New measures to assess the “Other” three pillars of food security–availability, utilization, and stability

Abstract

Background In recent reviews of available measures, no existing measures assessed all four pillars of food security and most only assessed one or two pillars–predominantly the access pillar. The purpose of this study was to preliminarily develop novel measures of availability, utilization, and stability that are complementary to the USDA’s household food security survey measure (HFSSM). Methods A formative phase included an expert advisory group, literature scans, and interviews with individuals experiencing food insecurity. From April-June 2021, the new measures were piloted in five states (California, Florida, Maryland, North Carolina, and Washington). The cross-sectional pilot survey included the new measures (perceived limited availability, utilization barriers, and food insecurity stability), scales and items for validation (e.g., food security, and self-reported dietary and health outcomes), and demographic questions. Exploratory factor analysis was used to assess dimensionality, internal consistency was assessed using Kuder-Richardson formula 21 (KR21), and convergent and discriminant validity were assessed using Spearman’s correlation coefficients. Also, a brief screener version was created for the utilization barriers measure that may be necessary for certain applications (e.g., clinical intake screening to inform referrals to assistance programs). Results The analytic samples (perceived limited availability (n = 334); utilization barriers (n = 428); food insecurity stability (n = 445)) were around 45 years old on average, most households had children, over two-thirds were food insecure, over three-fourths were women, and the samples were racially/ethnically diverse. All items loaded highly and unambiguously to a factor (factor loadings range 0.525–0.903). Food insecurity stability showed a four-factor structure, utilization barriers showed a two-factor structure, and perceived limited availability showed a two-factor structure. KR21 metrics ranged from 0.72 to 0.84. Higher scores for the new measures were generally associated with increased food insecurity (rhos = 0.248–0.497), except for one of the food insecurity stability scores. Also, several of the measures were associated with statistically significantly worse health and dietary outcomes. Conclusions The findings support the reliability and construct validity of these new measures within a largely low-income and food insecure sample of households in the United States. Following further testing, such as Confirmatory Factor Analysis in future samples, these measures may be used in various applications to promote a more comprehensive understanding of the food insecurity experience. Such work can help inform novel intervention approaches to address food insecurity more fully.

Differences in Socioeconomic, Dietary Choice, and Nutrition Environment Explanatory Variables for Food and Nutrition Security among Households with and without Children

“…Perceived limited availability was dichotomized as low (0–1) and high (2–3) for analytic purposes. Utilization barriers to healthful meals were assessed with 8 items regarding cooking skills (e.g., food selection or options, meal preparation, time) and storage/cooking equipment (e.g., access to cold storage, appliances, utensils, sanitation) [ 11 ]. The 3 response options were scored as 0 (never true) or 1 (sometimes true and often true).…”

“…Questions for both measures were phrased within a 12-month period and exact question wording is included on the GSCFN website [ 12 ]. The development, validation, and utility of the perceived limited availability and utilization barriers measures are published elsewhere [ 11 ].…”

Direct and Indirect Effects of Food and Nutrition Security on Dietary Choice and Healthfulness of Food Choice: Causal Mediation Analysis

“…Scale scores were calculated as sums of the item scores. Perceived limited availability was categorized as none (0 points), low (1 point), moderate (2 points), and high (3 points) [ 19 ]. For analytic purposes, perceived limited availability was categorized as low (0–1 points) and high (2–3 points).…”

“…A sixth response option, don’t know, was not scored and treated as missing in the current analysis. The development, validation, and utility of the perceived limited availability and utilization barriers measures may be found elsewhere [ 19 ].…”

Effects of guaranteed basic income interventions on poverty‐related outcomes in high‐income countries: A systematic review and meta‐analysis

“…These definitions refer to "household food insecurity," a term that is commonly used to distinguish this experience from food insecurity associated with other factors: food availability (production, supply, variety), physical access to food (distance, means of transportation, mobility), food utilization (knowledge, equipment, preparation, storage), and stability (political, macroeconomic, environmental) (Calloway, 2023;Carson, 2020;FAO, 2023).…”