Household food insecurity: a systematic review of the measuring instruments used in epidemiological studies

Abstract

Objective: To conduct a systematic review aimed at identifying and characterizing the experience-based household food security scales and to synthesize their psychometric properties.

Design: Search in the MEDLINE, LILACS and SciELO databases, using the descriptors ('food insecurity' OR 'food security') AND ('questionnaires' OR 'scales' OR 'validity' OR 'reliability'). There was no limitation on the period of publication. All articles had their titles and abstracts analysed by two reviewers. The studies of interest were read in their entirety and the relevant information extracted using a standard form.

Results: The initial bibliographic search identified 299 articles. Of these, the 159 that seemed to meet the criteria for inclusion were read fully. After consultation of the bibliographic references of these articles, twenty articles and five documents were added, as they satisfied the previously determined criteria for inclusion. Twenty-four different instruments were identified; all were brief and of easy application. The majority were devised in the USA. Forty-seven references reported results of psychometric studies. The instruments that presented the highest number of psychometric studies were the Core Food Security Measurement/Household Food Security Survey Module (CFSM/HFSSM) and the Self-Perceived Household Food Security Scale.

Conclusions: There are a number of structured scales available in the literature for characterization of household food insecurity. However, despite some psychometric studies already existing about the majority of the instruments, it is observed that, except for the studies of the CFSM/HFSSM, these are still restricted to appraisal of a few aspects of reliability and validity.

Keywords: Systematic review.

Fig. 1

Schematic representation of the systematic review

Fig. 2

Record of the development of the existing measuring instruments for detection of household food insecurity. Note: CSFII, Continuing Survey of Food Intake by Individuals; CCHIP, Community Childhood Hunger Identification Project; NHANES III_FIQ, Food Insecurity Questions of NHANES III; R/CS, Radimer/Cornell Scale; SPHFSS, Self-Perceived Household Food Security Scale; CFSM/HFSSM, Core Food Security Measurement/Household Food Security Survey Module; HFSSM-6SF, HFSSM Six-Item Short Form; R/CSm_a, Modified Radimer/Cornell Scale (a); CCHIP-m, Modified CCHIP; FIE, Food Insecurity by Elders; R/CSm_b, Modified Radimer/Cornell Scale (b); R/CSm_c, Modified Radimer/Cornell Scale (c); R/CSm_d, Modified Radimer/Cornell Scale (d); HFSB_a, Household Food Security of Bangladesh (a); EbMHFI, Experience-Based Measurement of Household Food Insecurity; HFIAS, Household Food Insecurity Access Scale; ELCSA, Latin American Food Security Measurement Scale; SAFSSM, Self-Administered Food Security Survey Module for Children Aged 12 and Older; NHANES III_FIQm, Modified Food Insecurity Questions of NHANES III; MHFI, Measurement of Household Food Insecurity; HFSSM-6SFm, Modified HFSSM Six-Item Short Form; HFSB_b, Household Food Security of Bangladesh (b); R/CSm_e, Modified Radimer/Cornell Scale (e); TAPFI, Tool to Assess Past Food Insecurity; IFI, Items of Food Insecurity; USDA, US Department of Agriculture. *NHANES III_FIQ are questions related to food insufficiency due to lack of income used NHANES III. The CCHIP was used in its development process, along with questions about food insecurity arising from the USDA Food Consumption Research. †In 2000, the USDA published the Guide to Measuring Household Food Security – Revised 2000 in which the CFSM is an update. This version was renamed HFSSM. CFSM and HFSSM must be considered as the same instrument because they contain exactly the same items. The only difference is in order of administration of the questions. ‡The ELCSA was developed from the linguistic and semantic variants of SPHFSS (Colombian Food Security Scale) and the Brazilian version of CFSM/HFSSM