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Overall, centers lacked parental outreach, staff training, and funding/resources to support nutrition and PA. These results provide insight into where child care centers within low-income, rural communities may need assistance to help prevent childhood obesity.

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Background: Prior research has indicated a varying relationship of food security and obesity risk between men and women yet factors affecting this relationship are unclear. Objective: The objective of this study was to examine factors related to the gender disparity in the food insecurity–obesity paradox within a sample of low-income parents. Methods: Low-income cohabiting mothers and father pairs (n = 25) living with their child were interviewed individually using the United States Department of Agriculture Household Food Security Module, Center for Epidemiological Studies Depression Scale, and Coping Strategies Index to examine gendered factors related to the food insecurity–obesity paradox. Results: There was a significant ( P = .003) difference in report of adults in the household sacrificing consumption to feed young children between mothers (2.91 ± 0.92) and fathers (3.59 ± 0.73), with mothers reporting greater sacrifice and compromised diet quality to feed their children, but no significant correlation among body mass index, depression, and food insecurity was detected. Conclusions: Food insecure mothers may be more likely to compromise their diet quality to feed their children than fathers. This could help explain why the food insecurity–obesity paradox is significant only in women, and this work gives insights into gender-based differential consequences of food insecurity.

Food insecurity, or limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways, affects more than 10% of Americans. The U.S. Department of Agriculture's 18‐item Household Food Security Survey Module (HFSSM) is the most common measure used in the United States to assess food insecurity. This measure is to be completed by one adult who reports on the severity of disruptions in the quality and quantity of the household food supply. Recent work suggests that men and women might respond differently to some of the items in this measure. Therefore, the aim of the current study was to further explore how men and women interpret each of the items and specific concepts in this measure. Pairs (n = 25) of low‐income and food‐insecure mothers and fathers of children aged 2.5–10 years participated in one‐on‐one interviews to answer the HFSSM questions using the think‐aloud method. The data were analyzed using basic inductive qualitative methods, and the findings suggest that gender is related to interpretation of key concepts relevant to food insecurity including “household,” “balanced meal,” and “worry.” These findings have policy implications for the use of this measure as a national benchmark of food insecurity such as the potential need for an additional, complementary instrument to include several male reference questions with different terminology.

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