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Coping Strategies Used by Food Insecure Households

9. maj 2016 opdateret af: RTI International

Understanding the Interdependencies Among Three Types of Coping Strategies Used by Very Low Food Security Households With Children

Children without consistent access to sufficient and nutritious food show sustained disadvantages. To improve food security, households utilize three types of coping strategies- participating in governmental feeding and financial assistance programs; obtaining food from nongovernment providers; and using individually developed strategies. To understand the interdependencies among strategies and decision-making processes used to select them, the investigators conducted a two-phased, mixed-methods study using a socio-ecological theoretical framework. First, employing a cross sectional, observational design the investigators administered in-person surveys to 320 adults in very low food secure (VLFS) households with children. Over 1 year later, the investigators repeated select questions and conducted in depth interviews with a cohort (n=28) of participants. Descriptive statistics defined magnitude of associations among strategies. Following bivariate analysis, the investigators assessed interdependencies and factors affecting relationships with log-linear models. The investigators analyzed interviews using an hierarchically ordered, analytical coding structure. With Qualitative Comparative Analysis (QCA), the investigators developed typologies of VLFS and created models treating food security as an outcome. The association of soup kitchen use and nutritionally risky behavior was altered by Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). Food safety-related risky behavior level related to intensity of food pantry use by participation in school food programs. Supplemental Nutrition Assistance Program (SNAP) did not affect the association between soup kitchen use and risky food safety behaviors. Key interview constructs included becoming and being short of food; coping strategies; decisions used to inform choice of strategies; and managing a devalued social status. Improved income stability was a necessary condition for improving food security.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Food insecurity is a serious issue facing households in the United States. In 2012, the time this study was begun, the U.S. Department of Agriculture reported that almost 15% of U.S. households and one in five households with children were considered to be food insecure. Over one third of these experienced very low food security (VLFS), with multiple indicators of disrupted eating patterns due to inadequate resources. These statistics are of particular concern because children without consistent access to sufficient and nutritious food show sustained disadvantages, including effects on cognition, academic performance, long-term nutritional status, and psychosocial development. To improve their food security, households utilize three types of coping strategies- (1) participating in federal feeding and financial assistance programs ("safety net"), (2) obtaining food from nongovernment Emergency Food Providers (EFPs), and (3) using individually developed coping strategies. The objectives of this study related to developing a better understanding of the coping strategies that VLFS households with children use to ensure that their households have sufficient food. Specifically, the study addressed two main research questions: What are the interdependencies among three types of coping strategies: participating in federal feeding and financial assistance programs ("safety net"), obtaining food from EFPs, and using individually developed coping strategies. What decision-making processes do people in VLFS households with children use when selecting coping strategies to ensure that their households have sufficient food? The investigators conducted a two-phased mixed-methods study of coping strategies used by VLFS households with children <18 years in North Carolina (NC), using a socio-ecological theoretical framework to guide their hypotheses, methods, and analyses. For phase I, the investigators employed a cross sectional, observational design. The investigators used a two-stage sample to recruit 320 clients of service providers who offer assistance to people with limited resources within eight NC counties with the highest food insecurity rates. Trained interviewers administered in-person a survey interview asking clients socio-demographic questions and about their use of three categories of coping strategies. Using a longitudinal design, more than a year after Phase I, in Phase II, the investigators completed in depth interviews with a cohort (n=28) of Phase I participants, selected using maximum variation sampling. During the largely unscripted interviews, participants were asked a select number of close ended questions from Phase I, including the 18 item food security module, to assess changes over the past year and permit comparisons between times one and two. To address the first question, two by two and multi-dimensional contingency tables were constructed to analyze the interdependencies among the three types of coping strategy outcomes. Descriptive statistics (odds ratios, counts and percentages) were performed to define the magnitude of the association among coping strategies. Fisher's exact tests and Chi-square statistics were then employed to assess the statistical significance of the interdependency among the outcomes. To further determine the interdependencies among the three coping strategies, and to assess how individual and household-level factors affect those interdependencies, the investigators employed log-linear models. To address the second research question, the investigators formulated a hierarchically ordered, analytical coding structure that reflected key decision-making constructs (e.g., knowledge of coping strategies, perception of risk of accessibility and availability of coping strategies, barriers to participation in "safety net" programs) and examined the results in terms of the key constructs. Lastly, responses to both sets of questions were jointly reviewed using Qualitative Comparative Analysis (QCA), a mixed-methods analysis technique. The investigators implemented a conventional, crisp set for (1) developing typologies of households and individuals experiencing very low food insecurity, and (2) exploring pathways to improving food security status among participants in the follow-up interviews. All procedures involving human participants was reviewed and approved by RTI International's Institutional Review Board (IRB).

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

320

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • North Carolina
      • Asheboro, North Carolina, Forenede Stater, 27203
        • Christians United Outreach Center
      • Asheboro, North Carolina, Forenede Stater, 27203
        • Salvation Army
      • Clarkton, North Carolina, Forenede Stater, 28433
        • Bladen Family Support
      • Elizabethtown, North Carolina, Forenede Stater, 28337
        • Bladen Crisis Assistance Center
      • Ellenboro, North Carolina, Forenede Stater, 28040
        • Liberty Baptist
      • Forest City, North Carolina, Forenede Stater, 28043
        • Chase Corner UMC Ministries
      • Forest City, North Carolina, Forenede Stater, 28043
        • Grace Country Kitchen at Grace of God Rescue Mission
      • Gibson, North Carolina, Forenede Stater, 28343
        • St. John's UMC
      • Laurel Hill, North Carolina, Forenede Stater, 28351
        • Higher Dimensions
      • Laurinburg, North Carolina, Forenede Stater, 28352
        • Church Community Service of Scotland County
      • Laurinburg, North Carolina, Forenede Stater, 28352
        • Laurinburg Hope In Christ Ministries
      • Lumberton, North Carolina, Forenede Stater, 28358
        • Robeson County Church and Community Center
      • New Bern, North Carolina, Forenede Stater, 28560
        • Living Bread Holiness Church
      • New Bern, North Carolina, Forenede Stater, 28560
        • Religious Community Services
      • Pembroke, North Carolina, Forenede Stater, 28372
        • Sacred Pathways
      • Rutherfordton, North Carolina, Forenede Stater, 28139
        • Little White Country Church
      • St. Pauls, North Carolina, Forenede Stater, 28384
        • New Bethel Church
      • Williamston, North Carolina, Forenede Stater, 27892
        • Black Swamp Church of Christ
      • Williamston, North Carolina, Forenede Stater, 27892
        • Holy Trinity Church
      • Williamston, North Carolina, Forenede Stater, 27892
        • Liberty Christian Center Food Pantry
      • Williamston, North Carolina, Forenede Stater, 27892
        • Unlimited Care
      • Wilson, North Carolina, Forenede Stater, 27893
        • Christ Deliverance Tabernacle Ministries
      • Wilson, North Carolina, Forenede Stater, 27893
        • New Christian Food Pantry
      • Wilson, North Carolina, Forenede Stater, 27893
        • Salvation Army
      • Wilson, North Carolina, Forenede Stater, 27893
        • Wilson County Interfaith Services: Hope Station
      • Wilson, North Carolina, Forenede Stater, 27894
        • Willson Praise & Worship Church

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

320 clients of service providers who offer assistance to people with limited resources within eight North Carolina counties with the highest food insecurity rates. Using a longitudinal design, more than a year after Phase I, in Phase II, the investigators completed in depth interviews with a cohort (n=28) of Phase I participants

Beskrivelse

Inclusion Criteria::

  • 18 years of age or older
  • responsible for getting food for household
  • household assessed to have very low food security
  • children <18 in household
  • consent to participate

Exclusion Criteria:

  • less than 18 years of age
  • never responsible for getting food for household
  • no children <18 in household
  • do not consent to participate

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Identify participants who have used at least one target coping strategy
Tidsramme: Initial contact
Participants were administered a survey to document their use of at least one target coping strategy within the last twelve months
Initial contact

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

RTI International

Efterforskere

  • Ledende efterforsker: Andrea Anater, Ph.D., RTI International

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. maj 2012

Primær færdiggørelse (Faktiske)

1. december 2014

Studieafslutning (Faktiske)

1. december 2014

Datoer for studieregistrering

Først indsendt

11. april 2016

Først indsendt, der opfyldte QC-kriterier

9. maj 2016

Først opslået (Skøn)

10. maj 2016

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

10. maj 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

9. maj 2016

Sidst verificeret

1. maj 2016

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • 13224

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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