Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA.
College of Social Work, University of South Carolina, Columbia, SC, USA.
J Nutr. 2022 Sep 6;152(9):2135-2144. doi: 10.1093/jn/nxac127.
Children ages 6 to 17 years can accurately assess their own food insecurity, whereas parents are inaccurate reporters of their children's experiences of food insecurity. No globally applicable scale to assess the food insecurity of children has been developed and validated.
We aimed to develop a globally applicable, experience-based measure of child and adolescent food insecurity and establish the validity and cross-contextual equivalence of the measure.
The 10-item Child Food Insecurity Experiences Scale (CFIES) was based on items previously validated from questionnaires from the United States, Venezuela, and Lebanon. Cognitive interviews were conducted to check understanding of the items. The questionnaire then was administered in 15 surveys in 13 countries. Other items in each survey that assessed the household socioeconomic status, household food security, or child psychological functioning were selected as criterion variables to compare to the scores from the CFIES. To investigate accuracy (i.e., criterion validity), linear regression estimated the associations of the CFIES scores with the criterion variables. To investigate the cross-contextual equivalence (i.e., measurement invariance), the alignment method was used based on classical measurement theory.
Across the 15 surveys, the mean scale scores for the CFIES ranged from 1.65 to 5.86 (possible range of 0 to 20) and the Cronbach alpha ranged from 0.88 to 0.94. The variance explained by a 1-factor model ranged from 0.92 to 0.99. Accuracy was demonstrated by expected associations with criterion variables. The percentages of equivalent thresholds and loadings across the 15 surveys were 28.0 and 5.33, respectively, for a total percentage of nonequivalent thresholds and loadings of 16.7, well below the guideline of <25%. That is, 83.3% of thresholds and loadings were equivalent across these surveys.
The CFIES provides a globally applicable, valid, and cross-contextually equivalent measure of the experiences of food insecurity of school-aged children and adolescents, as reported by them.
6 至 17 岁的儿童能够准确评估自己的食物无保障状况，而父母则无法准确报告其子女的食物无保障经历。目前尚未制定和验证用于评估儿童食物无保障状况的全球适用的衡量标准。
我们旨在开发一种全球适用的、基于经验的儿童和青少年食物无保障衡量标准，并确定该衡量标准的有效性和跨情境等效性。
该 10 项儿童食物无保障体验量表（CFIES）基于先前在美国、委内瑞拉和黎巴嫩的调查问卷中经过验证的项目。进行认知访谈以检查对项目的理解。然后，在 13 个国家的 15 项调查中实施了该问卷。每个调查中的其他项目评估了家庭社会经济地位、家庭食物保障或儿童心理功能，将其作为与 CFIES 得分进行比较的标准变量。为了研究准确性（即标准效度），线性回归估计了 CFIES 得分与标准变量之间的关联。为了研究跨情境等效性（即测量不变性），基于经典测量理论使用了对齐方法。
在 15 项调查中，CFIES 的平均量表分数范围为 1.65 至 5.86（可能范围为 0 至 20），Cronbach alpha 范围为 0.88 至 0.94。一个 1 因素模型解释的方差范围为 0.92 至 0.99。与标准变量的预期关联证明了准确性。在 15 项调查中，等效阈值和负荷的百分比分别为 28.0 和 5.33，无等效阈值和负荷的总百分比为 16.7，远低于<25%的准则。即，83.3%的阈值和负荷在这些调查中是等效的。
CFIES 为报告的学龄儿童和青少年的食物无保障经历提供了一种全球适用、有效且跨情境等效的衡量标准。
