EAL

HD: Food Security (2011)

Citation:

Study Design:

Class:

- Click here for explanation of classification scheme.

Quality Rating:

Research Purpose:

To explore issues of food insecurity and insufficiency within an urban Latino and predominantly immigrant population.

Inclusion Criteria:

As part of a larger study on ethnic Latino differences in health and nutrition attitudes and behaviors and child health services use, participants:

Lived in one of three Chicago community areas (West Town, Humboldt Park and Logan Square) with greater than 30% Latino population
Had a child aged four to eight years, entering school for the first time.

Exclusion Criteria:

Incomplete or invalid interviews were excluded.

Description of Study Protocol:

Recruitment

Communities were selected based on their Latino population
Schools which had at least 30% Latino population were used to recruit families of students entering school for the first time.

Design

Face-to-face survey interviews were used to collect data for this cross-sectional study:

Cornell/Radimer scale of food insufficiency
Marin acculturation scale.

Statistical Analysis

ANOVA
Chi-square.

Data Collection Summary:

Timing of Measurements

Participants were interviewed once for this study in the year 2000.

Dependent Variables

Food insufficiency per the Radimer/Cornell scale
Health status of child as reported by mother
Food assistance, child nutrition and emergency food program use.

Independent Variables

Demographics (including age, education, years in US, birthplace, household size and age of child).

Control Variables

Not applicable.

Description of Actual Data Sample:

Initial N

354 women.

Attrition (Final N)

320 women caregivers.

Age and Ethnicity

Mexican and other Hispanic (78%); mean age, 32.3±6.1 years
Puerto Rican (22%); mean age, 33.1±7.3 years.

Other Relevant Demographics

Education: Mexican and other, 8.8±3.5; Puerto Rican, 12.2±3
US residence in years: Mexican and other, 11.3±6.4; Puerto Rican, 18.4±12
Birthplace in US (or continental US): Mexican and other, 5.5%; Puerto Rican, 46%
Mean household size: Mexican and other, 5.1±1.5; Puerto Rican, 4.2±1.5
Mean age of target child: Mexican and other 5.48±1.09; Puerto Rican, 5.68±1.39.

Location

Chicago, Illinois area.

Summary of Results:

Key Findings

30% of respondents said they 'sometimes' or 'often' do not have enough to eat. This was slightly more prominent in Puerto Rican respondents.

Of these:

84% of these respondents said they 'sometimes' or 'often' worried about food running out before they had money to buy more
90% said they worried whether the food they could afford would be enough for their family
32% reported their child was sometimes hungry, but they couldn't afford more food
6% reported they or their child had skipped a meal yesterday due to lack of food
5% reported that there were days they or their child didn't eat at all due to lack of food.

Other Findings

No significant difference between perceived food-sufficient and perceived food-insufficient families for length of time living in the US, the number of household moves in the past five years, mother's employment status, acculturation level or housing type
23% of mothers of children in food-insufficient households reported them to be in fair or poor health
Most families consumed predominantly traditional Mexican or Puerto Rican foods regardless of food sufficiency status.

Author Conclusion:

The prevalence of food insufficiency among Latino families was greater than previously reported on a national level (30% vs. 8.2%)
Only 30% of low income food insufficient families were Food Stamp participants, although 90% of the children received school meals, indicating there is a need for better screening and outreach for low-income immigrant Latino families.

Funding Source:

Government:

HRSA/MCHB Grant MCJ 17080

Reviewer Comments:

Strengths: Excellent participation rate with interviews conducted by bi-lingual, bi-cultural interviewers
Weaknesses: All data is self-reported.

Quality Criteria Checklist: Primary Research
Relevance Questions
	1.	Would implementing the studied intervention or procedure (if found successful) result in improved outcomes for the patients/clients/population group? (Not Applicable for some epidemiological studies)	Yes
	2.	Did the authors study an outcome (dependent variable) or topic that the patients/clients/population group would care about?	Yes
	3.	Is the focus of the intervention or procedure (independent variable) or topic of study a common issue of concern to dieteticspractice?	Yes
	4.	Is the intervention or procedure feasible? (NA for some epidemiological studies)	Yes

Validity Questions
1.	Was the research question clearly stated?		Yes
	1.1.	Was (were) the specific intervention(s) or procedure(s) [independent variable(s)] identified?	Yes
	1.2.	Was (were) the outcome(s) [dependent variable(s)] clearly indicated?	Yes
	1.3.	Were the target population and setting specified?	Yes
2.	Was the selection of study subjects/patients free from bias?		Yes
	2.1.	Were inclusion/exclusion criteria specified (e.g., risk, point in disease progression, diagnostic or prognosis criteria), and with sufficient detail and without omitting criteria critical to the study?	Yes
	2.2.	Were criteria applied equally to all study groups?	Yes
	2.3.	Were health, demographics, and other characteristics of subjects described?	Yes
	2.4.	Were the subjects/patients a representative sample of the relevant population?	Yes
3.	Were study groups comparable?		Yes
	3.1.	Was the method of assigning subjects/patients to groups described and unbiased? (Method of randomization identified if RCT)	N/A
	3.2.	Were distribution of disease status, prognostic factors, and other factors (e.g., demographics) similar across study groups at baseline?	Yes
	3.3.	Were concurrent controls or comparisons used? (Concurrent preferred over historical control or comparison groups.)	N/A
	3.4.	If cohort study or cross-sectional study, were groups comparable on important confounding factors and/or were preexisting differences accounted for by using appropriate adjustments in statistical analysis?	Yes
	3.5.	If case control study, were potential confounding factors comparable for cases and controls? (If case series or trial with subjects serving as own control, this criterion is not applicable.)	N/A
	3.6.	If diagnostic test, was there an independent blind comparison with an appropriate reference standard (e.g., "gold standard")?	Yes
4.	Was method of handling withdrawals described?		Yes
	4.1.	Were follow-up methods described and the same for all groups?	N/A
	4.2.	Was the number, characteristics of withdrawals (i.e., dropouts, lost to follow up, attrition rate) and/or response rate (cross-sectional studies) described for each group? (Follow up goal for a strong study is 80%.)	Yes
	4.3.	Were all enrolled subjects/patients (in the original sample) accounted for?	Yes
	4.4.	Were reasons for withdrawals similar across groups?	Yes
	4.5.	If diagnostic test, was decision to perform reference test not dependent on results of test under study?	N/A
5.	Was blinding used to prevent introduction of bias?		No
	5.1.	In intervention study, were subjects, clinicians/practitioners, and investigators blinded to treatment group, as appropriate?	N/A
	5.2.	Were data collectors blinded for outcomes assessment? (If outcome is measured using an objective test, such as a lab value, this criterion is assumed to be met.)	No
	5.3.	In cohort study or cross-sectional study, were measurements of outcomes and risk factors blinded?	No
	5.4.	In case control study, was case definition explicit and case ascertainment not influenced by exposure status?	N/A
	5.5.	In diagnostic study, were test results blinded to patient history and other test results?	N/A
6.	Were intervention/therapeutic regimens/exposure factor or procedure and any comparison(s) described in detail? Were interveningfactors described?		Yes
	6.1.	In RCT or other intervention trial, were protocols described for all regimens studied?	N/A
	6.2.	In observational study, were interventions, study settings, and clinicians/provider described?	Yes
	6.3.	Was the intensity and duration of the intervention or exposure factor sufficient to produce a meaningful effect?	Yes
	6.4.	Was the amount of exposure and, if relevant, subject/patient compliance measured?	Yes
	6.5.	Were co-interventions (e.g., ancillary treatments, other therapies) described?	Yes
	6.6.	Were extra or unplanned treatments described?	Yes
	6.7.	Was the information for 6.4, 6.5, and 6.6 assessed the same way for all groups?	Yes
	6.8.	In diagnostic study, were details of test administration and replication sufficient?	N/A
7.	Were outcomes clearly defined and the measurements valid and reliable?		Yes
	7.1.	Were primary and secondary endpoints described and relevant to the question?	Yes
	7.2.	Were nutrition measures appropriate to question and outcomes of concern?	Yes
	7.3.	Was the period of follow-up long enough for important outcome(s) to occur?	N/A
	7.4.	Were the observations and measurements based on standard, valid, and reliable data collection instruments/tests/procedures?	Yes
	7.5.	Was the measurement of effect at an appropriate level of precision?	Yes
	7.6.	Were other factors accounted for (measured) that could affect outcomes?	Yes
	7.7.	Were the measurements conducted consistently across groups?	Yes
8.	Was the statistical analysis appropriate for the study design and type of outcome indicators?		Yes
	8.1.	Were statistical analyses adequately described and the results reported appropriately?	Yes
	8.2.	Were correct statistical tests used and assumptions of test not violated?	Yes
	8.3.	Were statistics reported with levels of significance and/or confidence intervals?	Yes
	8.4.	Was "intent to treat" analysis of outcomes done (and as appropriate, was there an analysis of outcomes for those maximally exposed or a dose-response analysis)?	Yes
	8.5.	Were adequate adjustments made for effects of confounding factors that might have affected the outcomes (e.g., multivariate analyses)?	Yes
	8.6.	Was clinical significance as well as statistical significance reported?	Yes
	8.7.	If negative findings, was a power calculation reported to address type 2 error?	N/A
9.	Are conclusions supported by results with biases and limitations taken into consideration?		Yes
	9.1.	Is there a discussion of findings?	Yes
	9.2.	Are biases and study limitations identified and discussed?	Yes
10.	Is bias due to study's funding or sponsorship unlikely?		Yes
	10.1.	Were sources of funding and investigators' affiliations described?	Yes
	10.2.	Was the study free from apparent conflict of interest?	Yes