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Coping Strategies Used by Food Insecure Households

2016年5月9日 更新者：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.

調査の概要

状態

完了

条件

介入・治療

詳細な説明

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).

研究の種類

観察的

入学 (実際)

320

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

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

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

サンプリング方法

非確率サンプル

調査対象母集団

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

説明

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

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Identify participants who have used at least one target coping strategy
時間枠：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

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

RTI International

捜査官

  • 主任研究者：Andrea Anater, Ph.D.、RTI International

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2012年5月1日

一次修了 (実際)

2014年12月1日

研究の完了 (実際)

2014年12月1日

試験登録日

最初に提出

2016年4月11日

QC基準を満たした最初の提出物

2016年5月9日

最初の投稿 (見積もり)

2016年5月10日

学習記録の更新

投稿された最後の更新 (見積もり)

2016年5月10日

QC基準を満たした最後の更新が送信されました

2016年5月9日

最終確認日

2016年5月1日

詳しくは

本研究に関する用語

キーワード

その他の研究ID番号

  • 13224

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