Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
Department of Medicine, University of California San Francisco, San Franciso, CA, United States.
J Nutr. 2024 Apr;154(4):1428-1439. doi: 10.1016/j.tjnut.2024.02.023. Epub 2024 Feb 24.
Social unacceptability of food access is part of the lived experience of food insecurity but is not assessed as part of the United States Household Food Security Survey Module (HFSSM).
The objectives were as follows: 1) to determine the psychometric properties of 2 additional items on social unacceptability in relation to the HFSSM items and 2) to test whether these 2 items provided added predictive accuracy to that of the HFSSM items for mental health outcomes.
Cross-sectional data used were from the Intersection of Material-Need Insecurities and HIV and Cardiovascular Health substudy of the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study. Data on the 10-item HFSSM and 2 new items reflecting social unacceptability were collected between Fall 2020 and Fall 2021 from 1342 participants from 10 United States cities. The 2 social unacceptability items were examined psychometrically in relation to the HFSSM-10 items using models from item response theory. Linear and logistic regression was used to examine prediction of mental health measured by the 20-item Center for Epidemiologic Studies Depression scale and the 10-item Perceived Stress Scale.
The social unacceptability items were affirmed throughout the range of severity of food insecurity but with increasing frequency at higher severity of food insecurity. From item response theory models, the subconstructs reflected in the HFSSM-10 and the subconstruct of social unacceptability were distinct, not falling into one dimension. Regression models confirmed that social unacceptability was distinct from the subconstructs reflected in the HFSSM-10. The social unacceptability items as a separate scale explained more (∼1%) variation in mental health than when combined with the HFSSM-10 items in a single scale, and the social unacceptability subconstruct explained more (∼1%) variation in mental health not explained by the HFSSM-10.
Two social unacceptability items used as a separate scale along with the HFSSM-10 predicted mental health more accurately than did the HFSSM-10 alone.
食品获取的社会不可接受性是粮食不安全的生活体验的一部分，但并未作为美国家庭粮食安全调查模块（HFSSM）的一部分进行评估。
本研究的目的如下：1）确定与 HFSSM 项目相关的另外 2 个关于社会不可接受性的项目的心理测量学特性；2）测试这 2 个项目是否为 HFSSM 项目对心理健康结果的预测提供了额外的准确性。
本研究使用的是横断面数据，来自艾滋病队列研究/妇女机构间艾滋病毒研究联合队列研究的多中心艾滋病队列研究/妇女机构间艾滋病毒研究联合队列研究的物质需求不安全与 HIV 和心血管健康的交叉研究的子研究。2020 年秋季至 2021 年秋季期间，从美国 10 个城市的 1342 名参与者那里收集了 10 项 HFSSM 和 2 项反映社会不可接受性的新项的调查数据。使用项目反应理论模型，从心理测量学的角度对这 2 项社会不可接受性项目与 HFSSM-10 项目进行了检验。线性和逻辑回归用于检验 20 项中心流行病学研究抑郁量表和 10 项感知压力量表测量的心理健康预测。
社会不可接受性项目在整个粮食不安全严重程度范围内得到了肯定，但在粮食不安全程度较高时，其频率会增加。从项目反应理论模型来看，HFSSM-10 所反映的子结构和社会不可接受性的子结构是不同的，并不属于一个维度。回归模型证实，社会不可接受性与 HFSSM-10 所反映的子结构不同。与 HFSSM-10 项目结合在一个单一的量表中相比，社会不可接受性项目作为一个单独的量表解释了更多（约 1%）的心理健康变化，社会不可接受性子结构解释了 HFSSM-10 无法解释的更多（约 1%）心理健康变化。
两个社会不可接受性项目作为一个单独的量表与 HFSSM-10 一起使用，比 HFSSM-10 单独使用能更准确地预测心理健康。
