Trauma-Informed Financial Empowerment Programming Improves Food Security Among Families With Young Children

Abstract

Objective: To determine how trauma-informed programming affects household food insecurity (HFI) over 12 months. Design: Change was assessed in HFI from baseline to 12 months in response to a single-arm cohort intervention. Measures were taken at baseline and in every quarter. Two participant groups were compared: participation in ≥4 sessions (full participation) vs participation in <4 sessions (low/no participation). Setting: Community-based setting in Philadelphia, Pennsylvania. Participants: A total of 372 parents of children aged <6 years, participating in Temporary Assistance for Needy Families and the Supplemental Nutrition Assistance Program, recruited from county assistance offices and community-based settings. Intervention: Trauma-informed programming incorporates healing-centered approaches to address previous exposures to trauma. Sixteen sessions addressed emotional management, social and family dynamics related to violence exposure and childhood adversity, and financial skills. Main Outcome Measures: Household food insecurity, as defined by the US Department of Agriculture Household Food Security Survey Module. Analysis: Mixed-effects logistic regression models were used to compare groups from baseline to 12 months, controlling for adverse childhood experiences, depression, and public assistance. Results: Those with full participation had 55% lower odds of facing HFI compared with the low/no participation group (adjusted odds ratio = 0.45; 95% confidence interval, 0.22−0.90). Conclusions and Implications: Trauma-informed programming can reduce the odds of HFI and may reduce trauma-related symptoms associated with depression and poverty.

Interventions to Address Food Insecurity Among Adults in Canada and the US

“…The miscellaneous category comprised 1 RCT and 5 before-after analyses, which included interventions such as educational programs and community gardens ( Table 1 ). 31 , 32 , 43 , 44 , 52 , 54 Three of the 5 before-after studies had similar outcomes that were associated with improvements in food insecurity 43 , 52 , 54 ( Figure 2 ).…”

“…A total of 39 publications, including 170 605 participants, met inclusion criteria ( Figure 1 ). Of these 39 studies, 8 were RCTs, 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 1 was a quasi-experimental study, 33 12 were before-after studies without controls, 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 9 were before-after studies with controls, 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 1 was a time-series study, 55 and 8 were cross-sectional studies. 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 Thirty-four studies were of interventions in the US, and 5 were of interventions in Canada.…”

Financial health as a measurable social determinant of health

“…All members provided written informed consent. Full methods and outcomes [41][42][43][44] of the Network can be found elsewhere [45]. The Drexel Institutional Review Board approved this study.…”

Systematic Review of Interventions Addressing Food Insecurity in Pregnant Women and New Mothers

“…An additional WIC visit reduced the odds of any household food insecurity Mridha et al [ 24 ] Bangladesh The provision of lipid-based nutrition supplements to pregnant and lactating women would result in positive nutritional change 4011 pregnant and post-partum women (6 months) 1047 in the experimental group and 2964 in the 3 control groups Cluster RCT Food supplementation 48 clusters received iron and folic acid and 16 clusters received lipid-based nutrition supplements Household Food Insecurity Access Score (HFIAS) Infants in the experimental group had higher weights and were less likely to be stunted. Household food security not reported Phojanakong et al [ 25 ] USA The effectiveness of a trauma-informed intervention to reduce household food insecurity 372 parents of children aged < 6 years, participating in Temporary Assistance for Needy Families and SNAP Mean age 28 years, 94.1% female, 91.1% Black, 75% high school or more Single-arm cohort intervention Counselling 16 sessions of trauma-informed programming incorporated healing-centred approaches to address previous exposures to trauma Household Food Security Survey Module (HFSSM) Full participation had 55% lower odds of facing HFI compared with the low/no participation group Raghunathan et al [ 26 ] India The effect of conditional cash transfers with the Mamata scheme on the delivery and uptake of nutrition interventions and household food security 1161 pregnant women and/or mothers with up to two live births with children aged 0–24 months Age: > 19 years, 25.8 no education 20.4%, primary school 17.1%, socioeconomic status: wealth SES quintile: 1 (low) 12.1% — 5 (highest) 26.6% Cohort study Cash transfer programme The Mamata scheme provided a partial wage compensation to pregnant and lactating mothers Direct payments were made in four instalments payable at the end of the second trimester, and at 3, 6, and 9 months after delivery, conditional on antenatal check-up, vaccination, counselling sessions and exclusive breastfeeding Household Food Insecurity Access Score (HFIAS) cash transfers were associated with decrease in the overall HFIAS score. Purchasing from the Public Distribution System was associated with a larger decrease in the overall food insecurity.…”