Denne siden ble automatisk oversatt og nøyaktigheten av oversettelsen er ikke garantert. Vennligst referer til engelsk versjon for en kildetekst.

Coping Strategies Used by Food Insecure Households

9. mai 2016 oppdatert av: 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.

Studieoversikt

Status

Fullført

Forhold

Matusikkerhet

Intervensjon / Behandling

Atferdsmessig: Coping Strategies

Detaljert 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).

Studietype

Observasjonsmessig

Registrering (Faktiske)

320

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Hva måler studien?

Primære resultatmål

Resultatmål	Tiltaksbeskrivelse	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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

RTI International

Etterforskere

Hovedetterforsker: Andrea Anater, Ph.D., RTI International

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. mai 2012

Primær fullføring (Faktiske)

1. desember 2014

Studiet fullført (Faktiske)