Development and Validity of a 2-Item Screen to Identify Families at Risk for Food Insecurity
Development and Validity of a 2-Item Screen to Identify Families at Risk for Food Insecurity
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DOI：
10.1542/peds.2009-3146
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发表时间：
2010-07-01
期刊：
影响因子：
8
通讯作者：
Frank, Deborah A.
中科院分区：
文献类型：
--
作者：
Hager, Erin R.;Quigg, Anna M.;Frank, Deborah A.
目的：开发一个简单的屏幕，以确定家庭的粮食不安全（FI）的风险，并评估灵敏度，特异性和收敛的屏幕效度。（年龄：出生到3岁）完成了美国农业部18项家庭食品安全调查（HFSS），儿童健康报告，一生中的住院情况，发展风险。孩子们被称重和测量。根据粮食不安全家庭的积极HFSS反应开发了FI筛查。评价敏感性和特异性。收敛效度（FI筛查和理论相关变量之间的对应关系）用逻辑回归进行评估，调整协变量，包括研究地点;照顾者的种族/民族，美国出生与移民身份，婚姻状况，教育和就业;母乳喂养史;孩子的性别;和孩子的低出生体重状态。样本包括30 098个家庭，其中23%的家庭粮食不安全。HFSS问题1和2在粮食不安全家庭中最常得到认可（分别为92.5%和81.9%）。对问题1或2的肯定回答的敏感性为97%，特异性为83%，与报告的儿童健康状况差/一般的风险增加相关（调整后的比值比[aOR]：1.56; P < .001），结论：2项FI筛查在有幼儿的低收入家庭中是敏感、特异和有效的。FI屏幕迅速识别家庭面临的FI风险，使供应商能够有针对性的服务，改善与FI相关的健康和发展后果。儿科2010; 126：e26-e32
OBJECTIVES: To develop a brief screen to identify families at risk for food insecurity (FI) and to evaluate the sensitivity, specificity, and convergent validity of the screen.PATIENTS AND METHODS: Caregivers of children (age: birth through 3 years) from 7 urban medical centers completed the US Department of Agriculture 18-item Household Food Security Survey (HFSS), reports of child health, hospitalizations in their lifetime, and developmental risk. Children were weighed and measured. An FI screen was developed on the basis of affirmative HFSS responses among food-insecure families. Sensitivity and specificity were evaluated. Convergent validity (the correspondence between the FI screen and theoretically related variables) was assessed with logistic regression, adjusted for covariates including study site; the caregivers' race/ethnicity, US-born versus immigrant status, marital status, education, and employment; history of breastfeeding; child's gender; and the child's low birth weight status.RESULTS: The sample included 30 098 families, 23% of which were food insecure. HFSS questions 1 and 2 were most frequently endorsed among food-insecure families (92.5% and 81.9%, respectively). An affirmative response to either question 1 or 2 had a sensitivity of 97% and specificity of 83% and was associated with increased risk of reported poor/fair child health (adjusted odds ratio [aOR]: 1.56; P < .001), hospitalizations in their lifetime (aOR: 1.17; P < .001), and developmental risk (aOR: 1.60; P < .001).CONCLUSIONS: A 2-item FI screen was sensitive, specific, and valid among low-income families with young children. The FI screen rapidly identifies households at risk for FI, enabling providers to target services that ameliorate the health and developmental consequences associated with FI. Pediatrics 2010; 126: e26-e32