Tomayko Emily J, Mosso Kathryn L, Cronin Kate A, Carmichael Lakeesha, Kim KyungMann, Parker Tassy, Yaroch Amy L, Adams Alexandra K
Nutrition, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
BMC Public Health. 2017 Jun 30;17(1):611. doi: 10.1186/s12889-017-4498-y.
High food insecurity has been demonstrated in rural American Indian households, but little is known about American Indian families in urban settings or the association of food insecurity with diet for these families. The purpose of this study was to examine the prevalence of food insecurity in American Indian households by urban-rural status, correlates of food insecurity in these households, and the relationship between food insecurity and diet in these households.
Dyads consisting of an adult caregiver and a child (2-5 years old) from the same household in five urban and rural American Indian communities were included. Demographic information was collected, and food insecurity was assessed using two validated items from the USDA Household Food Security Survey. Factors associated with food insecurity were examined using logistic regression. Child and adult diets were assessed using food screeners. Coping strategies were assessed through focus group discussions. These cross-sectional baseline data were collected from 2/2013 through 4/2015 for the Healthy Children, Strong Families 2 randomized controlled trial of a healthy lifestyles intervention for American Indian families.
A high prevalence of food insecurity was determined (61%) and was associated with American Indian ethnicity, lower educational level, single adult households, WIC participation, and urban settings (p = 0.05). Food insecure adults had significantly lower intake of vegetables (p < 0.05) and higher intakes of fruit juice (<0.001), other sugar-sweetened beverages (p < 0.05), and fried potatoes (p < 0.001) than food secure adults. Food insecure children had significantly higher intakes of fried potatoes (p < 0.05), soda (p = 0.01), and sports drinks (p < 0.05). Focus group participants indicated different strategies were used by urban and rural households to address food insecurity.
The prevalence of food insecurity in American Indian households in our sample is extremely high, and geographic designation may be an important contributing factor. Moreover, food insecurity had a significant negative influence on dietary intake for families. Understanding strategies employed by households may help inform future interventions to address food insecurity.
( NCT01776255 ). Registered: January 16, 2013. Date of enrollment: February 6, 2013.
美国印第安农村家庭中食品严重不安全的情况已得到证实，但对于城市环境中的美国印第安家庭，或这些家庭食品不安全与饮食之间的关联，人们了解甚少。本研究的目的是按城乡状况调查美国印第安家庭中食品不安全的患病率、这些家庭食品不安全的相关因素，以及食品不安全与这些家庭饮食之间的关系。
纳入来自美国印第安五个城乡社区同一家庭中的成年照料者和一名儿童（2至5岁）组成的二元组。收集人口统计学信息，并使用美国农业部家庭食品安全调查中的两个经过验证的项目评估食品不安全状况。使用逻辑回归分析与食品不安全相关的因素。通过食物筛查评估儿童和成人的饮食。通过焦点小组讨论评估应对策略。这些横断面基线数据是在2013年2月至2015年4月期间收集的，用于一项针对美国印第安家庭的健康生活方式干预的“健康儿童，强大家庭2”随机对照试验。
确定食品不安全的患病率很高（61%），且与美国印第安族裔、教育水平较低、单身成年人家庭、参加妇女、婴儿和儿童营养补充计划（WIC）以及城市环境有关（p = 0.05）。与食品安全的成年人相比，食品不安全的成年人蔬菜摄入量显著较低（p < 0.05），果汁（<0.001）、其他含糖饮料（p < 0.05）和炸土豆摄入量较高（p < 0.001）。食品不安全的儿童炸土豆（p < 0.05）、汽水（p = 0.01）和运动饮料摄入量显著较高（p < 0.05）。焦点小组参与者指出，城乡家庭应对食品不安全采用了不同策略。
我们样本中美国印第安家庭食品不安全的患病率极高，地理位置可能是一个重要的促成因素。此外，食品不安全对家庭饮食摄入有显著负面影响。了解家庭采用的策略可能有助于为未来解决食品不安全问题的干预措施提供信息。
（NCT01776255）。注册时间：2013年1月16日。入组日期：2013年2月6日。
