QUESTIONNAIRE-BASED MEASURES ARE VALID FOR THE IDENTIFICATION OF RURAL HOUSEHOLDS WITH HUNGER AND FOOD INSECURITY

This study assessed the validity of questionnaire-based measures for t he identification of rural households with hunger and food insecurity. Data used were from a 1993 survey of 193 households with women and ch ildren living at home in a rural county. Two interviews provided data on demographics, factors contributing to food insecurity, coping strat egies, fruit and vegetable consumption, disordered eating behaviors, h eight, weight, dietary recall and household food-stores inventory. Thi s information was used to develop a definitive criterion measure for h unger and food insecurity to compare with hunger and food insecurity i tems from Radimer/Cornell, the Community Childhood Hunger Identificati on Project (CCHIP) and the Third National Health and Nutrition Examina tion Survey (NHANES III). The Radimer/Cornell and CCHIP questionnaire- based measures had good specificity (i.e., percentage of truly food se cure correctly classified; 63-71%) and excellent sensitivity (i.e., pe rcentage of truly food insecure correctly classified; 84-89%) when com pared with the criterion measure. Estimates of the prevalence of house hold food insecurity from the criterion, Radimer/Cornell and CCHIP mea sures were almost identical, The overall agreement of the Radimer/Corn ell and CCHIP measures was very good. These measures can be validly us ed to screen for hunger and food insecurity among rural households sim ilar to those studied and to target subpopulations for food programs. The NHANES III item alone had excellent specificity but poor sensitivi ty, and underestimated prevalence.