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Coping Strategies Used by Food Insecure Households

9. Mai 2016 aktualisiert von: 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.

Studienübersicht

Status

Abgeschlossen

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

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).

Studientyp

Beobachtungs

Einschreibung (Tatsächlich)

320

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

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

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Probenahmeverfahren

Nicht-Wahrscheinlichkeitsprobe

Studienpopulation

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

Beschreibung

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

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Identify participants who have used at least one target coping strategy
Zeitfenster: 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

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

RTI International

Ermittler

  • Hauptermittler: Andrea Anater, Ph.D., RTI International

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn

1. Mai 2012

Primärer Abschluss (Tatsächlich)

1. Dezember 2014

Studienabschluss (Tatsächlich)

1. Dezember 2014

Studienanmeldedaten

Zuerst eingereicht

11. April 2016

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

9. Mai 2016

Zuerst gepostet (Schätzen)

10. Mai 2016

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Schätzen)

10. Mai 2016

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

9. Mai 2016

Zuletzt verifiziert

1. Mai 2016

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Schlüsselwörter

Andere Studien-ID-Nummern

  • 13224

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