Food security of older children can be assessed using a standardized survey instrument

Cognitive interviewing methods were used to adapt questions from the U.S. Food Security Survey Module for administration to children. Individual concurrent probing techniques using standardized probes were utilized to assess understanding of the items with 20 African American children (10 males, 10 females, aged 11-13 y). Item wording and response sets were revised, and small groups of boys (n = 5) and girls (n = 14) aged 12-15 y were asked to complete the 9-item survey. Retrospective probing techniques were then used to assess comprehension of items and response sets. Nine items were then piloted in a middle school using a self-administered format. Three hundred forty-five surveys were returned. The majority of the students were between 12 and 15 y (n = 215). Scaling analysis of the 345 completed surveys using statistical methods based on the Rasch measurement model indicated that the module measured a single underlying phenomenon (food insecurity) with sufficient reliability to be a useful tool. The measurable range of food insecurity was about 6 times the estimated measurement error, indicating that the scale could identify 3 categories of food security with reasonable reliability. A survey instrument that reliably measures food security status of individual children can provide researchers with an important tool to assess more accurately the individual-level effects of food security on nutritional status and mental and physical health among this population.