Cumulative Risk Factors Associated with Food Insecurity among Adults who Experience Homelessness.
Cumulative Risk Factors Associated with Food Insecurity among Adults who Experience Homelessness.
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DOI：
10.4148/2572-1836.1033
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发表时间：
2019-03-01
影响因子：
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通讯作者：
Businelle, Michael S
中科院分区：
文献类型：
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作者：
Hernandez, Daphne C;Daundasekara, Sajeevika S;Businelle, Michael S
导言：在经历过无家可归的成年人中，缺乏关于食物不安全的决定因素的研究。根据累积风险理论，是风险因素的累积将个人置于不利健康后果的危险之中。在累积风险理论的基础上，创建了领域特定指数，以检验四个累积风险因素与经历无家可归的成年人的食物不安全之间的关系。方法：2016年7月至8月，从俄克拉荷马城6个区域的庇护所招募成年参与者(N=565人)。对美国农业部六项食品安全量表中的两至六项做出肯定回答的参与者被归类为食品不安全。根据肯定的调查结果，创建了四个累积风险指数：不良健康和危险健康行为指数、个人和性受害指数、家庭破坏和经济压力。协变量调整的Logistic回归模型预测成年人经历食物不安全的几率。结果：78%的样本经历过食物不安全。健康不良和危险健康行为指数得分越高，食物不安全的几率越高(OR=1.80，CI：1.51~2.14)。个人和性受害指数得分越高，预示着经历食物不安全的几率越高(OR=1.57，CI：1.20-2.04)。结论：为了促进经历无家可归的成年人的食物安全，收容所和基于社区的计划需要将无家可归和食物不安全视为相互关联的多方面公共卫生问题。
INTRODUCTION: There is a dearth of research on the determinants of food insecurity among adults who experience homelessness. According to cumulative risk theory, it is the accumulation of risk factors that places individuals in jeopardy for negative health consequences. Building on the cumulative risk theory, domain specific indices were created to examine the relationship between four cumulative risk factors and food insecurity among adults who experience homelessness.METHODS: Adult participants were recruited from six-area shelters in Oklahoma City (N = 565) during July - August 2016. Participants who affirmatively responded to two-six items of the six-item USDA Food Security Scale-Short form were categorized as food insecure. Four indices of cumulative risk were created based on affirmative survey responses: poor health & risky health behaviors index, personal and sexual victimization index, household disruption, and financial strain. Covariate-adjusted logistic regression models predicted the odds of adults experiencing food insecurity.RESULTS: Seventy-eight percent of the sample experienced food insecurity. Higher scores for the poor health and risky health behaviors index predicted higher odds of experiencing food insecurity (OR = 1.80, CI: 1.51 - 2.14). Higher scores for the personal and sexual victimization index predicted higher odds of experiencing food insecurity (OR = 1.57, CI: 1.20 - 2.04).CONCLUSION: To facilitate food security among adults experiencing homelessness, shelters and community-based programs need to consider homelessness and food insecurity to be multi-faceted public health problems that are inter-related.