219905 Methods to develop a 2-Item food security screen

Tuesday, November 9, 2010 : 5:30 PM - 5:50 PM

Sharon M. Coleman, MS, MPH , Data Coordinating Center, Boston University School of Public Health, Boston, MA
Anna Quigg, MA, BCBA , Department of Pediatrics, University of Maryland, School of Medicine, Baltimore, MD
Erin Hager, PhD , Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
Maureen Black, PhD , Department of Pediatrics, University of Maryland, School of Medicine, Baltimore, MD
The Children's HealthWatch Research Group , Boston Medical Center, Children's HealthWatch Research Group, Boston, MA
Background: Food Security is access by all household members at all times to enough food for an active, healthy life. It includes at a minimum: 1) ready availability of nutritionally adequate and safe foods and 2) assured ability to acquire acceptable foods in socially acceptable ways. The 18-item US Household Food Security Scale (HFSS) is used to monitor the household food security status of the nation annually. Although the HFSS is widely used in research, its length may prohibit clinical use. Methods: A sample of 30,098 caregivers of children under 3 years of age from 7 urban medical centers completed the 18-item HFSS as part of the Children's HealthWatch Surveillance Study. The prevalence of endorsement for each of the 18-items was ascertained. The first two questions were the most frequently endorsed. Sensitivity and specificity analysis were performed to determine if a positive response to question 1 and/or 2 would yield acceptable values when compared to the “gold standard” HFSS. Results: The screen yielded a sensitivity of 97% and a specificity of 83%. A logistic regression model was run to determine the c-statistic or how well the screen predicts the gold standard. The c-statistic is equal to the area under the “receiver operating characteristic” curve (ROC). This value was 0.90. Discussion: FI is a serious public health concern for families with young children. The 2-item screen can be readily used in clinical settings as a quick screen for identifying families that may otherwise go undetected.

Learning Areas:
Biostatistics, economics
Clinical medicine applied in public health
Provision of health care to the public

Learning Objectives:
1)Discuss the USDA 18-item household food security screen and how it is used nationally. 2)Identify statistical methods such as sensitivity analysis and the use of ROC curves to identify the discrimination of a model. 3)Explain the benefits of a screening tool in a clinical setting.

Keywords: Food Security, Methodology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present as a Research Manager at the Boston University School of Public Health with a background in epidemiology and biostatistics. I work closely with The Children's HealthWatch Group on issues such as Food Insecurity and it's effects on infants and toddlers.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.