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Coping Strategies Used by Food Insecure Households

9 de mayo de 2016 actualizado por: 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.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

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).

Tipo de estudio

De observación

Inscripción (Actual)

320

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

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

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Método de muestreo

Muestra no probabilística

Población de estudio

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

Descripción

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

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Identify participants who have used at least one target coping strategy
Periodo de tiempo: 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

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

RTI International

Investigadores

  • Investigador principal: Andrea Anater, Ph.D., RTI International

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de mayo de 2012

Finalización primaria (Actual)

1 de diciembre de 2014

Finalización del estudio (Actual)

1 de diciembre de 2014

Fechas de registro del estudio

Enviado por primera vez

11 de abril de 2016

Primero enviado que cumplió con los criterios de control de calidad

9 de mayo de 2016

Publicado por primera vez (Estimar)

10 de mayo de 2016

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

10 de mayo de 2016

Última actualización enviada que cumplió con los criterios de control de calidad

9 de mayo de 2016

Última verificación

1 de mayo de 2016

Más información

Términos relacionados con este estudio

Palabras clave

Otros números de identificación del estudio

  • 13224

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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