Food Insecure Families Research Articles

Scaling up a home-visiting program for child development in Brazil: a comparative case studies analysis

In 2016, Brazil scaled up the Criança Feliz Program (PCF, from the acronym in Portuguese), making it one of the largest Early Childhood Development (ECD) programs worldwide. However, the PCF has not been able to achieve its intended impact. We aimed to identify barriers and facilitators to achieving the PCF implementation outcomes across the RE-AIM dimensions (Reach, Effectiveness or Efficacy, Adoption, Implementation and Maintenance) during the COVID-19 pandemic. This comparative case study analysis selected five contrasting municipalities based on population size, region of the country, implementation model, and length of time implementing the PCF. We conducted 244 interviews with PCF municipal team (municipal managers, supervisors, home visitors), families, and cross-sectoral professionals. A rapid qualitative analysis was used to identify themes across RE-AIM dimensions. Families' limited knowledge and trust in PCF goals were a barrier to its reach. While the perceived benefit of PCF on parenting skills and ECD enabled reach, the lack of referral protocols to address social needs, such as connecting food-insecure families to food resources, undermined effectiveness. Questions about whether the social assistance sector should be in charge of PCF challenged its adoption. Implementation barriers exacerbated by the COVID-19 pandemic included low salaries, temporary contracts, high turnover, infrequent supervision, lack of an effective monitoring system, and nonexistence or non-functioning multisectoral committees. The absence of institutionalized funding was a challenge for sustainability. Complex intertwined system-level barriers may explain the unsuccessful implementation of PCF. These barriers must be addressed for Brazil to benefit from the enormous reach of the PCF and the evidence-based nurturing care principles it is based upon. NIH/NICHD.

Prenatal Risks to Healthy Food Access and High Birthweight Outcomes

ObjectiveInfants with high birthweight have increased risk for adverse outcomes at birth and across childhood. Prenatal risks to healthy food access may increase odds of high birthweight. We tested whether having a poor neighborhood food environment and/or food insecurity had associations with high birthweight. MethodsWe analyzed cross-sectional baseline data in Greenlight Plus, an obesity prevention trial across six US cities (n = 787), which included newborns with a gestational age greater than 34 weeks and a birthweight greater than 2500 g. We assessed neighborhood food environment using the Place-Based Survey and food insecurity using the US Household Food Security Module. We performed logistic regression analyses to assess the individual and additive effects of risk factors on high birthweight. We adjusted for potential confounders: infant sex, race, ethnicity, gestational age, birthing parent age, education, income, and study site. ResultsThirty-four percent of birthing parents reported poor neighborhood food environment and/or food insecurity. Compared to those without food insecurity, food insecure families had greater odds of delivering an infant with high birthweight (adjusted odds ratios [aOR] 1.96, 95% confidence intervals [CI]: 1.01, 3.82) after adjusting for poor neighborhood food environment, which was not associated with high birthweight (aOR 1.35, 95% CI: 0.78, 2.34). Each additional risk to healthy food access was associated with a 56% (95% CI: 4%−132%) increase in high birthweight odds. ConclusionsPrenatal risks to healthy food access may increase high infant birthweight odds. Future studies designed to measure neighborhood factors should examine infant birthweight outcomes in the context of prenatal social determinants of health.

Examining the Relationship Between Food Insecurity and Family Violence: a Systematic Narrative Review

Abstract Purpose This review aimed to investigate and describe the current research that has reported on family violence and food insecurity and to explore any links. Research is beginning to explore the relationship between food insecurity and family violence, as such, this is a good time to review the current body of literature to identify existing gaps. Methods This research employed a narrative systematic review allowing for a broad search while maintaining methodological rigour. Key word searches were performed in 6 electronic databases in January 2023. Two overarching concepts were used: “family violence” and “food security”. The findings were synthesised into a narrative review, reporting on specific population groups separately. Results The search generated 1724 articles, of which 868 were duplicates. The titles and abstracts of 856 articles were screened; 765 articles were excluded because they did not investigate the experience of food insecurity and family violence. The full text of 91 articles was reviewed, with 32 included in this review. Most were from the USA, and most employed qualitative or mixed methods. Studies explored food insecurity and family violence in women, men and women, children, people who are HIV positive, and the relationship between the COVID-19 pandemic and food insecurity. Conclusions Food insecurity and family violence are significant societal problems, with evidence that both have increased in prevalence and severity due to the onset of the COVID-19 pandemic. This review provides initial evidence for a bi-directional relationship between food insecurity and family violence in high income countries.

Household food insecurity and health service use for mental and substance use disorders among children and adolescents in Ontario, Canada.

Food insecurity is a serious public health problem and is linked to the mental health of children and adolescents; however, its relationship with mental health service use is unknown. We sought to estimate the association between household food insecurity and contact with health services for mental or substance use disorders among children and adolescents in Ontario, Canada. We used health administrative data, linked to 5 waves of the Canadian Community Health Survey, to identify children and adolescents (aged 1-17 yr) who had a household response to the Household Food Security Survey Module. We identified contacts with outpatient and acute care services for mental or substance use disorders in the year before survey completion using administrative data. We estimated prevalence ratios for the association between household food insecurity and use of mental health services, adjusting for several confounding factors. The sample included 32 321 children and adolescents, of whom 5216 (16.1%) were living in food-insecure households. Of the total sample, 9.0% had an outpatient contact and 0.6% had an acute care contact for a mental or substance use disorder. Children and adolescents in food-insecure households had a 55% higher prevalence of outpatient contacts (95% confidence interval [CI] 41%-70%), and a 74% higher prevalence of acute care contacts (95% CI 24%-145%) for a mental or substance use disorder, although contacts for substance use disorders were uncommon. Children and adolescents living in a food-insecure household have greater use of health services for mental or substance use disorders than those living in households without food insecurity. Focused efforts to support food-insecure families could improve child and adolescent mental health and reduce strain on the mental health system.

Metode Simple Additive Weighting Untuk Pemilihan Penerima Bantuan Program Raskin

Program Raskin merupakan salah satu program pemerintah untuk membantu masyarakat miskin dan rawan pangan. Tidak semua warga masyarakat berhak mendapatkan Program Raskin, tetapi hanya warga yang tergolong kelurga miskin dan rawan pangan. Program Raskin berupa pemberian bantuan beras yang diberikan setiap triwulan (tiga bulan) sebanyak 15kg/bulan, selama 12 bulan. Kriteria masyarakat yang memperoleh bantuan program raskin berdasarkan pada penghasilan perbulan, jumlah tanggungan orang dalam keluarga, dan kondisi rumah. bantuan program raskin belum merata dalam pembagiannya, karena terkendala kuota. Sehingga diperlukan perangkingan untuk menentukan penerima Program Raskin, serta mengembangkan aplikasi untuk pemilihan penerima bantuan program Raskin. Perangkingan menggunakan sistem pengambilan keputusan dengan metode Simple Additive Weighting (SAW) di perlukan untuk membantu dalam pemilihan warga yang berhak menerima bantuan Program Raskin. Metode SAW mampu menentukan bobot untuk setiap kriteria, dan melakukan perankingan untuk menyeleksi alternatif terbaik dari sejumlah alternative, kriteria yang digunakan penghasilan, jumlah anak, kondisi rumah. Pengembangan sistem dengan menggunakan model Waterfall, pada tahap desain menggunakan pendekatan terstruktur. Hasil akhir berupa keputusan penerima Program Raskin, serta sebuah Aplikasi yang dapat dipergunakan untuk pengambilan keputusan pemilihan warga yang berhak mendapatkan bantuan Program Raskin. Pengujian sistem dengan menggunkan uji fungsionalitas (Black Box). Hasil uji sistem menunjukkan bahwa sistem berfungsi dengan dengan baik sesuai yang diharapkan. Uji validitas dilakukan untuk menguji hasil perhitungan Metode SAW dengan membandingkan yang menghasilkan uji sistem dinyatakan valid 100%.

STUNTING PADA KONDISI RAWAN PANGAN, SANITASI, DAN KELAYAKAN SUMBER AIR MINUM PADA KELUARGA DI PROVINSI BANTEN (ANALISIS DATA SSGI-2021)

Stunting is still a special concern, despite a decrease in cases from year to year. This decline has not yet reached the national target of 14% by 2024. The purpose of this study was to determine the incidence of stunting based on food insecurity conditions, sanitation feasibility, and feasibility of family minimum water sources. The method used in this research is quantitative. The data used comes from the results of the Indonesian Nutrition Status Survey (SSGI) in 2021. The data used is specific to the Banten Province area. The number of samples used was 3671 families with children under five years old. Data analysis using chi-square. The incidence of stunting is associated with food insecurity, an environment with vulnerable sanitation, and unhealthy drinking water sources. Food-insecure families have a 1.5 times risk of having stunted toddlers. Meanwhile, families that do not have proper sanitation will have a risk of stunting of 2.174 times. A healthy environment with proper sanitation will certainly reduce toddlers from infections caused by the environment.

Social and Health Determinants of the Families of Children Under Two Years of Age with Stunting in Sigi District

Social aspect is a determinant of stunting. Stunting in children is an indicator of well-being and an accurate reflection of social inequality. This study aims to analyze the social and health determinants of the families of children under two years of age with stunting in Sigi District. This was an analytical study with cross sectional design which involved a population of children aged 6-23 months. A sample size consisted of 380 people were selected through cluster simple random sampling technique. Respondents involved the mothers of children under two years of age. Data collection was conducted in February-June 2022. The dependent variables was stunting incidence. The independent variables were maternal age, parity, birth spacing, maternal education, child's gender, child's age in months, length of birth, early initiation of breastfeeding, exclusive breastfeeding, breastfeeding status, child condition at the time of study, history of ARI, diarrhea, pulmonary tuberculosis, measles, Helminth Infection, utilization of health facilities, growth and development stimulation, complementary food, water sources, ownership of family latrines, food insecurity, housing, and smoking family members. Stunting data was obtained by measuring body length using the Length Measuring Board (LMB) and measuring age by reading the birth certificate or MCH book of the child. Other data were obtained by filling out the kobocollect questionnaire. Data were analyzed using SPSS version 22.00. The WHO-Antro 2005 software was applied to determine the Z-Score. Height-for-Age data were analyzed using univariate, bivariate and multivariate analysis using Backward logistic regression method. Ethical clearance was obtained from the ethics committee of Palu Health Polytechnic number 0011/KEPK-KPK/IV/2022. The results showed that children aged 12-24 months had a 4.1 times higher risk of experiencing stunting compared to children aged 0-6 months (AOR=4.1; 95% CI: 2.0-8.4). Furthermore, children aged 7-11 months had a 2.2 times higher risk of experiencing stunting compared to children aged 0-6 months (AOR=2.2;95%CI: 1.2-3.9). Children who had a length of birth of <48 cm had a 2.1 times higher risk of experiencing stunting compared to children who had a length of birth of ≥48 cm (AOR=2.1; 95% CI: 1.2-3.6). Children of women with education of <9 years had a 2.7 times higher risk of experiencing stunting compared to children of women with education of ≥9 years (AOR=2.7; 95% CI: 1.4-5.0). Children from families with food insecurity had a 1.6 times higher risk of experiencing stunting compared to children from families with no food insecurity (AOR=1.6; 95% CI: 0.9-2.7). Social and health determinants of children under two years of age with stunting in Sigi District were child's age, length of birth of <48 cm, maternal education and food insecurity.

Strengthening Food Security Reduces The Anemic Status of Pregnant Women and Encourages Breastfeeding Immediately after Delivery in the Coastal Area of Central Tapanuli

According to WHO and UNICEF recommendations, one way to prevent stunting is exclusive breastfeeding until the baby is six months old. The aim of the study was to strengthen family food security through local food and nutrition literacy using behavior-based nutrition education methods (social cognitive theory). Action research is the method used, and the participants are pregnant women who moderately work as housewives, originate from food-insecure families, and have family incomes below the regional minimum wage of 30 people. Prior to the intervention, the consumption of pregnant women was measured using a 24-hour food recall and measurements of haemoglobin levels. For 12 weeks, community health professionals provided home visits and face-to-face lectures for pregnant women on local food literacy and nutrition interventions. Pregnant women consumed an average of 1926.3 calories prior to the intervention; 2315.2 calories were consumed after the intervention. Before the intervention, there were 19 pregnant women with anaemia (63.3%); after the intervention, there were only 4 (13.3%). There were 20 breastfeeding mothers (66.7%) on the first day. Pregnant women's nutrient consumption and dietary diversity increased as a result of the local food literacy and nutrition intervention, which was implemented for 4 months.

Prevalence and associations between food insecurity and overweight/obesity among native Hawaiian and Pacific Islander adolescents.

This study estimates the prevalence of, and associations between, family food insecurity and overweight/obesity among Native Hawaiian and Pacific Islander (NHPI) adolescents and explores socio-demographic factors which might have a moderation effect on the association. Cross-sectional study using 2014 NHPI-National Health Interview Survey data reported by a parent or guardian. Family-level food security was assessed by the US Department of Agriculture 10-item questionnaire. BMI for age and sex ≥ 85th and 95th percentiles defined overweight and obesity, respectively, according to US Centers for Disease Control and Prevention criteria. The USA, including all 50 states and the District of Columbia. 383 NHPI adolescents aged 12-17 in the USA. A third (33·5 %) of NHPI adolescents aged 12-17 were overweight (19·1 %) or obese (14·4 %); 8·1 % had low food security; and 8·5 % had very low food security. Mean family food security score was 1·06, which corresponds to marginal food security. We found no association between family food insecurity and adolescent overweight/obesity or between any other covariates and overweight/obesity, except for family Supplemental Nutrition Assistance Program (SNAP) participation. Odds of being overweight/obese were 77 % lower for adolescents in families participating in SNAP (OR: 0·23, 95 % CI: 0·08, 0·64, P = 0·007). The association between SNAP participation and lower odds of overweight/obesity was particularly pronounced for adolescent girls in food-insecure families. The association between SNAP participation and lower odds of overweight/obesity suggests potential benefit of research to determine whether interventions to increase SNAP enrollment would improve NHPI adolescents' health outcomes.

Social context and moderate-severe food and nutritional insecurity in families with children aged 0-59 months, Paraíba, Brazil, 2017-2018.

To analyze the association between the social context (demographic, socioeconomic and social support factors) and moderate-severe food and nutritional insecurity in families with children aged 0-59 months enrolled in municipal kindergartens in the state of Paraíba, Brazil. We conducted a cross-sectional study in Brazilian municipalities prioritized for the prevention of childhood obesity. A questionnaire was used to collect information on the social context of the family (demographic profile of the child, socioeconomic situation and social support) as well as the Brazilian food insecurity scale. The association between the independent variables and moderate-severe food and nutrition insecurity was determined by applying Poisson regression to estimate crude and adjusted prevalence ratios and their respective 95% confidence intervals. We included 382 families; 27.2% had moderate-severe food and nutrition insecurity. In addition, dysfunctional families with children under 24 months, from less affluent classes, beneficiaries of the Bolsa Família Program and without social support (material, emotional/informational and interaction) were more likely to present the outcome. Our results show that 27.2% of the families had moderate-severe food and nutritional insecurity, were beneficiaries of the Bolsa Família Program, dysfunctional and did not have social support. Therefore, the identification of these factors would be useful to improve family food and nutritional security.

Prevalence of household food insecurity in the marginal area of Birjand, Iran

IntroductionThe right to food is a human right. Food insecurity refers to the inability to prepare proper and healthy food. Food insecurity is associated with adverse outcomes among households. To determine the prevalence of food insecurity, its level, and the factors affecting it among households covered by health centers in marginalized areas of Birjand city.MethodsThis descriptive-analytical cross-sectional study was performed on 396 households aged 20-60 years covered by health centers in the marginal areas of Birjand in 2019. We used a 9-item Household Food Insecurity Access Scale (HFIAS) questionnaire. Chi-square, Fisher, and logistic regression analyses were performed using SPSS 22 software at a significance level of less than 0.05.ResultsThe mean age of the subjects was 34.04 ± 9.41 years. In total, 48% of the subjects had a level of food insecurity, of which 7.6% had severe, 12.6% moderate, and 27.5% mild insecurity. The prevalence of food insecurity in families with low members and higher levels of education is significantly lower (p < 001). Backward Logistic regression showed that illiteracy (OR: 8.26) and primary education (OR: 2.65), rental housing status (OR: 1.69), lower-income levels being covered by support organizations (OR: 3.13), employed members between 3-4 and more than five (OR: 2.73 and 2.93, respectively), and low weight (OR: 2.55) were associated with food insecurity. The prevalence of food insecurity in this study was high.ConclusionThe high prevalence of insecurity in studied households is an alarm for the authorities, which can be due to poverty and the low level of nutritional literacy of households' heads and mothers. Helping to improve the quality of life of families and food insecurity of households by improving physical and economic access, increasing literacy and nutritional culture, and reducing the burden of non-communicable diseases related to nutrition is a suggested solution.

Food insecurity and risk of cholera: A cross-sectional study and exploratory analysis of potential mediators.

Food insecurity has been independently associated with developing cholera and there is an inverse relationship between national food security and annual cholera incidence. However, the factors that mediate the risk of cholera among food insecure households remain largely unexplored. In a cross-sectional survey of rural households in Haiti, we explored the role of food behaviors (i.e., dietary choices and food-handling practices) as mediators of cholera risk among food-insecure families. We generated a series of multivariable regression models to test hypothesized associations between the severity of food insecurity (measured by the Household Hunger Scale), hygiene and food behaviors, and history of severe, medically-attended cholera. Moderate household hunger (Adjusted Odds Ratio [AOR] 1.47, 95% Confidence Interval (CI) 1.05-2.04; p = 0.021) and severe hunger (AOR 2.45, 95% CI 1.45-4.15; p = 0.001) were positively associated with a history of severe, medically-attended cholera compared with little to no household hunger. Household hunger was positively associated with three behaviors: antacid use, consumption of leftover non-reheated food, and eating food and beverages prepared outside of the home (i.e., at a restaurant or from a vendor). Consumption of outside food items and antacid use were positively associated with a history of cholera. Our findings suggest that food behaviors may mediate the association between food insecurity and cholera and contribute to an understanding of how interventions could be designed to target food insecurity as part of cholera prevention and control.

The Relationship Between Food Insecurity and Food Assistance Program Participation in Families of Preschool Children in the Rio Grande Valley

ABSTRACT The South Texas Early Prevention Study-PreK, a cluster randomized trial, explored the Bienestar Coordinated School Health Program’s influence on health variables in South Texas children. Factors associated with food insecurity (FI) were analyzed. Income-to-poverty ratio, income, and food assistance (FA) program participation were all associated with FI. Forty percent of families (257/643) reporting FI did not utilize FA. Of those families with FI, but who reported no FA participation, 31.8% were FA eligible. Families experiencing FI may underutilize FA programs, despite eligibility. Curtailing obstacles preventing FA program participation and matching those who are eligible with FA programs are crucial.

Food quality in pre-school and school children in Chile during the COVID-19 pandemic

the COVID-19 pandemic can affect the quality of food and nutrition of preschoolers and schoolchildren through an increase in food insecurity of families, by measures such as confinement and closure of educational establishments, which affects the daily structure, feeding schedules, and quality of food. analyze the overall food quality of preschool and school children in Chile during the COVID-19 pandemic. five hundred and fifty-one schoolchildren (22.5 % boys and 77.5 % girls) from five Chilean cities distributed in northern, central, and southern macro zones participated in a convenience sampling. The Global Food Quality Index was applied. The data were analyzed in the IBM SPSSV24 statistical program. Differences in proportions were analyzed employing crossed tables. schoolchildren from rural areas presented lower eating quality than their urban peers (p = .005). Schoolchildren who eat with the whole family had better indicators of eating quality than those who ate alone (p = .002). In nine out of 12 dietary components, evaluated females present higher compliance with dietary recommendations. further research is needed on changes in dietary intake and dietary quality of children and their families during the pandemic. This will allow us to analyze the impact of the pandemic on eating behavior and its possible consequences.

Food Insecurity Was Associated With Greater Family Health Care Expenditures In The US, 2016-17.

Food insecurity has been associated with the health care expenditures of individuals, but it can affect the entire family. Evaluating the relationship between food insecurity and family expenditures provides a better understanding of the financial implications of food insecurity interventions. Our primary objective was to evaluate the association between food insecurity in one year (2016) and family health care expenditures-for all members, for children only, and for adults only-in the next year (2017). We also evaluated whether this association varied across types of insurance coverage within families: all private, all public, or mixed (including uninsured). Using nationally representative data, we found that food-insecure families had 20percent greater total health care expenditures than food-secure families, for an annual difference of $2,456. Food insecurity was associated with greater expenditures across all family insurance patterns, including the 19.1percent of families with mixed coverage. Our findings suggest that in families with mixed coverage, positive impacts of food insecurity interventions on health care use may accrue to family members other than the targeted beneficiaries and those who have different insurance, benefiting the entire family but potentially discouraging investments on the part of any one payer.

Indicadores nutricionais da segurança alimentar e nutricional de famílias: Pesquisa de Orçamentos Familiares 2008/2009

ABSTRACT Objective To evaluate the food and nutrition insecurity of Brazilian families, according to indicators of food consumption and nutritional status, by location and situation of the households investigated using the 2008/2009 Household Budget Survey. Methods Inadequate consumption of macronutrients and nutritional dystrophies (underweight, short stature or overweight) in at least one family member were used as indicators, according to location and geographical situation of households. The prevalence of food and nutritional insecurity and their confidence intervals were calculated. Results Food consumption was assessed in a total of 13,569 households; a total of 67.55%, 43.96% and 6.85% revealed inadequacy for lipids, carbohydrates and proteins, respectively. Among the 53,640 households assessed by nutritional status, 15.10%, 35.15% and 45.50% had, at least one resident with low weight, short stature or overweight respectively. The Northeastern Region showed statistically higher prevalence than other Brazilian macro-regions for inadequate lipids (24.88%) and carbohydrates (15.32%), as well as for the presence of underweight (6.15%), overweight (14.77%) and short stature (15.17%), in at least one of the residents of the household. Conclusion Assessing the nutritional aspect of food insecurity allows for a better understanding of the dimensions of this situation by considering the effects of access and availability of food, as well as biological use and stability, based on indicators of inadequate food consumption and the presence of nutritional dystrophy. The results found in this study enhance the need to include nutritional indicators in the assessment of food security.

Food Insecurity, Federal Nutrition Support, and Parent Feeding Practices During COVID-19: A 1-Year Follow-up Study.

COVID-19 caused stark increases in food insecurity. To maintain food provision, policy changes to the National School Lunch Program (NSLP) and Supplemental Nutrition Assistance Program (SNAP) were instated. This longitudinal study examined (1) food security patterns across the timeline of COVID-19; (2) the relationship among food security patterns, NSLP/SNAP use, and parent feeding practices; and (3) parent perceptions of NSLP/SNAP policy changes. A total of 333 US parents completed online surveys during the COVID-19 pandemic: May 2020 (T1), September 2020 (T2), and May 2021 (T3). Food security and parent feeding practices were reported at each time point; pre-COVID-19 behaviors were retrospectively reported at T1. Use and perceptions of NSLP/SNAP policy changes were reported at T3. We examined associations between food security and parent feeding practices using repeated-measures mixed models. The percentage of parents with very low food security increased from pre-COVID-19 (9.6%) to T1 (29.1%) and remained elevated at T3 (16.8%). One-third (31.2%) of families fluctuated between food security and food insecurity, with 27.0% remaining food insecure at T3. Thirty percent of consistently food-insecure families reported not receiving school-provided meals, and 45% did not receive SNAP benefits. Most parents reported that pickup school meal sites (71.4%), Pandemic Electronic Benefit Transfer cards (51.4%), and increased SNAP benefits (79.6%) were beneficial. Initial changes in parent feeding practices reported at T1 returned to pre-COVID-19 levels by T3, yet concern for child overweight remained significantly elevated. Continued policy efforts to support food-insecure families via expanded food access in NSLP/SNAP are critical.

Determinants and consequences of food insecurity in families having children under the age of 2 years.

Background: Today, food insecurity is recognized as an important public health problem that can have detrimental effects on families. Aim: The aim of this study was to assess the determinants and consequences of food insecurity in families having children under the age of 2 years. Method: In this cross-sectional study, 307 mothers and their children under the age of 2 years were selected by stratified random sampling. Demographic and socioeconomic data were collected by completing questionnaires through face-to-face interview. Household food insecurity (HFI) status was determined using the United States Department of Agriculture (USDA) household food security questionnaire. Results: Based on the results, 67.4% of families were high food secure. Low and very low food security was 25.7% and 6.9%, respectively. House size (Beta = -0.019, 95% CI: -0.029, -0.009), father's job (Beta = -4.758, 95% CI:-6.777, -2.738), father education (Beta = -0.370, 95% CI: -0.717, -0.023), and economic status (Beta = -0.628, 95% CI: -0.809, -0.448) were significantly related to the USDA total food insecurity score (p < 0.05). Regression analysis showed that children birth weight, father's body mass index (BMI), and mother's waist circumference had a significant positive correlation with weight for age (Z-score) of children. Children's birth weight, father's BMI, and HFI status had significant and positive correlation with weight for length (Z-score). Moreover, the significant association between children's birth height, mother's BMI, and mother's waist circumference with length for age (Z-score) were observed (p < 0.05). Conclusion: We found the father's job was the most effective factor in food insecurity and economic status of the family was in the second place. Also, HFI had a relationship with weight status of children under the age of 2 years.

95 Prevalence and Characterization of Food Insecurity in a Canadian Paediatric Emergency Department

Abstract Background Food insecurity (FI), defined as inadequate or insecure access to food, is a key determinant of child health. FI is associated with a number of adverse physical, psychological and developmental health outcomes and increased emergency department (ED) use. The COVID-19 pandemic has exacerbated financial hardship faced by many families with an unprecedented rise in use of charitable food programs. Objectives We sought to determine the prevalence of FI among pediatric ED visits during the COVID-19 pandemic, compare this to pre-pandemic rates, and describe associated risk factors. Design/Methods From September to December 2021, families presenting to a tertiary Canadian paediatric ED were asked to complete a survey screening for FI with a validated two-item questionnaire, along with socio-demographic and child health information. Results were compared to data collected in 2012. Multivariable logistic regression was used to measure associations with FI. Results In 2021, 26% (n=173/665) of families identified as food insecure compared to 22.7% in 2012 (n=146/644), which was not statistically different (3.3%, 95% CI [-1.4%, 8.1%]). When the definition of FI is expanded to include use of charitable food assistance, the prevalence increased to 29.2%. In univariate analysis, FI was significantly associated with lack of primary care, caregivers born outside of Canada, status other than Canadian citizenship, having a child with a chronic medical condition, having financial strain related to medical expenses and reason for the ED visit being the child’s chronic condition. In multivariable analysis, only having more children in the home (OR 1.19, 95% CI [1.01, 1.41]), financial strain from medical expenses (OR 5.31, 95% CI [3.45, 8.18]) and lack of primary care access (OR 1.27, 95% CI [1.08, 1.51]) remained independent predictors of FI. Approximately half (48.5%) of food insecure families reported use of food charity, most commonly food banks (31.7%), while one-quarter (26%) received help from family or friends. Food insecure families indicated their preferred means of support in hospital would be free/low cost meals and financial assistance with medical expenses. Conclusion Greater than one in four families attending a Canadian tertiary pediatric ED screened positive for FI. FI was independently associated with lack of access to primary care, financial strain related to medical expenses, and greater number of children in the household. Further research is necessary to examine the effect of support interventions for families admitted to medical care facilities and financial support for chronic conditions.

Impacts of COVID-19 on the home food environment and eating related behaviors of families with young children based on food security status

This mixed-methods study endeavored to expand the current understanding of how early pandemic related disruptions impacted the home food environment and parent feeding practices of families with young children.Data for this study are taken from the Kids EAT! Study, a racially/ethnically diverse cohort of families with 2–5 year old children. Individual interviews were conducted by phone and video conference with mothers (n = 25) during August/September of 2020 and were coded using a hybrid deductive/inductive analysis approach. Parents also reported on their family's food insecurity status enabling qualitative findings to be stratified by family-level food security status.Two overarching themes were identified related to how families in this sample describe the COVID-19 pandemic's impact on their home food environment. Themes included 1) Impacts on obtaining food for one's family, and 2) Specific changes in parent feeding practices. Findings indicated variation within each theme by family food security status. Overall, families experiencing food insecurity more frequently discussed using various coping strategies, including stocking up, rationing food, and use of supplemental food resources, to overcome challenges associated with obtaining food brought on by COVID-19. Families with food insecurity also reported having more time for home cooked meals and more frequently discussed enforcing less structure (timing of meal, place) related to meals/snacks consumed at home during the pandemic.The impacts of the COVID-19 persist, ranging from ongoing economic challenges, inconsistent access to childcare for families, and the emergence of new, more contagious, variants. With this, interventions to address food insecurity amongst families with young children should consider how to optimize the home food environment and promote healthful parent feeding practices within the families they serve in the face of an evolving public health crisis.