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Two samples were used to test the results obtained in the analyses in two distinct scenarios. One of the studies was composed of low income families from Pelotas, RS, Southern Brazil, and the other was composed of 15, women, whose data were obtained from the National Survey on Demography and Health.
Two models were tested, the first containing seven questions, and the second, the five questions that were considered the most relevant ones in the concordance analysis. The models were compared to the Brazilian Food Insecurity Scale, and the sensitivity, specificity and accuracy parameters were calculated, as well as the kappa agreement test. Comparing the prevalence of food insecurity between the Brazilian Food Insecurity Scale and the two models, the differences were around 2 percentage points.
In the sensitivity analysis, the short version of seven questions obtained The five-question model showed similar results sensitivity of In the Pelotas sample, the kappa test of the seven-question version totaled In the National Survey on Demography and Health sample, the two models presented a We suggest that the model with five questions should be used as the short version of the Brazilian Food Insecurity Scale, as its results were similar to the original scale with a lower number of questions.
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This version needs to be administered to other populations in Brazil in order to allow for the adequate assessment of the validity parameters. The fulfilment of the right to regular and permanent access to sufficient amounts of high-quality foods without hindering the access to other essential needs is known as food security. An instrument that assesses food insecurity was developed in the s in the United States. National surveys have proposed to use the North American scale with six questions to investigate the food insecurity situation, 1112 but a study carried out in the city of Pelotas, RS, Southern Brazil, verified that there is no satisfactory concordance between the EBIA and this scale.
Two samples were used in this study. The second sample PNDS analyzed the health of women of reproductive age and of children younger than five years. Complementary information on the methodology can be obtained from the above-mentioned studies.
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The two samples were used to test the results of the analysis in different scenarios, which made the conclusions more robust. In both samples, the EBIA was administered to the person responsible for food in the household.
The questions referred to the period of three months prior to the interview. This did not influence the analysis, as this change originated from the division of question 5 in two questions, which were subsequently regrouped in the analysis. Only eight questions applied to households without individuals younger than 18 years. Therefore, the maximum score that could be achieved would be eight.
For households lej individuals younger than 18 years, the complete questionnaire was administered, with a maximum score of As the short version proposed here must serve as a food insecurity tracker among families and must function in the same way for households with and without individuals younger than 18 years, the questions of the scale referring to this age group were excluded from the proposed scale. In the last Technical Workshop for the Analysis of the Household Measurement Scale of Food Insecurity, d the exclusion of the association between weight loss and food insecurity was approved, as well as the exclusion of a repetitive item: After these exclusions, seven questions remained from the original scale.
Based on these llei questions, two short-scale models for food insecurity assessment were tested. The first contained the seven questions Table 1A. Table 1 Proposals for a food insecurity scale that 20066 a reduced version of the Brazilian Food Insecurity Scale. Pelotas, RS, Southern Brazil, A Proposal with seven questions A Proposal with seven questions 1 In the last 3 months, were you worried that the food in your home would end before you could buy, receive or produce more food?
B Proposal with five questions 1 In the last 3 months, were you worried that the food in your home would end before you could buy, receive or produce more food? To construct the second model, a concordance analysis was performed with the full df, that is, we investigated which questions had the highest proportions of positive answers among families with food insecurity.
Eli the analysis, the second model was composed of the five questions that were considered most relevant regarding concordance with the full scale Table 1B. To compare the proposed models with the full version of the EBIA, initially, the concordance of positive answers of families with food insecurity was analyzed in each remaining question, so as leo detect the most relevant questions in the identification of food insecurity.
Subsequently, the models of seven and five questions were compared to the EBIA, which lwi considered the gold standard. The following parameters were calculated: In addition, an agreement test kappa index was performed. The analyses were carried out in the Stata lie, version In the Pelotas sample, As for food insecurity measured by the EBIA, we observed a prevalence of more than Figure A shows the questions with the highest number of positive answers in families with food insecurity questions 1, 2, 3, 5 and 6.
Based on these results, we arrived at the five-question version composed of questions 1, 2, 3, 5 and 6 of the EBIA. Table 1 shows the short version based on seven questions of the EBIA A and the short version based on five questions B. When 2006 compared the prevalence of food insecurity that was found using the two proposed models with the EBIA, we observed that, while the full scale found a prevalence of approximately In the PNDS sample, the following prevalences were found: Tabela lwi Prevalence of food insecurity according to the Brazilian Food Insecurity Scale and to the two short version proposals in two samples.
In the sensitivity and specificity analysis, the short version with seven questions presented excellent results when the same cut-off point adopted by the EBIA to classify food lek was considered one positive answer or more. Sensitivity was close to Table 3 Sensitivity and specificity of the short version of the Brazilian Food Insecurity Scale, with seven questions.
Similar results were found in the proposed model with five questions.
The cut-off point with best results was, once again, the same recommended by the traditional version. Once more, for this cut-off point, accuracy was very high: Table 4 Sensitivity and specificity of the short version of 22006 Brazilian Food Insecurity Scale, with five questions.
In the kappa statistical leu, both the proposed models presented high agreement with the full version of the food insecurity scale, both in the Pelotas sample and in the PNDS sample.
In the former, the seven-question version re an agreement of In the PNDS, both proposals presented an agreement of Independently of the size of the proposed short version, both models showed high sensitivity and specificity when compared to the EBIA, a method that is considered the gold standard.
In addition, the proposed models were accurate when they measured the prevalence of food insecurity, and their results were similar to those found by the original version. We highlight that this is lwi first study that proposes a short version to measure food insecurity based on the EBIA. However, food insecurity is not easily measured, as diverse factors are associated with this condition, such as skin color, level of schooling and gender of the person of reference in the household, fg and must be dd in the assessment.
The short version dee proposed here do not aim to replace the EBIA, as they do not measure the degrees of intensity of food insecurity and do not detect families that live in hunger situation, ce is characterized by a scenario of severe food insecurity. The first scale that proposed to measure the household food insecurity level was created at the beginning of the s in the United States of America.
The differential of the present study was the use of two samples, one from a poor area of a medium-sized city in Brazil, and the other, representative of Brazilian women of childbearing age, which made the analysis become more robust. However, some limitations of the proposed instrument are: Given the above-mentioned circumstances and reasons, we suggest the use of the proposed model with five questions, as its results were very similar to the original scale but with a lower number of questions compared to the proposed model with seven questions.
In certain cases, like studies with very large samples, 14 questions increase the answering time; thus, the short version of the instrument will allow tracking the families in a food insecurity situation. If there is interest in verifying the food insecurity intensity degrees, the full scale can be subsequently administered only to the families classified with food insecurity by the short version.
Furthermore, many studies have used pei insecurity in a dichotomous way presence or absenceand, along this line, the short version is also an option of instrument. To conclude, it is necessary to apply the short version with five questions to population-based studies, in populations from different regions of Brazil, in order to attest its use as a food insecurity tracker and aid studies that investigate this condition, as well as the programs that aim to combat this problem.
Development of a Spanish-language version of the U. The effectiveness of a short form of the Household Food Security Scale. Cad Saude Publica, Mild but not light or severe food insecurity is associated with obesity among Brazilian women.
The precarious livelihood in waste dumps: This study aimed to propose a short version of the Brazilian Food Insecurity Scale. Figure Percentage of positive answers among families with food insecurity in the questionsa that remained in the proposal for a short version based on the Brazilian Food Insecurity Scale; A Pelotas sample, B sample of the National Survey on Demography and Health.
Segur Aliment Nutr, Am J Public Health. An adapted version of the U.
Department of Agriculture Food Insecurity module is a valid tool for assessing household food insecurity in Campinas, Brazil. Share this article Bookmarks.