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Coping Strategies Used by Food Insecure Households

9 mai 2016 mis à jour par: 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.

Aperçu de l'étude

Statut

Complété

Les conditions

Insécurité alimentaire

Intervention / Traitement

Comportemental: Coping Strategies

Description détaillée

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).

Type d'étude

Observationnel

Inscription (Réel)

320

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

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

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

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

La description

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 d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats	Description de la mesure	Délai
Identify participants who have used at least one target coping strategy Délai: 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

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

RTI International

Les enquêteurs

Chercheur principal: Andrea Anater, Ph.D., RTI International

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 mai 2012

Achèvement primaire (Réel)

1 décembre 2014

Achèvement de l'étude (Réel)