Abstract
BackgroundGlobally, food insecurity is a major public health concern. In North America, it is particularly prevalent in certain sub-groups, including Indigenous communities. Although many Indigenous and remote communities harvest and share food, most food security assessment tools focus on economic access. This study describes the psychometric evaluation of a modified Household Food Insecurity Access Scale (HFIAS), developed for mixed economies, to assess food insecurity among pregnant Inuit women.MethodsThe HFIAS was administered to 130 pregnant women in Nunavik (Arctic region of Quebec), Canada. Data were fit to a Rasch Rating Scale Model (RSM) to determine the discrimination ability of the HFIAS. Person parameter (Theta) estimates were calculated based on the RSM to provide a more accurate scoring system of the modified HFIAS for this population. Theta values were compared to known correlates of food insecurity.ResultsComparative fit indices showed preference for a modified version of the HFIAS over the original. Theta values displayed a continuum of severity estimates and those values indicating greater food insecurity were consistently linked to known correlates of food insecurity. Participants living in households with more than 1 hunter (Theta = -.45) or more than 1 fisher (Theta = -.43) experienced less food insecurity than those with no hunters (Theta = .48) or fishers (Theta = .49) in their household. The RSM indicated the scale showed good discriminatory ability. Subsequent analyses indicated that most scale items pertain to the classification of a household as moderately food insecure.ConclusionsThe modified HFIAS shows potential for measuring food insecurity among pregnant women in Nunavik. This is an efficient instrument that can inform interventions targeting health conditions impacting groups that obtain food through both monetary and non-monetary means.
Highlights
Numerous recent studies, both representative and population-specific, document alarmingly high rates of food insecurity among Indigenous Canadians, especially among the Inuit.[1]
This study describes the psychometric evaluation of a modified Household Food Insecurity Access Scale (HFIAS), developed for mixed economies, to assess food insecurity among pregnant Inuit women
Data were fit to a Rasch Rating Scale Model (RSM) to determine the discrimination ability of the HFIAS
Summary
Both representative and population-specific, document alarmingly high rates of food insecurity among Indigenous Canadians, especially among the Inuit.[1] Canadian Inuit living in Nunavut have the highest recorded prevalence of food insecurity among Indigenous populations in developed countries.[2] Concerns have been raised that currently accepted definitions of food insecurity and the assessment instruments based on these definitions might not accurately fit the unique Canadian Inuit food system.[3] In Nunavik, estimates of food insecurity vary between 24%-74% depending on the instruments used and the sub-population examined.[4] Research has linked food insecurity in Canadian Inuit populations to various indicators of poverty including: household crowding,[5, 6] lower levels of education,[7] low income,[5] less educational achievement,[7] and no hunters in the family. Many Indigenous and remote communities harvest and share food, most food security assessment tools focus on economic access. This study describes the psychometric evaluation of a modified Household Food Insecurity Access Scale (HFIAS), developed for mixed economies, to assess food insecurity among pregnant Inuit women
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