Landry Matthew J, van den Berg Alexandra E, Asigbee Fiona M, Vandyousefi Sarvenaz, Ghaddar Reem, Davis Jaimie N
Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA.
Michael & Susan Dell Center for Healthy Living, Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Austin Regional Campus, Austin, TX, USA.
Curr Dev Nutr. 2019 Sep 27;3(10):nzz106. doi: 10.1093/cdn/nzz106. eCollection 2019 Oct.
There is a need to directly and accurately conceptualize and measure food insecurity in children as part of surveillance and public health efforts.
The aim of this study was to compare parent and child perceptions of child-level food security status via questionnaires within a large, ethnically diverse population.
Cross-sectional baseline data from a cluster-randomized controlled trial involving primarily low-income, Hispanic third- to fifth-grade students and their parents were used for analysis. The sample consisted of 2408 dyadic (parent and child) pairs. Parents completed the 8-item child-referenced Household Food Security Survey Module and their responses were compared with an adaption of the 5-item Child Food Security Assessment completed by their child. Levels of association between child and parent perceptions within dyads were calculated using Goodman and Kruskal's γ statistic. A mixed-effects binomial logistic regression model was used to model discordance as a function of child, parent, and household sociodemographic characteristics.
The child sample was 53% girls, mean age of 9 y, and 63% were Hispanic. The parent sample was 86% women and 65% Hispanic. Child and parent perceptions of child-level food security agreed only 21.7% of the time. There was a weak positive association between child and parent perceptions of child-level food security (γ = 0.162, < 0.001). Children perceived themselves as less food secure than their parents' perception 70.1% of the time. Household receipt of Supplemental Nutrition Assistance Program benefits was associated with greater odds of discordant food security perceptions, whereas female children, older children, and parents not working were characteristics associated with lower odds of discordant perceptions.
Results, in combination with the existing literature, suggest that parent perceptions of child-level food insecurity may underestimate child-level food insecurity experiences. Inaccurate estimations or underestimations of the true prevalence of child-level food insecurity could be detrimental to maternal and child health efforts. This trial was registered at clinicaltrials.gov as NCT02668744.
作为监测和公共卫生工作的一部分，需要直接且准确地对儿童粮食不安全状况进行概念化和测量。
本研究的目的是通过问卷调查，在一个种族多样化的大群体中比较父母与孩子对儿童层面粮食安全状况的认知。
来自一项整群随机对照试验的横断面基线数据用于分析，该试验主要涉及低收入的西班牙裔三至五年级学生及其父母。样本包括2408对二元组（父母和孩子）。父母完成了8项以孩子为参照的家庭粮食安全调查模块，并将他们的回答与孩子完成的5项儿童粮食安全评估的改编版进行比较。使用古德曼和克鲁斯卡的γ统计量计算二元组中孩子与父母认知之间的关联程度。使用混合效应二项逻辑回归模型将不一致性建模为孩子、父母和家庭社会人口学特征的函数。
儿童样本中女孩占53%，平均年龄为9岁，63%为西班牙裔。父母样本中女性占86%，西班牙裔占65%。孩子和父母对儿童层面粮食安全的认知仅有21.7%的时间是一致的。孩子和父母对儿童层面粮食安全的认知之间存在微弱的正相关（γ = 0.162，P < 0.001）。在70.1%的时间里，孩子认为自己的粮食安全状况不如父母所感知的。家庭领取补充营养援助计划福利与粮食安全认知不一致的几率更高相关，而女童、年龄较大的孩子以及不工作的父母与不一致认知几率较低相关。
研究结果与现有文献表明，父母对儿童层面粮食不安全的认知可能低估了儿童层面的粮食不安全经历。对儿童层面粮食不安全真实患病率的不准确估计或低估可能对母婴健康工作有害。该试验在clinicaltrials.gov上注册为NCT02668744。
