Food Insecure Families Research Articles

Food Insecurity Associated With Underestimation of Weight Status in Children With a Healthy Weight

ObjectiveAccurate parental weight perception of one's child is an important step in addressing healthy behaviors, but its associations with socioeconomic status (SES) and household food insecurity (HFI) are unclear. We aimed to assess the association of parental weight perception with HFI. MethodsThis was a secondary data analysis of a cross-sectional study of 284 children ages 2 to 8 years whose parents completed surveys about weight perception, SES, and HFI. Height and weight were measured to determine the children's body mass index scores and were self-reported by parents. We performed chi-square tests to compare HFI and accuracy of parental weight perception and used logistic regression to assess accuracy, adjusting for significant covariates and stratifying by child weight category. ResultsApproximately two thirds of children had healthy weight, 18% had overweight, and 15% had obesity. About one third of parents inaccurately identified their child's weight category, almost always underestimating weight status. Twenty-eight percent of the families were food insecure. HFI was not associated with parental weight perception in bivariate analysis. When stratified by weight status, food insecure families with children at healthy weight had 0.16 times the odds of accurately perceiving their children's weight status. There was no association between HFI and accuracy of weight perception in children with overweight or obesity. ConclusionsFood insecurity was associated with a decrease in the accuracy of parental weight perceptions in children with healthy weight. Pediatricians should clearly communicate about weight status, as families with HFI may adopt unhealthy eating behaviors under the incorrect assumption that their child is underweight.

Feasibility of a Family Meal Intervention to Address Nutrition, Emotional Wellbeing, and Food Insecurity of Families With Adolescents

ObjectiveTo assess the feasibility of a family meal intervention to address indicators of parent and adolescent nutrition and well-being and household food security. MethodsNine adolescents and a parent/caregiver were recruited from a youth health clinic. Families were provided with meal plans, recipes, and ingredients for 5 meals weekly for 4 weeks. Participants completed baseline and follow-up surveys and open-ended interviews. ResultsOverall, fidelity to the intervention was high among families; the frequency of family meals increased by approximately 2 meals/wk. Both parent/caregivers and adolescents reported improvements to nutrition (4 of 9 increased vegetable consumption for both) and most reported improvements to mental well-being. Household food insecurity also reduced during the intervention (means of 8.2 and 0.2 at baseline and follow-up, respectively). Conclusions and ImplicationsProviding families with meal plans, recipes, and ingredients is an acceptable way to increase weekly frequency of family meals. Future research may consider the family meal as a way to engage with families about broader concerns.

Impact of fruits and vegetables vouchers on food insecurity in disadvantaged families from a Paris suburb

BackgroundSocial inequalities in nutrition lead a high number of families to struggle with food insecurity, even in developed countries. We aimed to assess the impact of fruits and vegetables vouchers on food security among disadvantaged households from a Paris suburb.MethodsWe used a pre-post assessment design. Families answered face-to-face questionnaires on food consumption and food security status before and after a randomly assigned intervention. Households in the intervention group received vouchers to buy exclusively fruits and vegetables over one year. Both intervention and control groups benefitted from nutritional education through workshops performed by dieticians during the study period. The Household Food Security Module (HFSM) was used to assess food security status of households at inclusion. Food Insufficiency Indicator (FSI) was used to assess food security at inclusion and follow-up. Evolution of FSI on both groups was evaluated using McNemar test.ResultsAmong the 91 families included between May 2015 and May 2016, 64 completed the post assessment questionnaire. At inclusion, 68.3% of families were experiencing food insecurity and 78.1% were experiencing food insufficiency. No association was found between food consumptions and food security status. After one-year follow-up, the prevalence of food insufficiency was significantly decreased in the intervention group (61.8%, with p value = 0.03), and unchanged in the control group.ConclusionIn this pilot study, food insufficiency was significantly decreased in families receiving vouchers for fruits and vegetables over a one-year period.Trial registrationNCT02461238, registered 3 June 2015 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02461238

Food Security in the Context of Paternal Incarceration: Family Impact Perspectives.

Although research about the unintended consequences of paternal incarceration for family well-being has grown in recent years, there has been minimal exploration of food insecurity. Using qualitative methods, we aimed to understand the relationships between paternal incarceration and family food insecurity in Canada. An ethnographic study (24 months) was conducted that included naturalistic observation and in-depth interviews with formerly incarcerated fathers, their partners, and societal reintegration-focused stakeholders (n = 63). Interpretive thematic analysis based on family impact and intersectional theories, indicated that family food insecurity was elucidated by pre-incarceration, economic, social, health, and relationship factors; stigma and social/structural constraints; and intersections among individual, correctional system, community, and macro-level (i.e., economic, social, policy, physical contexts) factors. Participatory approaches and collaborative action among diverse stakeholders that include practitioners, policy makers, researchers, as well as health, social, and criminal justice agencies can guide best practices in creating supportive food environments for families impacted by adversities of incarceration. In particular, interventions aimed at prescriptive ethics, social justice, and meaningful rehabilitation show promise at mitigating the collateral consequences of incarceration-related food insecurity.

Determining Food-Insecure Families' Resource Access with Health System and Public Data.

Families' access to local food-insecurity (FI) resources differs. This study examines how health system and public data may be combined to identify limitations in community resources designed to address FI. We conducted a retrospective cohort study using electronic health record (EHR) data from nine practices that screened families for FI. Electronic health record data included demographic and clinical characteristics. Publicly available data included local socioeconomic and food resource information. We calculated the distance from each household to the nearest food pantry and determined the percentage of families who might have difficulty accessing resources. We demonstrate how health systems could merge these data sources to map where food-insecure families live, describe families' access to local resources, and identify regions where gaps in services exist. Health systems could use this approach to support households with FI and advocate for additional services in areas lacking resources in order to target population health efforts.

CE: Addressing Food Insecurity in Vulnerable Populations.

: Food insecurity affects people of all ages, in every area in which nurses work or volunteer. The U.S. Department of Agriculture describes food insecurity as the lack of "consistent, dependable access to adequate food for active, healthy living." The health effects of food insecurity include, but are not limited to, obesity, diabetes, hypertension, low birth weight, depression, and anxiety. Food insecurity is associated with single parenthood, low socioeconomic status, having three or more children, having low educational attainment, being a member of a racial or ethnic minority, renting a home, living in a city, and having a disabled household member. Veterans and military families; college students; members of the lesbian, gay, bisexual, and transgender community; and immigrants have also been identified as at elevated risk. The American Academy of Pediatrics, Academy of Nutrition and Dietetics, and AARP have called for innovative programs and universal screening tools to identify those who are experiencing or are at risk for food insecurity and connect them to available resources. In addition to screening patients for food insecurity and intervening on their behalf, nurses play a vital role in advocating for food-insecure families and supporting community involvement.

Food parenting practices in rural poverty context

Little is known about how low-income, rural mothers shape child eating behaviors. Descriptive and qualitative analysis of 55 mothers' surveys and in-depth interviews with 17 mothers in Washington state revealed a lack of alignment between mothers' intent to promote healthy child eating habits and counterproductive food parenting behaviors. Individual, family and community ecologies contributing to the divide included mothers' current nutrition knowledge, their childhood experiences, family food insecurity, housing issues preventing recommended practices, and a lack of public transportation or access to affordable grocery stores. The study highlights the need for educational programming that addresses contextual challenges and rural mothers’ existing knowledge system to improve the family feeding environment.

Six Critical Solutions to Fix Peoria’s Community Emergency Food Assistance System

First paragraph: No food system can be considered successful unless all people are well fed with the best food available. —Ken Meter (2013, p. 11) For me, Ken Meter’s simple statement hits the nail on the proverbial head. In Peoria, Illinois, we see fundamental issues facing many of our community food programs as they attempt to overcome the challenge of providing people in need with good food—food that is healthy, green, fair, and affordable. Not only are we challenged in feeding all of our food-insecure families adequately; we really struggle in offering, on a consistent basis, healthier food options. In the city of Peoria (population just over 114,000), where I co-founded the Gifts in the Moment Foundation (the gitm Foundation), there are over 40 soup kitchens and food pantries that directly serve families as part of the emergency food assistance system. Collectively called community food programs (CFPs), most are part of faith-based organizations, and many exist within mere blocks of one another. Yet in Peoria there exists no mutually shared system for clients to know whether they qualify for participation, where all of these CFPs are located, or even their hours of operation. Most of these well-intentioned emergency food programs admit to poor communication, but are burdened by having volunteer staff and few resources to try to fix our dysfunctional system. In this Voices from the Grassroots brief, I elaborate on these challenges and offer six solutions critical to fixing Peoria’s emergency food assistance system. My hope is that this brief will inspire action within our Regional Fresh Food Council (https://www.regionalfreshfoodcouncil.org), and may possibly inform the work of other food policy councils dealing with similar challenges. We welcome input from other organizations and agencies.

P44 - Feasibility of a Family Meal Intervention to Address Nutritional Wellbeing, Emotional Wellbeing and Food Insecurity of Families with Adolescents

Background (Background, Rationale, Prior Research, and/or Theory): Observational research suggests that family meals have significant benefits for children. However, interventions to successfully increase family meals are difficult to implement. Objectives: To assess the feasibility of a family meal intervention to address nutrition, emotional wellbeing, and food insecurity among families with adolescents. Study Design, Setting, Participants, Intervention: Nine adolescents and a parent/caregiver were recruited from an outpatient youth health clinic. Families were provided with meal plans, recipes and ingredients to prepare five family dinners weekly, for four weeks. Participants completed baseline and follow-up surveys and open-ended interviews. Outcome Measures and Analysis: Frequency of family meals, adolescent cooking, vegetable consumption, parent and adolescent mental health, and household food insecurity. Interview data were analyzed to add context to findings. Results: Mean age of participating adolescents was 15 years and five were female. Participating adolescents were ethnically diverse and economically disadvantaged. Families reported the intervention was acceptable: frequency of family meals increased by 2 meals per week and adolescents reported more frequent cooking (0.9 times per week at baseline, 4.5 at follow-up). Among parent/caregivers and adolescents, 4 of 9 reported increases to vegetable consumption and most reported improvements to mental wellbeing. Specifically, eight parent/caregivers reported reductions in depression, anxiety and stress and seven adolescents reported improvements to wellbeing. Participants commented on better family communication and fewer arguments during the intervention. Household food insecurity reduced during the intervention (means 8.2 and 0.2 at baseline and follow-up, respectively). As one parent noted, “our budget is quite tight… and having the meals was good because you knew you were getting a lot more vitamins and vegetables.” Conclusions and Implications: Providing families with meal plans, recipes and ingredients is an acceptable way to improve family meals. Future research and interventions may consider the family meal as a way to engage with families on wider issues, including wellbeing and food insecurity. Funding: Maurice and Phyllis Paykel Trust.

P39 - Prevalence and Correlates of Family and Campus Food Insecurity Among Freshmen at a University in Appalachia

P39 - Prevalence and Correlates of Family and Campus Food Insecurity Among Freshmen at a University in Appalachia

Food insecurity transitions and housing hardships: Are immigrant families more vulnerable?

ABSTRACTFood insecurity and housing instability are pervasive issues in the United States and disproportionally affect immigrants and have many negative consequences for low-income families. Although evidence shows that food insecurity contributes to housing instability, how it affects immigrants, the duration of food insecurity, and the role of the neighborhood context in this relationship remain largely unknown. Using longitudinal data from the Fragile Families and Child Wellbeing Study, we find that the negative association of food insecurity is 3 times larger for immigrants than for nonimmigrants. In addition, persistently food insecure families have the highest risk of experiencing housing instability compared to families experiencing short-term food insecurity. The findings point to potential positive externality effects of anti-hunger and food assistance programs on reducing material hardships beyond food insecurity and the particular policy implications for immigrants.

DOES BREASTFEEDING DURATION INFLUENCE FAMILY FOOD INSECURITY?

Abstract BACKGROUND Across all demographics, families without consistent access to adequate food place children at health risk. Consequences may persist beyond early life into adulthood. Public policy positions breastfeeding, the ideal nutrition for infants, as an important solution to reducing family food insecurity (FFI). However, few studies have investigated the association between breastfeeding duration and FFI. OBJECTIVES To evaluate the association between total breastfeeding duration and FFI in Canadian urban children. DESIGN/METHODS A cross-sectional study was conducted of children aged 0–2 years, from a practice-based child research network. Total breastfeeding duration was collected from parent-reported questionnaires. FFI was measured using 2-item food insecurity and validated 1-item NutriSTEP screens. Multivariable regression analysis was performed adjusting for pre-specified covariates. RESULTS Among 3838 children, the mean total breastfeeding duration was 10.6 months (SD=6.7). Families with food insecurity (14.7%) had increased odds of younger mothers, more males and older and more children. In adjusted model, breastfeeding duration was not associated with FFI (OR 0.99; 95% CI 0.98, 1.01). Low-income families were 9 times more likely to be family food insecure than high-income families (p=0.00). CONCLUSION Contrary to public policy, our study found no association between breastfeeding and family food insecurity (FFI). However, other factors may predominate, in particular family income and structure. Given the detrimental impact of FFI, further research is needed to understand the role of infant feeding practices within the larger political, policy and cultural framework.

SISTEM PENDUKUNG KEPUTUSAN PENERIMAAN BERAS UNTUK KELUARGA MISKIN MENGGUNAKAN METODE SIMPLE ADDITIVE WEIGHTING DI KANTOR KEPALA DESA GUMPANG

The Gumpang Village Head Office is one of the village government offices that provide both economic and social services. In the service of the village head, there is a social program that every month there is a program for poor families, which is included in certain criteria governed by the rule of government in the village head gumpang. The all citizens are entitled to get Raskin, but only for those who belong to the poor family scope and food insecurity to support his family. For that in determining the poor family (based on criteria such as Earnings, Dependence Children, Home Conditions. Raskin program is only devoted to the poor citizens only. So as the village head is obliged to be able to select or select its citizens, to determine as the poor recipients of Raskin. Because the condition of the society is so diverse and the status of different citizens and there are various upheavals between the poor and the poor, where the citizens in the village of gumpang that look poor not necessarily poor and the citizens who look rich not necessarily rich, because citizens changed from rich to poor, poor to rich, making it difficult for village heads to determine poor families as Raskin recipients. Solution to handle the problem is to make Decision Support System used method SAW (Simple Additive Weighting). This method is chosen because this method is capable for the ranking process which will select the best alternative from a number of alternatives (poor people) The technique used in this research is with Observation, Interview and literature study The design of this system is made with Context Diagram, HIPO, DAD, inter-table relation and database design. Applications are created using PHP programming languages and databases using My SQL. The old system analysis to calculate the error rate of the old system has an error rate of 1 that is the result difference between the new system with the old system is 1 riping so that the accuracy of the new system is 90%. The system has been made capable of determining the poor based on many criteria resulting in more precise and comprehensive resultsKeywords: Raskin, Population, SAW, Decision Support System

Freshmen at a University in Appalachia Experience a Higher Rate of Campus than Family Food Insecurity.

Food insecurity means having limited or uncertain access, in socially acceptable ways, to an adequate and safe food supply. Ample evidence has identified college students as vulnerable to this problem, but little research has focused on freshmen. This cross-sectional study examined family and campus food insecurity among freshmen at a university in Appalachia. An online questionnaire contained sociodemographic items and scales that measured food security status, academic progress, coping strategies for accessing food, and social support. T-tests and Chi square analyses compared food insecure and food secure students. Statistical significance was p < .05. Participants were 456 freshmen, 118 males (26%) and 331 females (73%). Family and campus food insecurity were experienced by 32 (7.1%) and 98 (21.5%) of the freshmen, respectively, and 42.5% of those who experienced campus food insecurity believed their food access had worsened since starting college. Family and campus coping strategies, respectively, included stretching food (72.9 vs. 18.4%) and purchasing cheap, processed food (68.8 vs. 16.3%). Food secure students scored significantly higher on self-rated measures of academic progress (p < .01), and greater proportions of food secure students (60.7 vs. 43.9%, p < .01) perceived their eating habits since starting college as "healthy/very healthy," and perceived their health status as "good/excellent" (86.0 vs. 71.4%, p < .01). Students requested assistance with job opportunities (19.4%), affordable meal plans (18.4%), money management (13.3%), and eating healthy (11.2%). Findings suggest that college student food insecurity begins during the freshmen year, and that there is a need for campus and community-based interventions to increase food access among these freshmen and their families.

Relation between household food insecurity and breastfeeding in Canada.

Qualitative studies have suggested that food insecurity adversely affects infant feeding practices. We aimed to determine how household food insecurity relates to breastfeeding initiation, duration of exclusive breastfeeding and vitamin D supplementation of breastfed infants in Canada. We studied 10 450 women who had completed the Maternal Experiences - Breastfeeding Module and the Household Food Security Survey Module of the Canadian Community Health Survey (2005-2014) and who had given birth in the year of or year before their interview. We used multivariable Cox proportional hazards models and logistic regression to examine the relation between food insecurity and infant feeding practices, adjusting for sociodemographic characteristics, maternal mood disorders and diabetes mellitus. Overall, 17% of the women reported household food insecurity, of whom 8.6% had moderate food insecurity and 2.9% had severe food insecurity (weighted percentages). After adjustment for sociodemographic factors, women with food insecurity were no less likely than others to initiate breastfeeding or provide vitamin D supplementation to their infants. Half of the women with food insecurity ceased exclusive breastfeeding by 2 months, whereas most of those with food security persisted with breastfeeding for 4 months or more. Relative to women with food security, those with marginal, moderate and severe food insecurity had significantly lower odds of exclusive breastfeeding to 4 months, but only women with moderate food insecurity had lower odds of exclusive breastfeeding to 6 months, independent of sociodemographic characteristics (odds ratio 0.60, 95% confidence interval 0.39-0.92). Adjustment for maternal mood disorder or diabetes slightly attenuated these relationships. Mothers caring for infants in food-insecure households attempted to follow infant feeding recommendations, but were less able than women with food security to sustain exclusive breastfeeding. Our findings highlight the need for more effective interventions to support food-insecure families with newborns.

Food insecurity and social support in families of children with sickle-cell disease

ObjectiveTo examine the associations between food insecurity (IA) and social support in families of children with sickle-cell disease (DF). MethodsThis cross-sectional study in families of 190 children from five to nine years old in follow-up at a hematology referral hospital in Rio de Janeiro State. IA was measured using the Brazilian food insecurity scale and social support was measured using the Brazilian version of the MOS social support survey instrument. The relation between IA and social support was analyzed by way of a multinomial logistic model. ResultsThere was IA in 62.2% of the families, in moderate and severe form in, respectively, 11.1% and 7.9% of cases. In families of children with DF, levels of mild and severe food insecurity (IALe and IAGr) were found to relate inversely to levels of social support in the following dimensions: informational support (IALe OR=0.98; 95% CI 0.96–0.99 and IAGr OR=0.95; 95% CI 0.92–0.98); social interaction (IALe OR=0.98; 95% CI 0.96–0.99 and IAGr OR=0.96; 95% CI 0.93–0.99) and tangible social support (IALe OR=0.97; 95% CI 0.96–0.99 and IAGr OR=0.97; 95% CI 0.94–0.99). ConclusionConsidering the positive effects of social support on IA, public policies should be encouraged to assure food and nutritional security and social assistance for care for people with DF. Also, social support groups for people with DF should be strengthened.

Food Insecurity in Families of Overweight/obese Children Enrolled in the Wholesome Wave Fruit &amp; Vegetable Prescription Program® (fvrx®) in New York City Public Hospitals

Food Insecurity in Families of Overweight/obese Children Enrolled in the Wholesome Wave Fruit &amp; Vegetable Prescription Program® (fvrx®) in New York City Public Hospitals

Food insecurity and child behavior problems in fragile families

Food insecurity remains a persistent problem in the United States. Several studies have shown that food insecurity is associated with child externalizing and internalizing behavior problems. However, some potential methodological limitations remain. For example, most studies use a household measure of food insecurity while there is evidence that children, especially younger ones, tend to be shielded by their parents from experiencing food insecurity. In addition, the mechanisms through which food insecurity affects children are not well understood. This study uses longitudinal data from the Fragile Families and Child Wellbeing Study to address these limitations. Fixed-effects models show that the association is even larger using a measure of child food insecurity instead of a household one. Correlated-random effects models show a large difference in child behavior problems between food secure and food insecure children due to unobserved heterogeneity. In addition, the association between child food insecurity and child externalizing behaviors remains largely unexplained while food insecurity among adults explains almost all the variation in the association with child internalizing behaviors. Food insecure children and parents are at risk of micronutrient deficiencies, which may lead to behavior problems in young children. These findings underscore the need for greater focus on reducing the risk of food insecurity, especially for children in fragile families, in order to reduce behavior problems and improve their educational attainment.

Parental Psychological Distress and Family Food Insecurity: Sad Dads in Hungry Homes

To examine whether household food insecurity is associated with serious psychological distress (SPD) in fathers and mothers in a nationally representative US sample. We analyzed cross-sectional, matched child-parent data from the 2014 to 2015 National Health Interview Survey (N = 18,456). Parental psychological distress was assessed using the Kessler-6 (K-6) scale. Family food security was measured using the USDA's 10-item Food Security scale, and households were dichotomized as food secure or food insecure. Multivariate logistic regression analyses were performed to examine associations between SPD and food insecurity stratified by parental status (mother/father), controlling for sociodemographic factors. One hundred forty-seven (2.0%) fathers, 444 (3.9%) mothers, and 591 (3.2%) of all parents had K-6 scores indicating SPD. A total of 2414 (13.1%) parents reported being food insecure, including 750 (10.4%) fathers and 1664 (14.8%) mothers. In multivariate analyses, food insecurity was significantly associated with SPD both among fathers and mothers (odds ratio [OR] = 4.2; 95% confidence interval [CI], 2.4-7.3 and OR = 2.6; 95% CI, 1.9-3.5, respectively). This is the first study we are aware of to demonstrate that food insecurity is independently associated with SPD among fathers and mothers, and that fathers may be at higher risk of SPD than mothers in food insecure homes. These findings highlight the need to assess and treat the mental health of fathers, a historically underrepresented group in the fields of mental health and pediatrics, in addition to mothers, in food insecure homes.

Clinicians' Perceptions of Screening for Food Insecurity in Suburban Pediatric Practice.

National organizations recommend pediatricians screen for food insecurity (FI). Although there has been growing research in urban practices, little research has addressed FI screening in suburban practices. We evaluated the feasibility, acceptability, and impact of screening in suburban practices. We conducted a mixed methods study that implemented FI screening in 6 suburban pediatric primary care practices. We included all children presenting for either a 2-, 15-, or 36-month well-child visit (N = 5645). Families who screened positive were eligible to be referred to our community partner that worked to connect families to the Supplemental Nutrition Assistance Program. We conducted focus groups with clinicians to determine their perceptions of screening and suggestions for improvement. Of the 5645 children eligible, 4371 (77.4%) were screened, of which 122 (2.8%) screened positive for FI (range: 0.9%-5.9% across practices). Of the 122 food-insecure families, only 1 received new Supplemental Nutrition Assistance Program benefits. In focus groups, 3 themes emerged: (1) Time and workflow were not barriers to screening, but concerns about embarrassing families and being unable to provide adequate resources were; (2) Clinicians reported that parents felt the screening showed caring, which reinforced clinicians' continued screening; (3) Clinicians suggested implementing screening before the visit. We found it is feasible and acceptable for clinicians to screen for FI in suburban practices, but the referral method used in this study was ineffective in assisting families in obtaining benefits. Better approaches to connect families to local resources may be needed to maximize the effectiveness of screening in suburban settings.