The Four Domain Food Insecurity Scale (4D-FIS): development and evaluation of a complementary food insecurity measure

Cassandra M Johnson; Alice S Ammerman; Linda S Adair; Allison E Aiello; Valerie L Flax; Sinikka Elliott; Annie Hardison-Moody; Sarah K Bowen

doi:10.1093/tbm/ibaa125

The Four Domain Food Insecurity Scale (4D-FIS): development and evaluation of a complementary food insecurity measure

Transl Behav Med. 2020 Dec 31;10(6):1255-1265. doi: 10.1093/tbm/ibaa125.

Authors

Cassandra M Johnson¹, Alice S Ammerman², Linda S Adair³, Allison E Aiello⁴, Valerie L Flax⁵, Sinikka Elliott⁶, Annie Hardison-Moody⁷, Sarah K Bowen⁸

Affiliations

¹ Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, San Marcos, TX, USA.
² Department of Nutrition and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
³ Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁴ Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁵ Food, Nutrition and Obesity Policy Research, RTI International, Research Triangle Park, NC, USA.
⁶ Department of Sociology, University of British Columbia, Vancouver, BC, Canada.
⁷ Department of Agricultural and Human Sciences, North Carolina State University, Raleigh, NC, USA.
⁸ Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC, USA.

Abstract

The U.S. Department of Agriculture (USDA) Food Security Survey Module (FSSM) is a valuable tool for measuring food insecurity, but it has limitations for capturing experiences of less severe food insecurity. To develop and test the Four Domain Food Insecurity Scale (4D-FIS), a complementary measure designed to assess all four domains of the food access dimension of food insecurity (quantitative, qualitative, psychological, and social).Low-income Black, Latina, and White women (n = 109) completed semi-structured (qualitative) and structured (quantitative) interviews. Interviewers separately administered two food insecurity scales, including the 4D-FIS and the USDA FSSM adult scale. A scoring protocol was developed to determine food insecurity status with the 4D-FIS. Analyses included a confirmatory factor analysis to examine the hypothesized structure of the 4D-FIS and an initial evaluation of reliability and validity. A four-factor model fit the data reasonably well as judged with fit indices. Results showed relatively high factor loadings and inter-factor correlations indicated that factors were distinct. Cronbach's alpha (ɑ) for the overall scale was 0.90 (subscale ɑ ranged from 0.69 to 0.91) and provided support for the scale's internal consistency reliability. There was fair overall agreement between the 4D-FIS and USDA FSSM adult scale, but agreement varied by category. Findings provide preliminary support for the 4D-FIS as a complementary measure of food insecurity, with implications for researchers, practitioners, and policymakers working in U.S. communities.

Keywords: Food insecurity, Food supply; Hunger; Nutrition surveys; Vulnerable populations.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Female
Food Insecurity*
Food Supply*
Humans
Poverty
Reproducibility of Results
Surveys and Questionnaires

Grants and funding

P2C HD050924/HD/NICHD NIH HHS/United States