Higher rates of food insecurity have been observed among Hispanic immigrants, yet these individuals have traditionally been excluded from food insecurity survey development. The most common Spanish translated food insecurity scale—the Spanish Translation of the U.S. Household Food Security Survey Module (S-FSSM)—may not be capturing how Spanish-speaking immigrant parents conceptualize food insecurity. The purpose of this study was to gain insight into how Spanish-speaking immigrant parents with low English literacy conceptualize household food insecurity within the 18-item S-FSSM and to use this information to revise the S-FSSM instrument. Researchers conducted two rounds of cognitive interviews with Spanish-speaking adults at a community center in Houston, TX, USA (N = 19; Round 1: n = 9, October 2023; Round 2: n = 10, July 2024). Researchers used participants’ feedback to refine the S-FSSM. All participants were female (Rounds 1 and 2 = 100%) and most born in Mexico (Round 1 = 66.7%; Round 2 = 50%). In Round 1, eight items were combined to enhance cultural relevance and to add definitions. Follow-up questions were added to improve clarity. Two items were revised for relevancy, two items had no change, six items were deleted. In Round 2, modifications to wording occurred and one item was added. The revised scale, named Food Access Measure for Immigrant Latinos In America (FAMILIA), resulted in 17 survey items. Study findings suggested that the S-FSSM needed refinement to enhance relevancy for Spanish-speaking immigrant parents with low English literacy.

Supplementary Figure from A Contemporary Analysis of Racial and Ethnic Disparities in Diagnosis of Early-Stage Breast Cancer and Stage-Specific Survival by Molecular Subtype

While cortisol production has been studied in parent-child dyads, research has not specifically examined cortisol production of US-born adolescents and their undocumented immigrant Latino parents, despite the elevated stress associated with mixed status. The purpose of the small study was to 1) assess the cortisol production of undocumented immigrant parent-US-born adolescent dyads and 2) examine the cortisol production of the dyads identified as being at heightened risk for immigrant and economic stress. A community-based strategy was used to locate and recruit self-identifying undocumented immigrant, Latino parents and their US-born adolescents (12-16 years) in the Houston-area (September 2019-January 2020). Each participant within the dyad self-reported on immigration and economic stress, socio-demographic characteristics, and parents self-reported on their immigration documentation status. Each participant within the dyad also provided four saliva samples collected at-home during designated time points within the same day. Paired t-test were conducted to compare cortisol production at each of the four time-points among undocumented parent-US-born adolescent dyads and among mixed-status dyads whose parents reported elevated immigration and economic stress. Nineteen mixed-status dyads participated (adolescents: 63% male; average age 13.68 years; parents: 96% female; average age 41.95 years; primarily from Mexico). Cortisol production comparisons within mixed-status dyads did not differ at any of the four time points (i.e. cortisol production appeared to be the same) [t1(18)=1.54, p=0.14; t2(18)=-1.32, p=0.20; t3(18)=-0.43, p=0.67; t4(18)=-1.65, p=0.12]. Among mixed-status dyads whose parents reported elevated immigrant-related stress [t1(10)=1.15, p=0.28; t2(10)=-0.85, p=0.42; t3(10)=-1.31, p=0.22; t4(10)=-1.46, p=0.18] and economic stress [t1(10)=0.17, p=0.87; t2(10)=0.12, p=0.91; t3(10)=-0.25, p=0.80; t4(10)=-0.19, p=0.85], cortisol production did not differ at any of the four time points. The shared environment among mixed-status families appears to be co-activating adolescent-parent physiology, contributing to similar cortisol production. The constant level of stress may shape all members of the family similarly, regardless of documentation status.

Restaurants are the largest private sector employers in Texas. Yet only 48% of Texas restaurants have enough employees to support existing demand. The shortage of restaurant employees is an opportunity to develop culinary training programs for individuals that need employment, such as adults experiencing sheltered homelessness. Prior to program development it is important to understand their baseline knowledge of nutrition and food safety and potential attendance barriers. A cross-sectional survey was conducted among adults experiencing sheltered homelessness in Houston, Tx (October 16, 2024-November 13, 2024). Among 91 participants, on average, adults were 42 years old (SD = 12.98), 67% female, and 60% Black. Nutrition knowledge was low on 2 survey items (12% and 34% correct) and moderate on another 2 items (64% and 66% correct). Regarding food safety, 93% of the participants were able to answer 1 of the 5 items correctly. In terms of potential barriers, 82% of the sample experienced food insecurity. Seventy-seven percent of participants that had a car expressed not having money for gasoline and not making repairs to their car because of the expense. Forty-seven percent of the participants had children under the age of 18 and 44% of them needed childcare assistance in order attend a program. Curriculum associated with the culinary training program must include nutrition and food safety education. To address potential attendance barriers (food, transportation, childcare), it may be necessary to partner with community organizations that aim to reduce economic instability prior to developing and implementing the program.

BACKGROUND:Latinos compared with non-Latino Whites are more likely to experience food insecurity and report greater psychological distress than other racial/ethnic groups. However, limited research has compared the association between food insecurity and psychological distress among US-born and foreign-born Latinos. METHODS:We used cross-sectional 2014-2018 National Health Interview Survey data on 9942 Latino participants, 18-59 years of age that were ≤299 % of the federal poverty line (FPL). The 10-item USDA Food Security Scale was used to categorize participants as food secure (≤2 items) and food insecure (≥3 items). The Kessler-6 scale was used to measure psychological distress and to classify participants as having no psychological distress (<6 items), moderate psychological distress (MPD; 6-12 items), and serious psychological distress (SPD; ≥13 items). Covariate-adjusted multinomial logistic regression models estimated the associations between food insecurity and psychological distress for the full sample and stratified by nativity status. RESULTS:In adjusted models, compared with those that were food secure, food insecure Latinos were significantly more likely to report MPD (OR: 2.52, 95 % CI: 2.13-2.99) and SPD (OR: 3.94, 95 % CI: 3.08-5.02). Stratified by nativity, the association was slightly stronger among foreign-born Latinos. CONCLUSIONS:Latinos with greater psychological distress are less likely to utilize public assistance programs designed to facilitate food access, which can indirectly reduce psychological distress. Findings highlight the continued need for community-based interventions and programs designed to reduce food insecurity.

Objectives: First, to examine the effects of household food insecurity discordance status on adolescent antisocial behavior. Second, to determine if adolescents' gender moderates the association between household food insecurity discordance and adolescent antisocial behavior. Design: Cross-sectional data of Latino parents and adolescents from the same household were collected in Tulsa, Oklahoma, between January 1, 2013, and January 1, 2014. Using a general linear model (GLM), we examined associations between household food insecurity discordance and adolescents' antisocial behavior. Sample: The sample includes Latino parent and adolescent dyads (N = 69 dyads, 138 individuals), where parents were 89.9% women, Mage = 38.46, and adolescents were 43.5% girls, Mage = 14.3. Measurements: Food security assessed using the 18-item US Food Security Survey for adults, the 9-item Self-Administered Food Security Module for children aged 12 and older for adolescents. Adolescents were asked to complete a modified 24-item version of the Problem Behavior Frequency Scale to assess antisocial behavior. Results: Findings showed that adolescent food insecurity discordance was associated with greater antisocial behavior for girls. Parental food insecurity discordance was associated with greater antisocial behavior for boys. Conclusions: Findings provide insight into the negative implications of household food insecurity discordance on Latino adolescents' antisocial behavior.

BACKGROUND:The literature on the determinants of US food insecurity is extensive. Yet, the research on transitions in food insecurity among a group, especially those at risk of food insecurity-recipients of charitable food assistance-is more limited. OBJECTIVES:This study examines changes in financial well-being and health-related quality of life as correlates of transitions in food insecurity status among recipients of charitable food assistance. DESIGN:Survey data were collected 6 months apart during 2022 and 2023. Food insecurity was measured at both time points using the 18-item US Department of Agriculture Food Security Survey Module. At both time points, recipients reported on their financial well-being using a 10-item scale and their health-related quality of life using 3 measures: global health and the number of physical and mental unhealthy days. Other time-varying and time-invariant variables are also included. PARTICIPANTS:Recipients of charitable food assistance (n = 777) were recruited and surveyed from 10 food pantries in Atlanta, GA, and 10 food pantries in Houston, TX. Participants were followed up 6 months later. The sample is composed of those who participated in both surveys. MAIN OUTCOME MEASURES:Marginal food insecurity, food insecurity, and very low food security. STATISTICAL ANALYSES PERFORMED:Standard descriptive statistics are displayed along with results from 2-way fixed effects models. RESULTS:Over a 6-month period, 21.5% of respondents saw a change in marginal food insecurity, 24.1% in food insecurity, and 14.0% in very low food security. These changes were associated with changes in the number of days the respondent reported having trouble with mental health during the past 30 days and perceptions of financial well-being. CONCLUSIONS:These results demonstrate that practitioners, such as nutrition and dietetics practitioners, should be aware that food insecurity status among a group at high risk of food insecurity frequently changes over a short period. These changes were associated with factors potentially trackable by nutrition and dietetics practitioners in community settings, which may facilitate the distribution of appropriate resources more quickly.

INTRODUCTION:Prior cross-sectional research has identified incarceration as a risk factor for food insecurity across the life course. However, there is a lack of longitudinal studies on the relationship between prior incarceration and food insecurity over time. METHODS:This study uses biennial data across 10 time points from the Health and Retirement Study (years 2012-2022) to examine the association between prior incarceration and longitudinal trajectories of food insecurity among adults aged 55 and older in the USA (N=8229). Group-based trajectory modelling was used to assess patterns of food insecurity status over time. Multinomial logistic regression assessed the relationship between prior incarceration and food insecurity trajectory group membership. RESULTS:Three food insecurity trajectory groups were identified: no food insecurity (86.2%), declining food insecurity (11.0%) and chronic food insecurity (2.8%). Results from the multinomial logistic regression demonstrated that a history of incarceration was significantly associated with a higher likelihood of membership in the Declining Food Insecurity (relative risk ratio (RRR)=1.80, 95% CI 1.24 to 2.60) and Chronic Food Insecurity groups (RRR=2.14, 95% CI 1.35 to 3.39), relative to No Food Insecurity group after adjusting for covariates. However, after controlling for household income and wealth, this association was attenuated and remained statistically significant only for the Declining Food Insecurity group (RRR=1.59, 95% CI 1.06 to 2.37). CONCLUSIONS:A history of incarceration is associated with a greater risk of food insecurity across older adulthood, though this relationship appears to be largely due to disparities in socioeconomic status.

While IPV is often studied as a predictor of housing insecurity, few U.S. studies explore how different forms of housing instability may contribute to intimate partner violence (IPV) risk. Using a mixed-methods approach and a cross-sectional design, this study examined the association between four housing instability domains and IPV among a sample of tenants that had either experienced eviction or were at high risk for eviction. Tenants in Harris and Travis counties (Texas, USA) completed an online survey (n = 1085; March–July 2024). Housing instability was assessed across four domains: homelessness, lease violations, utility hardship, and poor housing quality. IPV was measured using the Hurt, Insult, Threaten, Scream Screener. Covariate-adjusted logistic regression models suggest indicators within the four housing instability domains were associated with IPV risk. Within the homelessness domain, experiences with lifetime homelessness (AOR = 1.92, 95%CI 1.61–2.28), in the past 12 months living in unconventional spaces (AOR = 2.10, 95%CI 1.92–2.29), and moving in with others (AOR = 1.20, 95%CI 1.06–1.36) were associated with IPV. Within the lease violations domain, missed rent payments (AOR = 1.69, 95%CI 1.68–1.71) and non-payment lease violations (AOR = 2.50, 95%CI 2.29–2.73) in the past 12 months were associated with IPV. Utility shutoffs (AOR = 1.62, 95%CI 1.37–1.91) and unsafe housing (AOR = 1.65, 95%CI 1.31–2.09) in the past 12 months were associated with IPV. Homelessness, housing-related economic hardships and substandard living conditions predict an elevated risk of IPV.

Increasing autonomy and potential engagement in risky health behaviors during adolescence creates a critical time for oral health and nutrition health promotion. A Social Cognitive Theory-based oral health promotion program was developed and piloted in an under-resourced urban high school. The program was designed to improve health literacy regarding oral health, nutrition, and risky health behaviors that influence oral health through didactic lessons and interactive in-class group activities. In this pilot study, twenty-four students participated and completed both pre-/post-program surveys (mean age=15.6 years [SD=0.97], 63% female; 75% Black; 46% food insecure). Over one-third (38%) of students had not visited a dentist in the past year (67% male; 56% Black, 44% food insecure). While health literacy slightly increased from pre- to post-program, the increase was not significant. The limited positive findings may be related to small sample size in this pilot, as well as implementation challenges that occurred: lack of partnership buy-in, turnover and vacancies, scheduling conflicts, low attendance, and available but inaccessible dental care. Lessons learned from the challenges can inform future program planning and implementation.

Background and Objectives: Individuals of color and of low socioeconomic status are at greater risk of experiencing community violence and food insecurity, which are both influenced by neighborhood conditions. We evaluated neighborhood collective efficacy as a linkage between community violence exposure and household food insecurity. Methods: Mothers from the Future of Families and Child Wellbeing Study who completed phone surveys when the child was 3 (time 1, T1) and 5 years old (time 2, T2) were included (n = 2068). A covariate-adjusted structural equation model estimated direct and indirect effects of community violence exposure on household food insecurity. A covariate-adjusted multiple mediator model estimated the indirect effects of the 2 neighborhood collective efficacy subscales (informal social control; social cohesion and trust). Results: At T1, 40% of mothers reported community violence exposure; 15% experienced food insecurity at T2. Mean neighborhood collective efficacy (range 1-5) at T1 was 2.44 (SD = 0.94). Neighborhood collective efficacy indirectly influenced the association between community violence exposure and food insecurity (indirect effect = 0.022, 95% CI = 0.007 to 0.040). Only social cohesion and trust contributed independent variance to the indirect effect model (indirect effect = 0.028, 95% CI = 0.001 to 0.056). Conclusions: Community-based efforts to reduce household food insecurity should emphasize building social cohesion and trust in communities experiencing violence.

Prior research has focused on various social determinants of health as risk factors to food insecurity. Less work has focused on modifiable behaviors. This study examined the relationship between grocery shopping and meal preparation self-efficacy and food insecurity among food pantry clients. Surveys were used to collect the data from 10 food pantries in Atlanta, Georgia and 10 food pantries in Houston, Texas in 2022. Food insecurity status was ascertained by 3 affirmative responses on the 18-item USDA Food Security Scale Module. A total score of affirmative responses to 6-items each on a 1= not all confident to 4 = very confident scale was used to measure grocery shopping and meal preparation self-efficacy. Covariate-adjusted logistic regression models were conducted to examine the relationship between grocery shopping and meal preparation self-efficacy and food insecurity among the full sample. Standard errors in all regression models were corrected to account for multiple observations within a pantry. On average, participants (N=1,219) were 56 years old and had a grocery shopping and meal preparation self-efficacy total score of 20.73 (SD=3.35) out of 24.00. Over half of the sample experienced food insecurity (57%). For each unit increase in grocery shopping and meal preparation self-efficacy, food pantry clients experienced 7% lower odds of experiencing food insecurity (95% CI: 0.89-0.97). The findings hold when the models were stratified by sex. The results suggest interventions to improve grocery shopping and meal preparation self-efficacy may help reduce food insecurity.

Food insecurity is an indicator of well-being in the United States. A high proportion of recipients of charitable food assistance (CFA) are women and are often in charge of specific household managerial responsibilities (e.g., childcare, transportation). Consequently, they frequently face choices between paying for food and paying for other basic need(s). This study aims to examine which hunger-coping economic tradeoffs place females with at least one dependent child in the house and females without a dependent child in the house at risk for experiencing food insecurity. Data was collected at 10 Houston-area and 10-Atlanta-area food pantries in 2022 (N = 883). Using USDA cutoff criteria, households were considered food insecure based on ≥3 affirmative responses to the 18-item Food Security Scale Module. Hunger-coping economic tradeoff experiences were based on affirmative responses to whether anyone in the household ever had to choose between food and six basic needs (i.e. childcare, medicine/medical care, utilities, rent/mortgage, transportation, education). Covariate-adjusted logistic regression models were conducted to understand the relationship between six hunger-coping economic tradeoffs and food insecurity for the entire analytic sample and stratified by whether the female participant had a child in house. Standard errors in all regression models were corrected to account for multiple observations within a pantry. Adults, on average, were 55 years old (58% food insecure; 47% Hispanic; 42% black). Four hunger-coping economic tradeoffs were related to experiencing food insecurity. Economic tradeoffs between food and a) medicine/medical care and b) transportation elevated the likelihood of food insecurity, regardless of child status. Tradeoffs between food and childcare increased the risk for experiencing food insecurity among females with a dependent child. Deciding to pay between food and utilities was related to food insecurity experiences among females without a dependent child. Increases in Supplemental Nutrition Assistance Program (SNAP) benefits and eligibility along with programs to enhance resources related to medical care, transportation, childcare and utilities could help reduce food insecurity, especially among CFA recipients.

Background Research on childhood nutritional environments, which are predictive of a variety of child and family health and wellbeing outcomes, has primarily focused on parenting behaviors and the home food environment. However, broader social and community factors play an important role in shaping nutritional environments during early childhood. Food security is a key example that is closely linked to nutrition-related health disparities, which can arise from constrained financial resources and material deprivations. Understanding parent and caregiver lived experiences related to social and community components of family nutritional environments in the context of economic constraints could help to support multi-level nutritional practices that are optimal for healthy child development. Method Semi-structured in-depth interviews were conducted using a narrative approach with parents (n = 21) of pre-school aged children living near or below the poverty line. Participants were recruited from social and community service sites pertinent to maternal and child health in Philadelphia where health disparities are highly concentrated. Analysis was conducted using MAX QDA analytic software following a systematic approach for thematic analysis in narrative research. Results Three themes describe the feeding and eating environments in the home and community context: 1) Food Procurement and Meal Planning; 2) Family Togetherness; 3) Creativity, Variety, and Flexibility. Creative decision making and food procurement strategies responsive to child preferences were balanced by shopping to save and visiting multiple stores for the best foods and savings. Logistical (e.g., transportation, childcare) and emotional supports facilitated food shopping habits and routines, while lack of trusted childcare, reliable transportation, and social support barriers challenged feeding and eating decisions. Conclusion Strategies for improving cost and time-efficiencies could help support health-promoting nutritional environments of families with food insecurity. Building social and community capacity and facilitating connections to practical supports that include trustworthy childcare and peer support may be particularly important for this population.

Objective To assess the feasibility of administrating an electronic and paper-based food insecurity screener among patients presenting to a stroke clinic during the study period. We aimed to ensure a consecutive sample for our retrospective analysis and evaluate the prevalence and characteristics of food insecurity in this population. Materials and methods We conducted a retrospective review of patients with an initial telemedicine or in-person appointment to a stroke outpatient clinic between February 1 and July 31, 2021. Prior to their initial visit, patients were sent an electronic questionnaire to screen for food insecurity using the 2-item Hunger Vital Sign™ and to collect socio-demographic characteristics. Patients who were evaluated in-person were given a paper questionnaire if the electronic version was not completed upon clinic appointment. We collected data on patient demographics, screener completion rates, and the prevalence of food insecurity. The feasibility was evaluated by comparing the amount of missing data between electronic and paper-based screeners. Results Among 406 adult stroke survivors, 365 (89.9 %) completed the food insecurity screener, with 234 (64.1 %) completing it electronically and 131 (35.9 %) by paper. Overall, 14.3 % of the stroke patients experienced food insecurity. A higher prevalence of food insecurity was observed among patients who completed paper-based compared to electronic questionnaires (21.4 % vs 10.2 %, p = 0.004). Hispanic patients were more likely to complete paper-based questionnaires (32.1 %) compared to electronic questionnaires (18.0 %, p = 0.011). Patients with a 12th grade education or less were more likely to complete paper-based (49.5 %) vs. electronic questionnaires (36.4 %, p = 0.029). Feasibility was evaluated by comparing the amount of missing data between the screener delivery modalities. A higher percentage of socio-demographic characteristics was missing in the paper-based questionnaires compared to electronic questionnaires (105.3 % vs. 14.11 %). Conclusions Sample characteristics differ based on the mode of questionnaire delivery, suggesting that different screening modalities may be necessary to identify patients at the highest risk for food insecurity. Our study provides detailed insights into the feasibility of using electronic and paper-based screeners in a clinical setting, highlighting the importance of considering delivery methods in food insecurity assessments. It is important to note that the Spanish language electronic survey was only available during the last two months of the study, which may affect the findings regarding Hispanic patients' preference for paper surveys.