Epidemiology Program, Post-Deployment Health Services (12POP5), Office of Patient Care Services, 8267US Department of Veterans Affairs, Veterans Health Administration, Washington, DC, USA.
49462US Department of Veterans Affairs (VA) Puget Sound Health Care System, Health Services Research and Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, USA.
Food Nutr Bull. 2020 Dec;41(4):399-423. doi: 10.1177/0379572120963952.
Food insecurity (FI) is an important public health issue for US veterans. For many veterans, civilian life is fraught with service-incurred health issues and socioeconomic challenges, each risk factors for FI. The FI literature on veterans is limited due to insufficient coverage of the topic's complexity and the methods used to study it in this population. No published analysis has evaluated how FI has been examined in US veterans.
We assessed how FI has been examined in US military veterans by identifying (1) the major content areas, or domains, studied in association with FI and (2) the existing research gaps.
A scoping literature review was conducted to map the main research domains of the FI literature and identify knowledge gaps. Electronic database and hand searches identified potentially relevant studies (n = 61). Data extraction, utilizing a standardized set of design parameters, was completed. Duplicate removal and application of inclusion/exclusion criteria resulted in the studies (n = 21) selected for critical review.
Eight research domains were determined: FI prevalence, health status, dietary practices, health care utilization, economic instability, homelessness/housing instability, food program participation, and community/emergency preparedness-the most dominant was health status and the least dominant were social determinants (ie, homelessness/housing instability, food program participation). Research on validity and usability of FI assessment methods in veterans was virtually absent. Military service factors, longitudinal effects, FI among women, intervention effectiveness, and other areas lacked sufficient inquiry.
Research is required on lesser examined content areas and methodology to optimize surveillance and policy for veteran FI.
粮食不安全（FI）是美国退伍军人的一个重要公共卫生问题。对于许多退伍军人来说，平民生活充满了因服役而导致的健康问题和社会经济挑战，这些都是 FI 的风险因素。由于该主题的复杂性以及在该人群中研究该主题的方法覆盖不足，退伍军人的 FI 文献有限。没有发表的分析评估过 FI 在美退伍军人中的研究情况。
通过确定（1）与 FI 相关研究的主要内容领域，或研究领域，以及（2）现有的研究空白，评估 FI 在美退伍军人中的研究情况。
进行了范围广泛的文献综述，以绘制 FI 文献的主要研究领域，并确定知识空白。电子数据库和手工搜索确定了潜在相关的研究（n=61）。利用一套标准化的设计参数进行数据提取。重复去除和应用纳入/排除标准导致研究（n=21）被选择进行关键审查。
确定了八个研究领域：FI 流行率、健康状况、饮食实践、医疗保健利用、经济不稳定、无家可归/住房不稳定、食品计划参与度和社区/应急准备度——最主要的是健康状况，最次要的是社会决定因素（即无家可归/住房不稳定、食品计划参与度）。关于 FI 评估方法在退伍军人中的有效性和可用性的研究几乎不存在。军事服务因素、纵向效应、女性 FI、干预效果和其他领域缺乏足够的探究。
需要对研究较少的内容领域和方法进行研究，以优化对退伍军人 FI 的监测和政策。
