Adaptation of the US Household Food Security Survey Module for Low-Income Pregnant Latinas: Qualitative Phase

Abstract

The objectives of this study were to (1) assess the face validity of the 18-item US Household Food Security Scale Module (US HFSSM) among low-income pregnant Latinas and (2) adapt the US HFSSM to the target population. This study was conducted in the United States in Hartford, Conn, where 40% of residents are of Latina descent. Three focus groups (N = 14total) were held with pregnant and postpartum Latinas from April to June 2004 to assess the understanding and applicability (face validity) of the US HFSSM as well as adapt the US HFSSM based on their recommendations. This was followed by pretesting (N = 7) to make final adaptations to the US HFSSM. Overall, the items in the US HFSSM were clear and understandable to participants, but some questions sounded repetitive to them. Participants felt that the questions were applicable to other pregnant Latinas in their community and shared food security-related experiences and strategies. Participants' recommendations led to key adaptations to the US HFSSM including reducing the scale to 15 items, wording statements as questions, including 2 time periods, replacing the term balanced meals with healthy and varied, replacing the term low-cost foods with cheap foods and including a definition of the term, and including a coping mechanism for avoiding running out of food. The adapted US HFSSM was found to have good face validity among pregnant Latinas and can be used to assess food insecurity among this vulnerable population.