Parent Attitudes and Behaviors Associated with Household Food Security among Rural Lower Income Families

Objective: To examine associations between Theory of Planned Behavior constructs related to parent engagement in health-promoting behaviors and food resource management with household food security status. Methods: A cross-sectional secondary analysis of baseline data from 1622 parents enrolled in the ENCIRCLE study, a pragmatic cluster-randomized controlled trial to prevent obesity among preschool-aged children from rural lower-income families. Logistic regression models examined associations between parent engagement in health-promoting behaviors (attitude, subjective norm, perceived behavioral control) and food resource management (self-confidence, behaviors) with household food security status. Results: Parents with greater perceived behavioral control (OR=1.44, CI:1.14-1.82) and food resource management self-confidence (OR=2.08, CI:1.80-2.41) had significantly higher odds of experiencing household food security in adjusted models. Conclusions and Implications: Findings suggest that perceived behavioral control and food resource management self-confidence may help safeguard lower-income families. Health promotion efforts should target these factors to help parents engage in health-promoting behaviors during times of economic hardship. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported through a Patient-Centered Outcomes Research Institute (PCORI) Project Program Award (CER-2019C1-16040). All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of the PCORI, its Board of Governors or Methodology Committee. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee/ Institutional Review Board of Geisinger, a large integrated health system, gave ethical approval for this work and this work is registered with ClinicalTrials.gov ([NCT04406441][1]). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes De-identified data are available upon reasonable request to the authors and with a data sharing agreement in place. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04406441&atom=%2Fmedrxiv%2Fearly%2F2024%2F08%2F23%2F2024.08.22.24312452.atom