Development and validation of an Arab family food security scale

The objective of this article was to describe 1) the validation of 2 similar but not identical food security modules used to collect data from 2 vulnerable populations, southern Lebanon residents (n = 815) and Palestinian refugees in Lebanon (n = 2501), and 2) the development and validation of an Arab Family Food Security Scale (AFFSS). The surveys used a cluster-randomized sampling design. The 2 food security subscales underwent face and construct validity. In addition, both of these tools and the AFFSS underwent psychometric assessment for internal validity by using statistical methods based on Item Response Theory. The food security questions tested by focus groups were understood and accepted in all regions of Lebanon. The food security subscales and the AFFSS had acceptable levels of internal consistency. The psychometric assessment confirmed that the 7 items of the AFFSS had good internal validity and reasonable reliability with item in-fits from 0.73 to 1.16. Food insecurity was identified among 42% of southern Lebanese and 62% of Palestinian refugee households. The determinants and consequences of food security measured in this study provide additional support for the validity of the modules. Using multivariate logistic regression, the higher the mean monthly income per household member and the higher the educational attainment of the head of household, the lower the risk of food insecurity [ORs (95% CIs): 0.99 (0.98, 0.99) and 0.66 (0.54, 0.80), respectively]. There was a strong significant association between food insecurity and lower food expenditure and lower intake of all food categories except for legumes, which was significantly associated in the opposite direction (P < 0.001). The odds of borrowing money and accepting gifts/donations were significantly higher among moderately and severely food-insecure households (P < 0.000). The AFFSS has been validated within Lebanon and can potentially be extended to other Arab-speaking populations.