Roncarolo Federico, Bisset Sherri, Potvin Louise
Public Health Research Institute, University of Montreal (IRSPUM), Montreal, Quebec, Canada.
Public Health School, University of Montreal, Montreal, Quebec, Canada.
PLoS One. 2016 Mar 14;11(3):e0150250. doi: 10.1371/journal.pone.0150250. eCollection 2016.
Despite the effects of food insecurity on health are well documented, clear governmental policies to face food insecurity do not exist in western countries. In Canada, interventions to face food insecurity are developed at the community level and can be categorized into two basic strategies: those providing an immediate response to the need for food, defined "traditional" and those targeting the improvement of participants' social cohesion, capabilities and management of their own nutrition, defined "alternative".
The objective of this study was to evaluate the effects of food insecurity interventions on food security status and perceived health of participants.
This was a longitudinal multilevel study implemented in Montreal, Quebec, Canada. Participants were recruited in a two-stage cluster sampling frame. Clustering units were community organizations working on food insecurity; units of analysis were participants in community food security interventions. A total of 450 participants were interviewed at the beginning and after 9 months of participation in traditional or alternative food security interventions. Food security and perceived health were investigated as dependent variables. Differences overtime were assessed through multilevel regression models.
Participants in traditional interventions lowered their food insecurity at follow-up. Decreases among participants in alternative interventions were not statistically significant. Participants in traditional interventions also improved physical (B coefficient 3.00, CI 95% 0.42-5.59) and mental health (B coefficient 6.25, CI 95% 4.15-8.35).
Our results challenge the widely held view suggesting the ineffectiveness of traditional interventions in the short term. Although effects may be intervention-dependent, food banks decreased food insecurity and, in so doing, positively affected perceived health. Although study findings demonstrate that food banks offer short term reprise from the effects of food insecurity, the question as to whether food banks are the most appropriate solution to food insecurity still needs to be addressed.
尽管粮食不安全对健康的影响已有充分记录,但西方国家尚无明确应对粮食不安全的政府政策。在加拿大,应对粮食不安全的干预措施在社区层面开展,可分为两种基本策略:一类是对粮食需求做出即时响应的,定义为“传统型”;另一类是旨在改善参与者社会凝聚力、能力及其自身营养管理的,定义为“替代型”。
本研究的目的是评估粮食不安全干预措施对参与者粮食安全状况和自我感知健康的影响。
这是一项在加拿大魁北克省蒙特利尔实施的纵向多层次研究。参与者通过两阶段整群抽样框架招募。整群单位是致力于解决粮食不安全问题的社区组织;分析单位是社区粮食安全干预措施的参与者。共有450名参与者在参与传统或替代型粮食安全干预措施开始时及9个月后接受了访谈。将粮食安全和自我感知健康作为因变量进行调查。通过多层次回归模型评估随时间的差异。
参与传统干预措施的参与者在随访时降低了其粮食不安全程度。参与替代型干预措施的参与者的降幅无统计学意义。参与传统干预措施的参与者在身体(B系数3.00,95%置信区间0.42 - 5.59)和心理健康(B系数6.25,95%置信区间4.15 - 8.35)方面也有所改善。
我们的结果挑战了普遍认为传统干预措施在短期内无效的观点。尽管效果可能因干预措施而异,但食品银行减少了粮食不安全,并在此过程中对自我感知健康产生了积极影响。尽管研究结果表明食品银行能在短期内缓解粮食不安全的影响,但食品银行是否是解决粮食不安全的最合适方案这一问题仍有待解决。