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Coping Strategies Used by Food Insecure Households

9 мая 2016 г. обновлено: 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.

Обзор исследования

Статус

Завершенный

Условия

Отсутствие продовольственной безопасности

Вмешательство/лечение

Поведенческий: Coping Strategies

Подробное описание

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).

Тип исследования

Наблюдательный

Регистрация (Действительный)

320

Контакты и местонахождение

В этом разделе приведены контактные данные лиц, проводящих исследование, и информация о том, где проводится это исследование.

Места учебы

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

Критерии участия

Исследователи ищут людей, которые соответствуют определенному описанию, называемому критериям приемлемости. Некоторыми примерами этих критериев являются общее состояние здоровья человека или предшествующее лечение.

Критерии приемлемости

Возраст, подходящий для обучения

18 лет и старше (Взрослый, Пожилой взрослый)

Принимает здоровых добровольцев

Нет

Полы, имеющие право на обучение

Все

Метод выборки

Невероятностная выборка

Исследуемая популяция

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

Описание

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

Учебный план

В этом разделе представлена подробная информация о плане исследования, в том числе о том, как планируется исследование и что оно измеряет.

Как устроено исследование?

Детали дизайна

Что измеряет исследование?

Первичные показатели результатов

Мера результата	Мера Описание	Временное ограничение
Identify participants who have used at least one target coping strategy Временное ограничение: 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

Соавторы и исследователи

Здесь вы найдете людей и организации, участвующие в этом исследовании.

Спонсор

RTI International

Следователи

Главный следователь: Andrea Anater, Ph.D., RTI International

Даты записи исследования

Эти даты отслеживают ход отправки отчетов об исследованиях и сводных результатов на сайт ClinicalTrials.gov. Записи исследований и сообщаемые результаты проверяются Национальной медицинской библиотекой (NLM), чтобы убедиться, что они соответствуют определенным стандартам контроля качества, прежде чем публиковать их на общедоступном веб-сайте.

Изучение основных дат

Начало исследования

1 мая 2012 г.

Первичное завершение (Действительный)

1 декабря 2014 г.

Завершение исследования (Действительный)