Measuring Food Security Using a Self‐Administered Mail Survey Method among Older Georgians Requesting Older Americans Act Nutrition Program: Georgia Advanced Performance Outcomes Measures Project

Abstract

Food security is one of the key outcomes in Older Americans Act Nutrition Program (OAANP), however it is unknown how best to measure food security to evaluate this program's impact on a large scale. We measured food security in all new OAANP participants and waitlisted people in Georgia between July and early November, 2008 (n=4,731) using the self‐administered mail survey method used in the ongoing Georgia Performance Outcomes Measures project. We used a modified 6‐item US Household Food Security Survey Module (HFSSM) with a 30 day reference period and two reminder postcards. About 33% of those identified completed the survey (n=1,594, mean age 74.6±9.5, 68.6% female, 30.6% black). Most of the respondents (91%) completed all 6 food security questions while 26 did not respond to any question. Infit and outfit statistics for each of the 6 questions and overall Rasch model fit were within an acceptable range. Overall psychometric properties observed in our food security data were comparable to the national food security statistics provided by USDA. Our findings suggest that food security can be reasonably measured by a mail survey and a short form of HFSSM in older adults requesting OAANP. Such methodology can be also used to estimate the extent of food insecurity and help guide program and policy decisions to meet the nutrition assistance needs of vulnerable older adults. This study was funded in part by US AoA and USDA ERS.