Protocol - Food Insecurity

Six-Item Standard Measure from USDA Economic Research Service

1. I'm going to read you two statements that people have made about their food situation. Please tell me whether the statement was OFTEN, SOMETIMES, or NEVER true for (you/you and the other members of your household) in the last 12 months.

The first statement is, "The food that (I/we) bought just didn't last, and (I/we) didn't have money to get more." Was that often, sometimes, or never true for (you/your household) in the last 12 months?

1[ ]Often true

2[ ]Sometimes true

3[ ]Never true

[ ] Don't know

[ ] Refused

2. "(I/we) couldn't afford to eat balanced meals." Was that often, sometimes, or never true for (you/your household) in the last 12 months?

1[ ]Often true

2[ ]Sometimes true

3[ ]Never true

[ ] Don’t know

[ ] Refused

3. In the last 12 months, since (date 12 months ago) did (you/you or other adults in your household) ever cut the size of your meals or skip meals because there wasn't enough money for food?

1[ ]Yes

2[ ]No (GO TO 5)

[ ] Don’t know (GO TO 5)

[ ] Refused (GO TO 5)

Optional Screener: If any of the first 3 questions are answered affirmatively (i.e., if either Q1 or Q2 are "often true" or "sometimes true" or Q3 is "yes"), proceed to the next question. Otherwise, skip to end.

3a. [Ask only if Q3 = YES] How often did this happen—almost every month, some months but not every month, or in only 1 or 2 months?

1[ ]Almost every month

2[ ]Some months but not every month 

3[ ]Only 1 or 2 months

[ ] Don’t know

[ ] Refused

4. In the last 12 months, did you ever eat less than you felt you should because there wasn't enough money to buy food?

1[ ]Yes

2[ ]No

[ ] Don’t know

[ ] Refused

5. In the last 12 months, were you ever hungry but didn't eat because you couldn't afford enough food?

1[ ]Yes

2[ ]No

[ ] Don’t know

[ ] Refused

END

It may be noted that this set of six items constitutes the full set of adult items within the intermediate range of severity captured by the full scale derived from the core module. This particular set has been shown to be the strongest available 6-item set, across households both with and without children, for achieving the most accurate. Guide to Measuring Household Food Security -- 200061TRANSITION/LEADER.   

If the placement of items in your survey makes the transitional or introductory sentence unnecessary, you may add the word “Now” to the beginning of question 1: “Now I’m going to read you...."

FILL INSTRUCTIONS.   

Select the appropriate fill from parenthetical choices depending on the number of persons and number of adults in the household. If this information is unknown, or very few single-adult households are included in your sample, the plural forms may be used throughout.

USING AN INTERNAL SCREENER.

The 6-item set can be used with an optional internal screener, comparable to the first-level internal screen used in the 18-item core module. Testing has shown that a screen placed after the first three questions in the 6-item sequence causes a negligible misclassification of food-insecure households (false negative classifications) The procedure results in a 0.2 percent reduction in the number of households identified as food insecure without hunger and a zero loss of households identified as food insecure with hunger - i.e., this screen has no effect on the power of the scale to classify households with hunger.

CODING THE DATA FOR SCALING.

• Responses of “often” or “sometimes” on questions 1 and 2, and “yes” on 3, 4, and 5 are coded as affirmative (yes).
• Responses of “almost every month” and “some months but not every month” on 3a are coded as affirmative (yes).
• The sum of affirmative responses to the six questions in the module is the household’s raw score on the scale.

MISSING VALUES. Missing values as the result of item nonresponse ("Don’t know" or Refused) may be handled the same way in scoring the standard 6-item data sets as in scoring the full core-module data (Guide to Measuring Household Food Security, Chapter 3 "Imputing Missing Values for Households with Incomplete Responses").

Food security status is assigned as follows:

• Raw score 0-1—High or marginal food security (raw score 1 may be considered marginal food security, but a large proportion of households that would be measured as having marginal food security using the household or adult scale will have raw score zero on the six-item scale)
• Raw score 2-4—Low food security
• Raw score 5-6—Very low food security

For some reporting purposes, the food security status of households with raw score 0-1 is described as food secure and the two categories “low food security” and “very low food security” in combination are referred to as food insecure.

For statistical procedures that require an interval-level measure, the following scale scores, based on the Rasch measurement model may be used: 

However, no interval-level score is defined for households that affirm no items. (They are food secure, but the extent to which their food security differs from households that affirm one item is not known.)