Protocol - Food Insecurity

Six-Item Standard Measure from USDA Economic Research Service

These next questions are about the food eaten in your household in the last 12 months, since (current month) of last year and whether you were able to afford the food you need.

NOTE: If the placement of these items in the survey makes the transition/introductory sentence unnecessary, add the word "Now" to the beginning of question 1: "Now Im 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.

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 true, sometimes true, or never true for (you/your household) in the last 12 months - that is, since last (name of current month).

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?

[ ] Often true

[ ] Sometimes true

[ ] Never true

[ ] DK or 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?

[ ] Often true

[ ] Sometimes true

[ ] Never true

[ ] DK or Refused

3. In the last 12 months, since (name of current month) 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?

[ ] Yes

[ ] No (Skip 3a)

[ ] Don’t know (Skip 3a)

3a. [IF YES ABOVE, ASK] How often did this happen—almost every month, some months but not every month, or in only 1 or 2 months?

[ ] Almost every month

[ ] Some months but not every month 

[ ] Only 1 or 2 months

[ ] DK

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?

[ ] Yes

[ ] No

[ ] DK

5. In the last 12 months, were you ever hungry but didn't eat because there wasnt enough money for food?

[ ] Yes

[ ] No

[ ] DK

END

(1) Coding Responses and Assessing Households Food Security Status:

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 households raw score on the scale.

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.)

(2) Response Options: For interviewer-administered surveys, DK ("dont know") and "Refused" are blind responses - that is, they are not presented as response options but marked if volunteered. For self-administered surveys, "dont know" is presented as a response option.

(3) Screening: If it is important to minimize respondent burden, respondents may be screened after question 3. Households that have responded "never" to 1 and 2 and "no" to 3 may skip over the remaining questions and be assigned raw score zero. In pilot surveys intended to validate the module in a new cultural, linguistic, or survey context, however, screening should be avoided if possible and all questions should be administered to all respondents.

(4) 30-Day Reference Period: The questionnaire items may be modified to a 30-day reference period by changing the "last 12-month" references to "last 30 days." In this case, item 3a must be changed to read as follows:

3a. [IF YES ABOVE, ASK] In the last 30 days, how many days did this happen?

______ days

[ ] DK

Responses of 3 days or more are coded as "affirmative" responses.

(5) Self Administration: The six-item module has been used successfully in mail-out, take-home, and on-site self-administered surveys. For self-administration, question 3a may be presented in one of two ways:

• Indent 3a below 3 and direct the respondent to 3a with an arrow from the "Yes" response box of 3. In a parenthetical following the "No" response box of 3, instruct the respondent to skip question 3 and go to question 4.
• Present the following response options to question 3 and omit question 3a:
  • Yes, almost every month
  • Yes, some months but not every month
  • Yes, only 1 or 2 months
  • No
  
  In this case, either of the first two responses is scored as two affirmative responses, while "Yes, only 1 or 2 months" is scored as a single affirmative response.

The two approaches have been found to yield nearly equal results. The latter may be preferred because it usually reduces the proportion of respondents with missing information on how often this behavior occurred.