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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.

研究概览

地位

完全的

条件

粮食不安全

干预/治疗

行为的：Coping Strategies

详细说明

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).

研究类型

观察性的

注册 (实际的)

320

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习地点

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

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

取样方法

非概率样本

研究人群

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

描述

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

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

研究衡量的是什么？

主要结果指标

结果测量	措施说明	大体时间
Identify participants who have used at least one target coping strategy 大体时间：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

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

RTI International

调查人员

首席研究员：Andrea Anater, Ph.D.、RTI International

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2012年5月1日

初级完成 (实际的)

2014年12月1日

研究完成 (实际的)

2014年12月1日

研究注册日期

首次提交

2016年4月11日

首先提交符合 QC 标准的

2016年5月9日

首次发布 (估计)

2016年5月10日

研究记录更新

最后更新发布 (估计)