Validation of the Latin American and Caribbean Food Security Scale (ELCSA) for use in Samoa

Measuring food security accurately has implications for policies and programming designed to address both hunger and obesity risk among children.

We aimed to examine the validity of the Latin American and Caribbean Food Security Scale (ELCSA) for use in Samoa.

The ELCSA was administered verbally to 454 Samoan mothers who were participants in an ongoing longitudinal cohort study (the Ola Tuputupua'e Study). Internal consistency and construct validity were examined with Rasch modeling, which generated item severity and item infit statistics. Associations between food security and several cohort characteristics including maternal education, household income, and child dietary intake were examined to determine whether common associations present in the extant literature could be replicated. Face and content validity were explored through focus group discussions with n = 34 of the participants.

The ELCSA showed strong reliability and internal consistency and, with minor exceptions, participants clearly understood the survey questions. On the basis of Rasch modeling, the score thresholds for food insecurity used in the original tool are appropriate for use in Samoa. Many families in Samoa experience some degree of food insecurity, primarily driven by a lack of access to "healthy" foods, although extreme food insecurity was infrequent. The managed process of food insecurity is largely consistent with that found elsewhere, although uniquely protective factors such as continued subsistence farming and community food sharing mitigate the absolute lack of food for most families.

The Samoan translation of the 15-question ELCSA has validity for use among nonpregnant Samoan women with children. Although there are unique protective factors, food insecurity should be continuously monitored in Samoa with efforts made to provide resources to families experiencing extreme food insecurity.