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Coping Strategies Used by Food Insecure Households

9 de maio de 2016 atualizado 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.

Visão geral do estudo

Status

Concluído

Condições

Insegurança alimentar

Intervenção / Tratamento

Comportamental: Coping Strategies

Descrição detalhada

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 estudo

Observacional

Inscrição (Real)

320

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

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

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Método de amostragem

Amostra Não Probabilística

População do estudo

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

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado	Descrição da medida	Prazo
Identify participants who have used at least one target coping strategy Prazo: 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

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

RTI International

Investigadores

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

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo

1 de maio de 2012

Conclusão Primária (Real)

1 de dezembro de 2014

Conclusão do estudo (Real)