List Experiment to Measure Food and Water Insecurity

List experiment to measure food and water insecurity

Study Overview

• Status: Completed
• Conditions: Water Deprivation; Food Deprivation
• Intervention / Treatment: Other: Survey questionnaire

Detailed Description

Food and water insecurity are complex, multi-domain constructs. Given their known association with important health and mental health outcomes, accurate assessment of food and water insecurity in resource-limited settings is paramount. The purpose of this study is to use a list experiment methodology to assess the extent to which there is bias in conventional survey-based means of direct elicitation of food and water insecurity. The list experiment provides an indirect means to measure a particular construct of interest. It is hypothesized that social desirability may cause upward bias in conventional survey-based means of direct elicitation of food and water insecurity.

• Study Type: Interventional
• Enrollment (Actual): 1550
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Uganda
  • Mbarara, Uganda
    • Mbarara University of Science and Technology

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• All adults who consider Nyakabare their primary place of residence and who are capable of providing consent

Exclusion Criteria:

• Minors younger than 18 years of age, with the exception of emancipated minors
• Persons who do not consider Nyakabare Parish their primary place of residence, e.g., persons who happen to be visiting Nyakabare at the time of the survey or who own a home in Nyakabare but spend most of their time outside the parish
• Persons with psychosis, neurological damage, acute intoxication, or other cognitive impairment (all of which are determined informally in the field by non-clinical research staff in consultation with a supervisor)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental: V1: List No. 1; As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. The first version of the questionnaire includes 6 sets of 3 true-false statements that are innocuous and contextually applicable (e.g., weather, cultural norms) such that there is a low likelihood that the participant will answer untruthfully. The statements on food and water insecurity that are included in the experimental version are omitted.	Other: Survey questionnaire; Each version of the questionnaire includes a different number of true-false statements that study participants are asked to identify.
Experimental: Experimental: V2: List No. 2; As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. The second version of the questionnaire includes 6 sets of 4 true-false statements that are innocuous and contextually applicable (e.g., weather, cultural norms) such that there is a low likelihood that the participant will answer untruthfully for 3 of the true-false statements. One statement in each set relates to food and water insecurity and is designed to determine the extent to which social desirability bias may influence responses to food and water insecurity questions.	Other: Survey questionnaire; Each version of the questionnaire includes a different number of true-false statements that study participants are asked to identify.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
No Food Due to Lack of Money	"In the last month, was there ever no food to eat in the house because the participant lacked money to buy more?" (single item, culturally adapted from the 3-item Household Hunger Scale of USAID's Household Food Insecurity Access Scale [HFIAS]; response options yes/no)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate even though participants are asked about the past month)
No Water Due to Difficulty Collecting	"In the last month, was there ever no water in the participant's house because it was too difficult to collect more?" (single item, culturally adapted to indicate water insecurity, paralleling the 3-item Household Hunger Scale of USAID's Household Food Insecurity Access Scale [HFIAS]; response options yes/no)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate even though participants are asked about the past month)
Going to Sleep Hungry	"In the last month, did the participant or one of their household members ever go to sleep hungry because there was not enough food?" (single item, culturally adapted from the 3-item Household Hunger Scale of USAID's Household Food Insecurity Access Scale [HFIAS]; response options yes/no)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate even though participants are asked about the past month)
Going to Sleep Thirsty	"In the last month, did the participant or one of their household members ever go to sleep thirsty because there was not enough water?" (single item, culturally adapted to indicate water insecurity, paralleling the 3-item Household Hunger Scale of USAID's Household Food Insecurity Access Scale [HFIAS]; response options yes/no)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate even though participants are asked about the past month)
No Food for Entire Day	"In the last month, did the participant or one of their household members ever go an entire day and night without eating anything because there was not enough food?" (single item, culturally adapted from the 3-item Household Hunger Scale of USAID's Household Food Insecurity Access Scale [HFIAS]; response options yes/no)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate even though participants are asked about the past month)
Drink Unsafe Water	"In the last month, did the participant or one of their household members ever drink water that they thought might not be safe for their health?" (single item, culturally adapted to indicate water insecurity, developed specifically for this study; response options yes/no)	Baseline (The experimental manipulation in this study has to do with which version of the survey the study participant receives, so the time frame for assessment is immediate even though participants are asked about the past month)

Collaborators and Investigators

• Sponsor: Massachusetts General Hospital
• Collaborators: Mbarara University of Science and Technology
• Investigators: Principal Investigator: Alexander C Tsai, MD, Massachusetts General Hospital

Study record dates

Study Major Dates

• Study Start (Actual): February 12, 2021
• Primary Completion (Actual): August 15, 2022
• Study Completion (Actual): August 15, 2022

Study Registration Dates

• First Submitted: April 1, 2021
• First Submitted That Met QC Criteria: April 2, 2021
• First Posted (Actual): April 5, 2021

Study Record Updates

• Last Update Posted (Actual): June 1, 2026
• Last Update Submitted That Met QC Criteria: May 28, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Food Insecurity; Water Insecurity
• Additional Relevant MeSH Terms: Health Care Quality, Access, and Evaluation; Investigative Techniques; Epidemiologic Methods; Data Collection; Health Care Evaluation Mechanisms; Quality of Health Care; Public Health; Environment and Public Health; Surveys and Questionnaires
• Other Study ID Numbers: 2013P000395_2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No