Department of Family and Community Medicine, University of Oklahoma-University of Tulsa School of Community Medicine, Tulsa, Oklahoma, USA.
Hudson College of Public Health, Department of Health Promotion Sciences, University of Oklahoma Tulsa Schusterman Center, Tulsa, Oklahoma, USA.
Soc Work Public Health. 2021 Aug 18;36(6):732-748. doi: 10.1080/19371918.2021.1943099. Epub 2021 Sep 1.
Very low food security among children (VLFS-C), often referred to as child hunger, can profoundly hinder child development, family well-being, and community health. Food pantries are important community resources that routinely serve at-risk families. This study investigated the influence of various candidate risk factors for VLFS-C within a food pantry population to inform the development of the "Pantry Assessment Tool against Child Hunger (PATCH)." We collected standardized surveys among a representative sample of households with children accessing food pantry services in Oklahoma (n = 188). Weighted analyses revealed a large majority of households experienced child-level food insecurity (70.6%), with nearly half reporting low food security and nearly one-quarter reporting VLFS-C. We then used logistic regression to identify factors associated with VLFS-C, followed by chi-square automatic interaction detection (CHAID) to assess if, and in what progression, significant risk factors predicted VLFS-C. In unadjusted models, annual household income <$15,000, non-urban residence, lack of health insurance, unstable housing, heavier food pantry reliance, fair or poor adult health, adult anxiety, and adult smoking to reduce hunger pangs were all positively associated with VLFS-C. Receipt of Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and higher social support were protective against VLFS-C. However, in adjusted models, only receipt of WIC remained significant. CHAID analysis revealed that access to insurance best differentiated groups with and without VLFS-C. Informed by these analyses, the PATCH tool may be useful for the development of screening programs to identify and address potential root causes of VLFS-C in pantry settings.
儿童极重度粮食不安全（VLFS-C），通常被称为儿童饥饿，可严重阻碍儿童发展、家庭福祉和社区健康。食品储藏室是重要的社区资源，经常为处于危险中的家庭提供服务。本研究调查了食品储藏室人群中各种候选风险因素对 VLFS-C 的影响，旨在为“食品储藏室儿童饥饿评估工具 (PATCH)”的开发提供信息。我们在俄克拉荷马州使用标准化问卷对接受食品储藏室服务的有孩子的家庭进行了代表性抽样调查（n=188）。加权分析显示，绝大多数家庭经历了儿童层面的粮食不安全（70.6%），近一半报告粮食不安全程度低，近四分之一报告 VLFS-C。然后，我们使用逻辑回归来确定与 VLFS-C 相关的因素，然后使用卡方自动交互检测（CHAID）来评估是否以及以何种顺序，显著的风险因素可以预测 VLFS-C。在未调整的模型中，家庭年收入<15000 美元、非城市居住、没有医疗保险、住房不稳定、对食品储藏室的依赖程度更高、成人健康状况一般或较差、成人焦虑和成人吸烟以减轻饥饿感，这些都与 VLFS-C 呈正相关。接受妇女、婴儿和儿童特别补充营养计划（WIC）和更高的社会支持可预防 VLFS-C。然而，在调整后的模型中，只有接受 WIC 仍然具有统计学意义。CHAID 分析表明，获得保险可以最好地区分有和没有 VLFS-C 的人群。根据这些分析，PATCH 工具可能有助于制定筛查计划，以在食品储藏室环境中识别和解决 VLFS-C 的潜在根本原因。
