Food insecurity is a common stressor for many children around the world, and it contributes to behavioral problems, impaired school performance, poor dietary intake patterns, as well as multiple health issues. Most work done to determine the extent of food insecurity and its impacts has been conducted from the perspective of adults in the household. However, the information gathered may not accurately capture food insecurity from a child’s perspective. Assessment methods to determine food insecurity in children living in countries around the world do not exist. Frongillo and colleagues developed a measurement tool, validated it, and then used it to assess food insecurity in multiple countries. The outcomes of their work are published in the September 2022 issue of The Journal of Nutrition.
A Child Food Insecurity Experiences Scale (CFIES) was developed using content derived from previously validated questionnaires. Understanding of the material was evaluated through cognitive interviews before 15 surveys were conducted in 13 low-, middle-, and high-income countries. In addition to determining children’s perceptions, information on household socioeconomic status, household food insecurity, or child psychological functioning were used to compare the scores from CFIES. Associations among CFIES scores and criterion variables were determined to estimate accuracy.
The mean scores ranged from 1.65 to 5.86 across the 15 surveys, and the Cronbach alpha ranged from 0.88 to 0.94, with variances ranging from 0.92 to 0.99. The percentages of nonequivalent thresholds and loadings (16.7%) was below guidelines, indicating that the majority (83.3%) of thresholds and loadings were equivalent across the 15 surveys. These observations led the authors to conclude that the CFIES was globally applicable and would provide valid measures of food insecurity from school-aged children and adolescents.
In an editorial, Young reiterates that food insecurity can be experienced in different ways by members of a single household, and that current measurement approaches do not capture the perceptions of children through direct measurement. Young states the CFIES will permit more accurate estimates of child food insecurity and its impacts, and can be used to promote further work designed to not only document food insecurity at the individual level but design effective approaches to deal with this struggle and its impacts on the health and well-being of individuals.
Edward A Frongillo, Maryah S Fram, Hala Ghattas, Jennifer Bernal, Zeina Jamaluddine, Sharon I Kirkpatrick, David Hammond, Elisabetta Aurino, Sharon Wolf, Sophie M Goudet, Mara Nyawo, Chika Hayashi, Development, Validity, and Cross-Context Equivalence of the Child Food Insecurity Experiences Scale for Assessing Food Insecurity of School-Age Children and Adolescents, The Journal of Nutrition, Volume 152, Issue 9, September 2022, Pages 2135–2144, https://doi.org/10.1093/jn/nxac127.
Sera L Young, The Value of Children’s Voices in Public Health Research, The Journal of Nutrition, Volume 152, Issue 9, September 2022, Pages 2011–2012, https://doi.org/10.1093/jn/nxac145.
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