The Four Domain Food Insecurity Scale (4D-FIS): development and evaluation of a complementary food insecurity measure.

The U.S. Department of Agriculture (USDA) Food Security Survey Module (FSSM) is a valuable tool for measuring food insecurity, but it has limitations for capturing experiences of less severe food insecurity. To develop and test the Four Domain Food Insecurity Scale (4D-FIS), a complementary measure designed to assess all four domains of the food access dimension of food insecurity (quantitative, qualitative, psychological, and social).Low-income Black, Latina, and White women (n = 109) completed semi-structured (qualitative) and structured (quantitative) interviews. Interviewers separately administered two food insecurity scales, including the 4D-FIS and the USDA FSSM adult scale. A scoring protocol was developed to determine food insecurity status with the 4D-FIS. Analyses included a confirmatory factor analysis to examine the hypothesized structure of the 4D-FIS and an initial evaluation of reliability and validity. A four-factor model fit the data reasonably well as judged with fit indices. Results showed relatively high factor loadings and inter-factor correlations indicated that factors were distinct. Cronbach's alpha (ɑ) for the overall scale was 0.90 (subscale ɑ ranged from 0.69 to 0.91) and provided support for the scale's internal consistency reliability. There was fair overall agreement between the 4D-FIS and USDA FSSM adult scale, but agreement varied by category. Findings provide preliminary support for the 4D-FIS as a complementary measure of food insecurity, with implications for researchers, practitioners, and policymakers working in U.S. communities.

Relationship of food insecurity to women's dietary outcomes: a systematic review.

Context: Food insecurity matters for women's nutrition and health. Objective: This review sought to comprehensively evaluate how food insecurity relates to a full range of dietary outcomes (food groups, total energy, macronutrients, micronutrients, and overall dietary quality) among adult women living in Canada and the United States. Data sources: Peer-reviewed databases (PubMed/MEDLINE, CINAHL, Scopus, Web of Science) and gray literature sources from 1995 to 2016 were searched. Data extraction: Observational studies were used to calculate a percentage difference in dietary intake for food-insecure and food-secure groups. Results: Of the 24 included studies, the majority found food-insecure women had lower food group frequencies (dairy, total fruits and vegetables, total grains, and meats/meat alternatives) and intakes of macro- and micronutrients relative to food-secure women. Methodological quality varied. Among high-quality studies, food insecurity was negatively associated with dairy, fruits and vegetables, grains, meats/meats alternatives, protein, total fat, calcium, iron, magnesium, vitamins A and C, and folate. Conclusions: Results hold practical relevance for selecting nutritional targets in programs, particularly for nutrient-rich foods with iron and folate, which are more important for women's health.

Shared Use of Physical Activity Facilities Among North Carolina Faith Communities, 2013.

INTRODUCTION: Shared use of recreational facilities is a promising strategy for increasing access to places for physical activity. Little is known about shared use in faith-based settings. This study examined shared use practices and barriers in faith communities in North Carolina. METHODS: Faith communities in North Carolina (n = 234) completed an online survey (October-December 2013) designed to provide information about the extent and nature of shared use of recreational facilities. We used binary logistic regression to examine differences between congregations that shared use and those that did not share use. RESULTS: Most of the faith communities (82.9%) that completed the survey indicated that they share their facilities with outside individuals and organizations. Formal agreements were more common when faith communities shared indoor spaces such as gymnasiums and classroom meeting spaces than when they shared outdoor spaces such as playgrounds or athletic fields. Faith communities in the wealthiest counties were more likely to share their spaces than were faith communities in poorer counties. Faith communities in counties with the best health rankings were more likely to share facilities than faith communities in counties that had lower health rankings. The most frequently cited reasons faith communities did not share their facilities were that they did not know how to initiate the process of sharing their facilities or that no outside groups had ever asked. CONCLUSION: Most faith communities shared their facilities for physical activity. Research is needed on the relationship between shared use and physical activity levels, including the effect of formalizing shared-use policies.

Prevalence and covariates of food insecurity among residents of single-room occupancy housing in Chicago, IL, USA.

OBJECTIVE: Emerging evidence suggests that food insecurity is a significant public health concern among people who are homeless or marginally housed. The present study assessed prevalence of food insecurity and its covariates among a group of marginally housed individuals living in single-room occupancy (SRO) dwellings, a population for which there is little extant health or nutrition research. DESIGN: Cross-sectional survey incorporating the Household Food Insecurity Access Scale. SETTING: Ten private SRO residences in the Uptown neighbourhood of Chicago, IL, USA, 2013. SUBJECTS: SRO residents over 18 years of age who were able to communicate verbally in English (n 153). RESULTS: Food insecurity was widespread among SRO residents, with 75 % of the sample considered food insecure and 52 % meeting criteria for severe food insecurity. Bivariate analyses indicated that female gender, eating most meals at a soup kitchen, having a mental health condition, problem drinking, having at least one chronic health condition, and diabetes were all significantly associated with food insecurity. In the multivariate ordered logistic regression model, eating most meals at a soup kitchen remained as the only significant correlate of food insecurity (OR=10·13). CONCLUSIONS: SRO residents and other marginally housed populations face unique food access challenges. Although targeted assistance in the form of food stamps and congregate meal programmes remains critical, efforts to prevent and address food insecurity among homeless and marginally housed individuals should include policy interventions that recognize poverty as the root cause of food insecurity and aim to increase overall income and improve housing conditions.