TY - JOUR
T1 - Reliability and validity of an individually focused food insecurity access scale for assessing inadequate access to food among pregnant Ugandan women of mixed HIV status
AU - Natamba, Barnabas K.
AU - Kilama, Hillary
AU - Arbach, Angela
AU - Achan, Jane
AU - Griffiths, Jeffrey K.
AU - Young, Sera L.
PY - 2015/7/30
Y1 - 2015/7/30
N2 - Objective To determine the reliability, validity and correlates of measures of food insecurity (FI) obtained using an individually focused food insecurity access scale (IFIAS) among pregnant women of mixed HIV status in northern Uganda. Design A mixed-methods study involving cognitive interviews nested within a cross-sectional survey. Setting The antenatal care clinic of Gulu Regional Referral Hospital. Subjects Survey respondents included 403 pregnant women, recruited in a ratio of one HIV-infected to two HIV-uninfected respondents, twenty-six (nine of them HIV-infected) of whom were asked to participate in the cognitive interviews. Results Over 80 % of cognitive interview participants reported understanding the respective meanings of six of the nine items (i.e. items 4 to 9) on the IFIAS. Two main factors emerged from rotated exploratory factor analysis of the IFIAS: mild to moderate FI (IFIAS items 1-6) and severe FI (items 7-9). Together, they explained 90·4 % of the FI measure's variance. The full IFIAS and the two subscales had moderate to high internal consistency (Cronbach's α ranged from 0.75 to 0.87). Dose-response associations between IFIAS scores, and measures of socio-economic status and women's diet quality, were observed. Multivariate linear regression revealed significant positive associations between IFIAS scores and HIV infection, maternal age, number of children and a history of internal displacement. IFIAS scores were negatively associated with women's diet diversity score, asset index and being employed. Conclusions The IFIAS showed strong reliability, validity and contextual relevance among women attending antenatal care in northern Uganda.
AB - Objective To determine the reliability, validity and correlates of measures of food insecurity (FI) obtained using an individually focused food insecurity access scale (IFIAS) among pregnant women of mixed HIV status in northern Uganda. Design A mixed-methods study involving cognitive interviews nested within a cross-sectional survey. Setting The antenatal care clinic of Gulu Regional Referral Hospital. Subjects Survey respondents included 403 pregnant women, recruited in a ratio of one HIV-infected to two HIV-uninfected respondents, twenty-six (nine of them HIV-infected) of whom were asked to participate in the cognitive interviews. Results Over 80 % of cognitive interview participants reported understanding the respective meanings of six of the nine items (i.e. items 4 to 9) on the IFIAS. Two main factors emerged from rotated exploratory factor analysis of the IFIAS: mild to moderate FI (IFIAS items 1-6) and severe FI (items 7-9). Together, they explained 90·4 % of the FI measure's variance. The full IFIAS and the two subscales had moderate to high internal consistency (Cronbach's α ranged from 0.75 to 0.87). Dose-response associations between IFIAS scores, and measures of socio-economic status and women's diet quality, were observed. Multivariate linear regression revealed significant positive associations between IFIAS scores and HIV infection, maternal age, number of children and a history of internal displacement. IFIAS scores were negatively associated with women's diet diversity score, asset index and being employed. Conclusions The IFIAS showed strong reliability, validity and contextual relevance among women attending antenatal care in northern Uganda.
KW - Africa
KW - Food access
KW - Food security
KW - HIV
KW - Pregnancy
KW - Uganda
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U2 - 10.1017/S1368980014001669
DO - 10.1017/S1368980014001669
M3 - Review article
C2 - 25171462
AN - SCOPUS:84948424762
SN - 1368-9800
VL - 18
SP - 2895
EP - 2905
JO - Public Health Nutrition
JF - Public Health Nutrition
IS - 16
ER -