Published online Dec 31, 2011.
https://doi.org/10.5720/kjcn.2011.16.6.771
Validation of Food Security Measures for the Korean National Health and Nutrition Examination Survey
Abstract
The objective of this study was to assess the reliability and validity of food security measures, which was developed based on the US household food security survey module (US HFSSM) with content validity in the Korean population. The reliability and validity were assessed by internal consistency, construct validity and criterion-related validity. The study included 446 households. Among those, 46.2% were households with children. The proportion of food insecure households was 33.3%. Among those, 35.4% and 64.6% households were food insecure with hunger and without hunger, respectively. The Cronbach's alpha coefficients were 0.84 and the infit value by the Rasch model analysis ranged from 0.68 to 1.43. The scale item response curves by food insecurity severity explained well the nature and characteristics of food security, indicating the highest proportion of "yes" for the items on diet quality, followed by those with diet quantity. The result of criterion-related validity showed that food insecurity status was significantly related in a dose-response manner with the household income level, food expenditure, subjective health state, subjects' educational level. Household food security status was also related to dietary diversity regarding protein foods, fruits and fruit juice, and milk and dairy product. These findings suggest that the food security instrument is reliable and valid and would be used to assess food security status in the Korean population.
Fig. 1
1='Worried food would run out before we got money to buy more.', 2='Food bought didn't last and we didn't have money to get more.', 3='Couldn't afford to eat balanced meals.', 4='Adult cut size of meals or skipped meals.', 5='Respondent ate less than felt he/she should.', 6='Respondent hungry but didn't eat because couldn't afford.', 7='Respondent lost weight.', 8='Adult did not eat for whole day.', 9='Relied on few kinds of low-cost food to feed children.', 10='Couldn't feed children balanced meals.', 11='Children were not eating enough.', 12='Cut size of children's meals.', 13='Children skipped meals.', 14='Children were hungry but didn't eat because couldn't afford.', 15='Children did not eat for whole day.', Questions of 4-1, 8-1, and 13-1 indicate 'how often.'
Assessment of food security questionnaire severity according to household income
Table 1
General characteristics of household
Table 2
Household food security status
Table 3
Sensitivity and specificity of food insufficiency questionnaire with food security status by the developed questionnaire
Table 4
Meeting degree coefficient after elimination of questions
Table 5
Infit mean square using Rasch model
Table 6
Relations of household food security status with socioeconomic status and level of subjective health state
Table 7
Relations of household food security status with variety score of diet
This research was supported by grants from the Korean Center of Disease and Control(Project No. 2010E0075600, Principal investigator, Se-Young Oh).
References
-
Core indicators of nutritional state for difficult-to-sample populations. J Nutr 1990;120 Suppl 11:1559–1600.
-
-
Connell CL, Nord M, Lofton KL, Yadrick K. Food security of older children can be assessed using a standardized survey instrument. J Nutr 2004;134:2566–2572.
-
-
Food and Agriculture Organization of the United Nations. The State of Food Insecurity in the World 2001. Rome: Food and Agriculture Organization of the United Nations; 2002a.
-
-
Food and Agriculture Organization of the United Nations. Measurement and assessment of food deprivation and undernutrition; International Scientific Symposium; Rome: Food and Agriculture Organization of the United Nations; 2002b.
-
-
Frongillo EA. Validation of measures of food insecurity and hunger. J Nutr 1999;129:506S–509S.
-
-
Frongillo EA, Nanama S. Development and validation of an experience-based measure of household food insecurity within and across seasons in Northern Burkina Faso. J Nutr 2006;136(5):1409S–1419S.
-
-
Gonzalez W, Jimenez A, Madrigal G, Munõoz LM, Frongillo EA. Development and validation of measure of household food insecurity in urban costa rica confirms proposed generic questionnaire. J Nutr 2008;138:587–592.
-
-
Habicht JP, Pelto G, Frongillo EA, Rose D. Conceptualization and instrumentation of food insecurity; Proceedings of the Workshop on the Measurement of Food Insecurity and Hunger; Washington DC: National Academy Press; 2004.
-
-
Hamilton WL, Cook JT, Thompson WW, Buron LF, Frongillo EA, Olson CM, Wehler CA. In: Summary report of the food security measurement project. Washington DC: US Department of Agriculture; 1997. Household food security in the United States in 1995.
-
-
Jeong JH, Hwang DS, Kum JH, Lee BH, Park CY. In: A study on the working poor in Korea. Report no. 2005-03. Seoul: Korea Labor Institute; 2005.
-
-
Kendall A, Olson CM, Frongillo EA. Validation of the Radimer/Cornell measures of hunger and food insecurity. J Nutr 1995;125:2793–2801.
-
-
Kim K, Hong SA, Kim MK. Nutritional status and food insufficiency of Korean population through the life-course by education level based on 2005 National Health and Nutrition Survey. Korean J Nutr 2008;41(7):667–681.
-
-
Kim K, Kim MK. Development and validation of food security measure. Korean J Nutr 2009;42(4):374–385.
-
-
Kim K, Kim MK, Shin YJ. Household food insecurity and its characteristics in Korea. Health Soc Welf Rev 2009;29(2):268–292.
-
-
Korea Health Industry Development Institute. Korean National Health and Nutrition Examination Survey, In depth analysis - Nutrition survey. Seoul: Ministry of Health and Welfare; 2003.
-
-
Korea Health Industry Development Institute. The third(2005) Korean National Health and Nutrition Examination Survey, In depth analysis - Nutrition survey. Seoul: Ministry of Health and Welfare; 2007.
-
-
Korean Nutrition Society. Dietary reference intake for Koreans. Seoul: Hanarum; 2010. pp. 23-553.
-
-
Kwon SO, Oh SY. Associations of household food insecurity with socioeconomic measures, health status and nutrient intake in low income elderly. Korean J Nutr 2007;40(8):762–768.
-
-
Lee HJ, Kim MG, Noe DM, Kang SH, Son BD, You JY, Lim WS. In: The structure of poverty in Korea. Report no. 2006-10. Seoul: Korean Institute for Health and Social Affairs, Ministry of Health and Welfare; 2006.
-
-
Linacre JM. In: A user's guide to WINSTEPS MINISTEPS: Rasch model computer programs. Chicago: Winsteps.com; 2004.
-
-
National Research Council. Food insecurity and hunger in the United States: An assessment of the measure. Panel to Review U.S. Department of Agriculture's Measurement of Food Insecurity and Hunger. In: Wunderlich GS, Norwood JL, editors. Committee on National Statistics, Division of Behaviroal and Social Science and Education. Washington DC: The National Academies Press; 2006.
-
-
Nord M, Andrews M, Carlson S. In: Household Food Security in the United States in 2005. Washington DC: US Department of Agriculture; 2006.
-
-
Nord M, Andrews M, Carlson S. In: Household Food Security in the United States in 2007. Washington DC: US Department of Agriculture; 2008.
-
-
Nord M, Bickel G. In: Measuring children's food security in US household, 1995-99. Washington DC: US Department of Agriculture, Economic Research Service; 2002.
-
-
Office of Nutrition Policy and Promotion, Health Products and Food Branch. Ottawa, Ontario: 2007 [cited 2011 January 5]. Canadian Community Health Survey, Cycle 2.2, Nutrition (2004) - Income-related household food security in Canada. Health Canada.Available from http://dsp-
psd.pwgsc.gc.ca/collection_ 2007/hc- sc/H164- 42- 2007- 1E.pdf.
-
-
Oh S-Y, Kim K, Kwon SO, Hong SA. In: Development and validation of Korean food security measures. Seoul: Center for Disease Control & Prevention; 2010.
-
-
Pérez-Escamilla R, Segall-Corra AM, Kurdian Maranha L, Sampaio Md, Marin-Leon L, Panigassi G. An adapted version of the US department of agriculture food insecurity module is a valid tool for assessing household food insecurity in campinas. J Nutr 2004;134:1923–1928.
-
-
Radimer KL, Olson CM, Campbell CC. Development of indicators to assess hunger. J Nutr 1990;120 Suppl 11:1544–1548.
-
-
Shim JS, Oh K, Nam CM. Association of household food security with dietary intake - Based on the third (2005) Korea National Health and Nutrition Examination Survey (KNHANES III). Korean J Nutr 2008;41(2):174–183.
-
-
Swindale A, Bilinsky P. Development of a universally applicable household food insecurity measurement tool: Process, current status, and outstanding issues. J Nutr 2006a;136:1449S–1452S.
-
-
Swindale A, Bilinsky P. Household Dietary Diversity Score (HDDS) for measurement of household food access: Indicator guide. 2006b [cited 2010 May 5].Available from http://www.fantaproject.org/publications.
-
-
Temple JB. Severe and moderate forms of food insecurity in Australia: are they distinguishable? Aust J Soc Issues 2008;43:649–668.
-
-
US Department of Agriculture. Guide to measuring household food security. Washington DC: US Department of Agriculture; 2000.
-
-
Wilde PE. Differential response patterns affect food-security prevalence estimates for households with and without children. J Nutr 2004;134:1910–1915.
-