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Methods (Poster Session)

(P11-004-24) Development, Implementation, and Validation of 2-Item Nutrition Security Screener

Sunday, June 30, 2024
11:45 AM – 12:45 PM CT
Location: Poster Board 61

    Presenting Author(s)

  • Hope Craig, MSPH

    PhD Student
    Friedman School of Nutrition Science and Policy at Tufts University
    Cambridge, Massachusetts, United States

    • Co-Author(s)

  • JR

    Julia E. Reedy, MS

    Senior Research Coordinator
    Friedman School of Nutrition Science and Policy at Tufts University
    Boston, Massachusetts, United States

  • RR

    Ronit Ridberg

    Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, United States

  • JC

    Julia Caldwell

    Los Angeles County Department of Public Health, United States

  • DS

    Dipa Shah-Patel

    Los Angeles County Department of Public Health, United States

  • KW

    Kelly Warner

    Los Angeles County Department of Public Health, United States

  • MB

    Meagan Brown

    Kaiser Permanente, United States

  • CC

    Ceping Chao

    Kaiser Permanente, United States

  • CN

    Claudia Nau

    Kaiser Permanente, United States

  • Pamela Schwartz, MPH

    Executive Director, Community Health
    Kaiser Foundation Health Plan and Hospitals
    Piedmont, California, United States

  • KH

    Kurt Hager

    Population and Quantitative Health Sciences, University of Massachusetts Medical School, United States

  • MA

    Matthew Alcusky

    Population & Quantitative Health Sciences, University of Massachusetts Medical School, United States

  • SL

    Shiwei Liang

    Population & Quantitative Health Sciences, University of Massachusetts Medical School, United States

  • Kd

    Kayla de la Haye

    Center for Economic and Social Research, University of South California, United States

  • MH

    Mina Habib

    Kaiser Permanente, United States

  • VP

    Vivian Peng

    Rockefeller Foundation, United States

  • TO

    Tasnuva Orchi

    Rockefeller Foundation, United States

  • Dariush Mozaffarian, MD, DrPH

    Dean
    Friedman School of Nutrition Science and Policy at Tufts University
    Boston, Massachusetts, United States

Disclosure(s):
Hope Craig, MSPH: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Nutrition security refers to access, availability, and affordability of foods that support well-being and prevent and manage nutrition related diseases. Healthcare and government entities are focusing on nutrition insecurity (NI) in light of the distinction between access to calories vs. nourishing foods but validated screening measures are not established.

Methods: Experts at Tufts University, Kaiser Permanente, and Los Angeles County Department of Public Health designed a 2-item Nutrition Security Screener (NSS), refined it in pilot studies, and validated it against measures of food insecurity (FI), sociodemographics, and health in five diverse populations. A logistic model examined associations with NI adjusting for covariates.

Results: Results include 19,348 respondents total, from Los Angeles County Public Health Survey (n=9372), Kaiser Permanente Social Needs Survey (n=6317), and Tufts Food is Medicine National (n=3009) and California Polls (n=650) (two more surveys are being analyzed). Among L.A. County and Kaiser Permanente, about half were ages 40-64 years (42.5%, 41.8%) and college graduates (47.7%, 49.9%). In the two Tufts Polls, most were 18-49 years old (66.1%, 58.15%), had at least some college education (46.4%, 72.8%) and earned < $49,000/year (52.1%, 38.2%). Prevalence of FI in the four surveys was 25.4%, 15.5%, 36.9%, and 41.7%, respectively; and NI, 33.1%, 17.7%, 40.5%, and 43.8%. NI was associated with Black race, lower income, and lower education in all surveys. FI and NI only partly overlapped, with discordance in ~20% of all respondents. In Tufts National Poll, adjusting for age, income, race, and FI, NI was an independent predictor of diabetes (OR = 1.47, 95% CI 1.05-2.05, p=0.022) and possibly obesity (OR=1.26, 95% CI 0.99-1.61, p=0.065). Most common barriers to nutrition security in Tufts Polls were cost (81%, 75%), low cooking knowledge (74%, 74%), and few healthy choices (53%, 50%); and in L.A. County Survey, cost (79%), uncertainty about food assistance qualifications (60%) and time to cook (57%).

Conclusions: A 2-item NSS provides new information independent of FI, associates with key sociodemographics and disease outcomes, and provides insight on barriers to inform interventions in clinical and public health settings.

Funding Sources: Bia-Echo Foundation; HAND Foundation; Kaiser Permanente; Seeding the Future Foundation