Colleges and Department Research
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Browsing Colleges and Department Research by Author "Adair, Linda S."
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Item Re-conceptualizing Food Insecurity with a New, Multi-dimensional Scale(2016-06) Johnson, Cassandra M.; Ammerman, Alice S.; Adair, Linda S.; Aiello, Allison E.; Flax, Valerie L.; Elliott, Sinikka; Bowen, Sarah K.Background: USDA's Food Security Survey Module - measure of food insecurity; Used for national monitoring and surveillance in Canada and US; FSSM has important limitations. Objective: To develop and evaluate a new, multi-dimensional measure of food insecurity for use in programs and research. Methods: Cross-sectional data (2014-2015) from prospective project; Voices Into Action: The Families, Food, and Health Project; Diverse sample of mothers from North Carolina (n=109); Qualitative and quantitative data; In-depth interviews; Surveys; Four-Dimensional Food Insecurity Scale (4D-FIS) reflects four dimensions of food insecurity: Quantitative; Qualitative; Psychological; Social. Categorization of severity: Food secure; Mildly food insecure; Severely food insecure. Confirmatory factor analysis (CFA) to examine the hypothesized, four-factor structure of 4D-FIS. Concordance analysis to compare categorization between the two food insecurity scales: 1) 4D-FIS and 2) USDA FSSM adult scale (2). Results: Data supported the four-factor model; 4D-FIS categorized more participants as food insecure vs. USDA scale; Fair to moderate agreement in categorization between scales. Conclusions: Promising alternative measure; Implications for programs, interventions, and research applications.Item Relationship of Food Insecurity to Women's Dietary Outcomes: A Systematic Review(Oxford University Press, 2018-09) Johnson, Cassandra M.; Sharkey, Joseph R.; Lackey, Mellanye J.; Adair, Linda S.; Aiello, Allison E.; Bowen, Sarah K.; Fang, Wei; Flax, Valerie L.; Ammerman, Alice S.Context: Food insecurity matters for women's nutrition and health. Objective: This review sought to comprehensively evaluate how food insecurity relates to a full range of dietary outcomes (food groups, total energy, macronutrients, micronutrients, and overall dietary quality) among adult women living in Canada and the United States. Data Sources: Peer-reviewed databases (PubMed/MEDLINE, CINAHL, Scopus, Web of Science) and gray literature sources from 1995 to 2016 were searched. Data Extraction: Observational studies were used to calculate a percentage difference in dietary intake for food-insecure and food-secure groups. Results: Of the 24 included studies, the majority found food-insecure women had lower food group frequencies (dairy, total fruits and vegetables, total grains, and meats/meat alternatives) and intakes of macro- and micronutrients relative to food-secure women. Methodological quality varied. Among high-quality studies, food insecurity was negatively associated with dairy, fruits and vegetables, grains, meats/meats alternatives, protein, total fat, calcium, iron, magnesium, vitamins A and C, and folate. Conclusions: Results hold practical relevance for selecting nutritional targets in programs, particularly for nutrient-rich foods with iron and folate, which are more important for women’s health.Item The Four Domain Food Insecurity Scale (4D-FIS): Development and evaluation of a complementary food insecurity measure(Oxford University Press, 2020-12) Johnson, Cassandra M.; Ammerman, Alice S.; Adair, Linda S.; Aiello, Allison E.; Flax, Valerie L.; Elliott, Sinikka; Hardison-Moody, Annie; Bowen, Sarah K.The U.S. Department of Agriculture (USDA) Food Security Survey Module (FSSM) is a valuable tool for measuring food insecurity, but it has limitations for capturing experiences of less severe food insecurity. To develop and test the Four Domain Food Insecurity Scale (4D-FIS), a complementary measure designed to assess all four domains of the food access dimension of food insecurity (quantitative, qualitative, psychological, and social).Low-income Black, Latina, and White women (n = 109) completed semi-structured (qualitative) and structured (quantitative) interviews. Interviewers separately administered two food insecurity scales, including the 4D-FIS and the USDA FSSM adult scale. A scoring protocol was developed to determine food insecurity status with the 4D-FIS. Analyses included a confirmatory factor analysis to examine the hypothesized structure of the 4D-FIS and an initial evaluation of reliability and validity. A four-factor model fit the data reasonably well as judged with fit indices. Results showed relatively high factor loadings and inter-factor correlations indicated that factors were distinct. Cronbach’s alpha (ɑ) for the overall scale was 0.90 (subscale ɑ ranged from 0.69 to 0.91) and provided support for the scale’s internal consistency reliability. There was fair overall agreement between the 4D-FIS and USDA FSSM adult scale, but agreement varied by category. Findings provide preliminary support for the 4D-FIS as a complementary measure of food insecurity, with implications for researchers, practitioners, and policymakers working in U.S. communities.