in a localised area through low-cost, convenient, dignified and nutritious offerings.
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Affiliation(s)
- Rebecca Lindberg
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Vic, Australia
| | - Julia McCartan
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Vic, Australia
| | - Alexandra Stone
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Vic, Australia
| | - Ashleigh Gale
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Vic, Australia
| | - Alice Mika
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Vic, Australia
| | - Marina Nguyen
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Vic, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Vic, Australia
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Newman K, O'Donovan K, Bear N, Robertson A, Mutch R, Cherian S. Nutritional assessment of resettled paediatric refugees in Western Australia. J Paediatr Child Health 2019; 55:574-581. [PMID: 30288837 DOI: 10.1111/jpc.14250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 08/19/2018] [Accepted: 09/07/2018] [Indexed: 11/26/2022]
Abstract
AIM Nutritional deprivation, inadequate diet and food insecurity are common refugee experiences. The growth and nutritional status of paediatric refugees following resettlement in developed countries and the related interplay with socio-economic factors remain less defined; this study aims to describe these features. METHODS Standardised dietary, medical and socio-demographic health assessments of new refugee patients attending a multidisciplinary paediatric Refugee Health Service (RHS) in Western Australia between 2010 and 2015 were analysed. RESULTS Demographic data from 1131 paediatric refugees are described (age 2 months to 17.8 years). The majority experienced socio-economic disadvantage, had limited parental education and required interpreters. Nutritional deficiencies were common but varied across ethnicities: iron deficiency (ID) (12.3%), anaemia (7.3%) and inadequate dairy intake (41.0%). A third of children (32.6%) did not consume meat. Infant breastfeeding was sustained (77.8%) in infants <12 months. Prolonged breastfeeding (44.9% aged 12-24 months) was associated with an increased risk of ID (odds ratio 4.0, 95% confidence interval 1.4-11.6). Median body mass index increased significantly for those >24 months between referral and RHS assessment (median period 1.8 months). Overall, 27.1% required additional formal dietetic follow-up, with higher nutritional concerns in refugee children <24 months compared to older patients. CONCLUSIONS Identification of frequent post-settlement nutritional concerns has been captured through structured multidisciplinary paediatric health screening. Specific screening for socio-economic influencing factors, including education, poverty and food insecurity, during refugee clinical assessments is recommended. Development of targeted, culturally appropriate parental education resources and interventions may improve management following resettlement. Longitudinal research assessing resettlement growth trajectories is required.
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Affiliation(s)
- Katie Newman
- Refugee Health Service, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Kelly O'Donovan
- Women and Newborn Health Service, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Natasha Bear
- Department of Clinical Research and Education, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Annie Robertson
- Refugee Health Service, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Raewyn Mutch
- Refugee Health Service, Perth Children's Hospital, Perth, Western Australia, Australia.,Division of Paediatrics, Faculty of Health and Medical Sciences, Perth, Western Australia, Australia
| | - Sarah Cherian
- Refugee Health Service, Perth Children's Hospital, Perth, Western Australia, Australia.,Division of Paediatrics, University of Western Australia, Perth, Western Australia, Australia
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Jovanovski N, Cook K. How Australian welfare reforms shape low-income single mothers’ food provisioning practices and their children’s nutritional health. CRITICAL PUBLIC HEALTH 2019. [DOI: 10.1080/09581596.2019.1577951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Natalie Jovanovski
- Faculty of Business & Law, Swinburne University of Technology, Hawthorn, Australia
| | - Kay Cook
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
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McKay FH, Haines BC, Dunn M. Measuring and Understanding Food Insecurity in Australia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030476. [PMID: 30736305 PMCID: PMC6388276 DOI: 10.3390/ijerph16030476] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 01/29/2023]
Abstract
The number of Australians seeking food aid has increased in recent years; however, the current variability in the measurement of food insecurity means that the prevalence and severity of food insecurity in Australia is likely underreported. This is compounded by infrequent national health surveys that measure food insecurity, resulting in outdated population-level food insecurity data. This review sought to investigate the breadth of food insecurity research conducted in Australia to evaluate how this construct is being measured. A systematic review was conducted to collate the available Australian research. Fifty-seven publications were reviewed. Twenty-two used a single-item measure to examine food security status; 11 used the United States Department of Agriculture (USDA) Household Food Security Survey Module (HFSSM); two used the Radimer/Cornell instrument; one used the Household Food and Nutrition Security Survey (HFNSS); while the remainder used a less rigorous or unidentified method. A wide range in prevalence and severity of food insecurity in the community was reported; food insecurity ranged from 2% to 90%, depending on the measurement tool and population under investigation. Based on the findings of this review, the authors suggest that there needs to be greater consistency in measuring food insecurity, and that work is needed to create a measure of food insecurity tailored for the Australian context. Such a tool will allow researchers to gain a clear understanding of the prevalence of food insecurity in Australia to create better policy and practice responses.
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Affiliation(s)
| | - Bronte C Haines
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Waterfront campus, Geelong, Victoria 3220, Australia.
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Lee S, Ball GDC, Farmer A, Willows ND. Exploring the Experience of Food Insecurity among University Students Caring for Children: A Qualitative Descriptive Study. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018. [DOI: 10.1080/19320248.2018.1557093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sarah Lee
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Geoff DC Ball
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Anna Farmer
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Noreen D Willows
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
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Aceves-Martins M, Cruickshank M, Fraser C, Brazzelli M. Child food insecurity in the UK: a rapid review. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06130] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundFood insecurity (FI) is a multifaceted, socioeconomic problem involving difficulties accessing sufficient, safe and nutritious food to meet people’s dietary requirements and preferences for a healthy life. For children experiencing FI, there are some potentially negative developmental consequences and it is, therefore, important to understand the links between FI and children’s health and well-being as well as any strategies undertaken to address FI. The overall objective of this assessment was to determine the nature, extent and consequences of FI affecting children (aged ≤ 18 years) in the UK.ObjectiveTo determine the nature, extent and consequences of FI affecting children (aged ≤ 18 years) in the UK.Data sourcesThe databases searched on 4 December 2017 included MEDLINE (including In-Process & Other Non-Indexed Citations and E-pub ahead of print files), EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Commonwealth Agricultural Bureaux (CAB) abstracts, The Cochrane Library, Education Resources Information Centre (ERIC), PsycINFO, the Social Science Citation Index and the Applied Social Sciences Index and Abstracts (ASSIA).MethodsA rapid review of the current published and unpublished literature was conducted, including all study designs from specified high-income countries in children aged ≤ 18 years. Searches were conducted of major health-care, nutrition, education and social science databases from 1995 onwards, and websites of relevant UK and international organisations. Final searches were undertaken in December 2017.ResultsIn total, 109 studies were selected. Only five studies were conducted in the UK, four of which provided qualitative data. Possible factors associated with child FI were identified, for example socioeconomic status, material deprivation, living in public housing and having unemployed or poorly educated parents. Children’s health, well-being and academic outcomes were all negatively affected by FI. The mediating effects of family stressors and parenting practices in the relationship between FI and children’s health and well-being outcomes were not clear. Food assistance programmes were generally effective in mitigating FI and improving nutritional outcomes (including hunger) in the short term, but did not eradicate FI, eliminate its effects on children’s health or have an impact on academic outcomes. No reports assessing the prevalence of child FI in the UK or the cost-effectiveness and sustainability of interventions to tackle FI were identified.LimitationsThere was a lack of consistency in how FI was defined and measured across studies. Most of the studies used indirect measurements of child FI through parental reports. The majority of studies were conducted in North America. Only five studies were conducted in the UK. Thirty potentially relevant studies were not included in the review as a result of time and resource constraints. Most studies were observational and caution is advised in interpreting their results.ConclusionsA number of factors that were related to child FI were identified, as were negative associations between child FI and physical, mental and social outcomes. However, these findings should be interpreted with caution because of the correlational nature of the analyses and the fact that it is difficult to determine if some factors are predictors or consequences of FI.Future researchThere is an urgent requirement for the development of a reliable instrument to measure and monitor child FI in the UK and for well-designed interventions or programmes to tackle child FI.Study registrationThis study is registered as PROSPERO CRD42017084818.FundingThe National Institute for Health Research Public Health Research programme. The Health Services Research Unit is core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.
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Affiliation(s)
| | | | - Cynthia Fraser
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Miriam Brazzelli
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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The Association between Stressful Events and Food Insecurity: Cross-Sectional Evidence from Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112333. [PMID: 30360491 PMCID: PMC6266169 DOI: 10.3390/ijerph15112333] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/05/2018] [Accepted: 10/17/2018] [Indexed: 11/17/2022]
Abstract
A considerable body of empirical evidence exists on the demographic and socio-economic correlates of food insecurity in Australia. An important omission from recent studies, however, is an understanding of the role of stressful life events, or stressors in explaining exposure to food insecurity. Using nationally representative data from the 2014 General Social Survey and multivariable logistic regression, this paper reports on the association between 18 discrete stressors and the likelihood of reporting food insecurity in Australia. The results, adjusted for known correlates of food insecurity and complex survey design, show that exposure to stressors significantly increased the likelihood of experiencing food insecurity. Importantly, stressors related to employment and health approximately doubled the odds of experiencing food insecurity. The results underscore the complex correlates of food insecurity and indicates that conceptually it interacts with many important social and economic problems in contemporary Australia. There is no simple fix to food insecurity and solutions require co-ordination across a range of social and economic policies.
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Kleve S, Booth S, Davidson ZE, Palermo C. Walking the Food Security Tightrope-Exploring the Experiences of Low-to-Middle Income Melbourne Households. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102206. [PMID: 30308968 PMCID: PMC6210237 DOI: 10.3390/ijerph15102206] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/05/2018] [Accepted: 10/06/2018] [Indexed: 11/16/2022]
Abstract
There is limited evidence of how Australian low-to-middle income (AUD $40,000⁻$80,000) households maintain food security. Using a sequential explanatory mixed methods methodology, this study explored and compared the food security (FS) and insecurity (FIS) experiences of these households. An initial quantitative survey categorised participants according to food security status (the 18-item United States Department of Agriculture Household Food Security Survey Module) and income level to identify and purposefully select participants to qualitatively explore food insecurity and security experiences. Of the total number of survey participants (n = 134), 42 were categorised as low-to-middle income. Of these, a subset of 16 participants (8 FIS and 8 FS) was selected, and each participant completed an in-depth interview. The interviews explored precursors, strategies to prevent or address food insecurity, and the implications of the experience. Interview data were analysed using a thematic analysis approach. Five themes emerged from the analysis: (i) food decision experiences, (ii) assets, (iii) triggers, (iv) activation of assets, and (v) consequences and emotion related to walking the food security tightrope. The leverage points across all themes were more volatile for FIS participants. Low-to-middle income Australians are facing the challenges of trying to maintain or improve their food security status, with similarities to those described in lower income groups, and should be included in approaches to prevent or address food insecurity.
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Affiliation(s)
- Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill 3168, Australia.
| | - Sue Booth
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide 5000, Australia.
| | - Zoe E Davidson
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill 3168, Australia.
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill 3168, Australia.
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McKechnie R, Turrell G, Giskes K, Gallegos D. Single-item measure of food insecurity used in the National Health Survey may underestimate prevalence in Australia. Aust N Z J Public Health 2018; 42:389-395. [DOI: 10.1111/1753-6405.12812] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 04/01/2018] [Accepted: 05/01/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Rebecca McKechnie
- School of Exercise and Nutrition Sciences; Queensland University of Technology
| | - Gavin Turrell
- Institute for Health and Ageing; Australian Catholic University; Victoria
- School of Public Health and Social Work; Queensland University of Technology
| | - Katrina Giskes
- School of Exercise and Nutrition Sciences; Queensland University of Technology
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences; Queensland University of Technology
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Association of Food Insecurity with Children's Behavioral, Emotional, and Academic Outcomes: A Systematic Review. J Dev Behav Pediatr 2017; 38:135-150. [PMID: 28134627 DOI: 10.1097/dbp.0000000000000383] [Citation(s) in RCA: 227] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Food Insecurity (FI) occurs in 21% of families with children and adolescents in the United States, but the potential developmental and behavioral implications of this prevalent social determinant of health have not been comprehensively elucidated. This systematic review aims to examine the association between FI and childhood developmental and behavioral outcomes in western industrialized countries. METHOD This review provides a critical summary of 23 peer reviewed articles from developed countries on the associations between FI and adverse childhood developmental behavioral outcomes including early cognitive development, academic performance, inattention, externalizing behaviors, and depression in 4 groups-infants and toddlers, preschoolers, school age, and adolescents. Various approaches to measuring food insecurity are delineated. Potential confounding and mediating variables of this association are compared across studies. Alternate explanatory mechanisms of observed effects and need for further research are discussed. RESULTS This review demonstrates that household FI, even at marginal levels, is associated with children's behavioral, academic, and emotional problems from infancy to adolescence across western industrialized countries - even after controlling for confounders. CONCLUSIONS While the American Academy of Pediatrics already recommends routine screening for food insecurity during health maintenance visits, the evidence summarized here should encourage developmental behavioral health providers to screen for food insecurity in their practices and intervene when possible. Conversely, children whose families are identified as food insecure in primary care settings warrant enhanced developmental behavioral assessment and possible intervention.
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45
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Godrich S, Lo J, Davies C, Darby J, Devine A. Prevalence and socio-demographic predictors of food insecurity among regional and remote Western Australian children. Aust N Z J Public Health 2017; 41:585-590. [PMID: 28906569 DOI: 10.1111/1753-6405.12716] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Inequities can negatively impact the health outcomes of children. The aims of this study were to: i) ascertain the prevalence of food insecurity (FI) among regional and remote Western Australian (WA) children; and ii) determine which socio-demographic factors predicted child FI. METHODS Caregiver-child dyads (n=219) completed cross-sectional surveys. Descriptive statistics and logistic regression analyses were conducted using IBM SPSS version 23. RESULTS Overall, 20.1% of children were classified as FI. Children whose family received government financial assistance were more likely to be FI (OR 2.60; CI 1.15, 5.91; p=0.022), as were children living in a Medium disadvantage area (OR 2.60; CI 1.18, 5.72; p=0.017), compared to High or Low SEIFA ratings. CONCLUSIONS Study findings are suggestive of the impact low income has on capacity to be food secure. The higher FI prevalence among children from families receiving financial assistance and living in medium disadvantage areas indicates more support for these families is required. Recommendations include: ensuring government plans and policies adequately support disadvantaged families; increasing employment opportunities; establishing evidence on the causes and the potential impact of FI on children's health. Implications for public health: One in five children were FI, demonstrating that FI is an issue in Western Australia.
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Affiliation(s)
- Stephanie Godrich
- School of Medical and Health Sciences, Edith Cowan University, Western Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Western Australia
| | - Christina Davies
- School of Population Health, The University of Western Australia.,Public Health Advocacy Institute of Western Australia, Curtin University, Western Australia
| | - Jill Darby
- School of Medical and Health Sciences, Edith Cowan University, Western Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Western Australia
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46
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The pervasive effect of youth self-report of hunger on depression over 6 years of follow up. Soc Psychiatry Psychiatr Epidemiol 2017; 52:537-547. [PMID: 28285453 DOI: 10.1007/s00127-017-1361-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 02/16/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE We used longitudinal data to clarify the association between self-report of hunger and subsequent depression risk among youth and young adults, accounting for other risk factors. METHODS Youth self-report of ever experiencing hunger data were collected from cycles 4-6 of the National Longitudinal Survey of Children and Youth cohort of Canadian youth 16 years and older (n = 4139). Data on depressive symptoms (CES-D 12) were collected over three cycles (2004-2009, cycles 6-8). We used multivariable regression based on generalized estimating equations (GEE) to examine prior youth hunger on later depression risk, adjusting for time-stable, time-varying, and lagged variables (e.g., depressive symptoms in previous cycle), thereby clarifying the temporal relationship. RESULTS The prevalence of youth hunger experience and depression risk reached 5.9 and 15.0%, respectively. The adjusted odds ratio of depression for participants reporting hunger was 2.31 (95% CI 1.54, 3.46) and changed little [2.17 (95% CI 1.29, 3.67)] after accounting for previous CES-D 12 scores, suggesting a temporal relationship in which hunger contributes to depression risk. Unlike never-hungry youth, depression in ever-hungry youth remained comparatively elevated over time. CONCLUSIONS Our models support an independent and temporal relationship between youth self-report of hunger and depression in adolescence and young adulthood.
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48
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Godrich SL, Davies CR, Darby J, Devine A. What are the determinants of food security among regional and remote Western Australian children? Aust N Z J Public Health 2017; 41:172-177. [PMID: 28110492 DOI: 10.1111/1753-6405.12636] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 04/01/2016] [Accepted: 10/01/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To explore how determinants of food security affect children in regional and remote Western Australia (WA), across food availability, access and utilisation dimensions. METHODS The Determinants of Food Security framework guided the thematic analysis (using NVivo 10) of semi-structured interviews with 20 key informants. RESULTS Food availability factors included availability, price, promotion, quality, location of outlets and variety. Food access factors included social support, financial resources, transport to food outlets, distance to food outlets and mobility. Food utilisation factors included nutrition knowledge and skills, children's food preferences, storage facilities, preparation and cooking facilities and time to purchase food. CONCLUSIONS Key food availability recommendations include increasing local food supply options. Food access recommendations include ensuring equitable formal social support and empowering informal support options. Food utilisation recommendations include prioritising food literacy programs focusing on quick, healthy food preparation and budgeting skills. Implications for public health: Policymakers should invest in local food supply options, equitable social support services and experiential food literacy programs. Practitioners should focus child/parent programs on improving attitude, knowledge and skills.
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Affiliation(s)
- Stephanie L Godrich
- School of Medical and Health Sciences, Edith Cowan University, Western Australia
| | | | - Jill Darby
- School of Medical and Health Sciences, Edith Cowan University, Western Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Western Australia
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49
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Liese AD, Draper CL, Martini L, Bell BA, Freedman DA, Burke MP, Younginer N, Blake CE, Probst JC, Jones SJ. Recruitment Strategies and Participation in a Study of Childhood Hunger. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016. [DOI: 10.1080/19320248.2015.1112760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Angela D. Liese
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Carrie L. Draper
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Lauren Martini
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Bethany A. Bell
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Educational Psychology and Research Program, College of Education, University of South Carolina, Columbia, South Carolina, USA
| | - Darcy A. Freedman
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio, USA
| | - Michael P. Burke
- U.S. Department of Agriculture, Food and Nutrition Service, Alexandria, Virginia, USA
| | - Nicholas Younginer
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Christine E. Blake
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Janice C. Probst
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- South Carolina Rural Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Sonya J. Jones
- Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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50
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Harvey K. "When I go to bed hungry and sleep, I'm not hungry": Children and parents' experiences of food insecurity. Appetite 2016; 99:235-244. [PMID: 26767615 DOI: 10.1016/j.appet.2016.01.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 12/03/2015] [Accepted: 01/04/2016] [Indexed: 11/18/2022]
Abstract
Evidence demonstrates food insecurity has a detrimental impact on a range of outcomes for children, but little research has been conducted in the UK, and children have rarely been asked to describe their experiences directly. We examined the experiences of food insecure families living in South London. Our mixed-methods approach comprised a survey of parents (n = 72) and one-to-one semi-structured interviews with children aged 5-11 years (n = 19). The majority of parents (86%) described their food security during the preceding year as very low. Most reported they had often or sometimes had insufficient food, and almost all had worried about running out of food. Two thirds of parents had gone hungry. Most parents reported they had been unable to afford a nutritionally balanced diet for their children, and just under half reported that their children had gone hungry. Four themes emerged from the interviews with children: sources of food; security of food, nutritional quality of food, and experiences of hunger. Children's descriptions of insufficient food being available indicate that parents are not always able to shield them from the impact of food insecurity. The lack of school-meals and after-school clubs serving food made weekends particularly problematic for some children. A notable consequence of food insecurity appears to be reliance on low-cost takeaway food, likely to be nutritionally poor.
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Affiliation(s)
- Kate Harvey
- Department of Psychology, The University of Reading, PO Box 217, Reading, Berks, RG6 6AH, UK.
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