Validity and reliability of the Arabic version of the Household Food Insecurity Access Scale in rural Lebanon

Abstract

Objective: To assess the validity and reliability of the Arabic version of the Household Food Insecurity Access Scale (HFIAS) in rural Lebanon. Design: A cross-sectional study on a sample of households with at least one child aged 0-2 years. In a one-to-one interview, participants completed an adapted Arabic version of the HFIAS. In order to evaluate the validity of the HFIAS, basic sociodemographic information, anthropometric measurements of the mother and child, and dietary intake data of the child were obtained. In order to examine reproducibility, the HFIAS was re-administered after 3 months. Setting: Rural Lebanon. Subjects: Mother and child pairs (n 150). Results: Factor analysis of HFIAS items revealed two factors: 'insufficient food quality' and 'insufficient food quantity'. Using Pearson's correlation, food insecurity was inversely associated with mother's and father's education levels, number of cars and electrical appliances in the household, income, weight-for-age and lengthfor-age of the child and the child's dietary adequacy. In contrast, mother's BMI and crowding index were positively associated with food insecurity scores (P , 0?05 for all correlations). Cronbach's a of the scale was 0?91. A moderate correlation was observed between the two administrations of the questionnaire (intra-class correlation 5 0?58; P , 0?05). Conclusions: Our findings indicated that the adapted Arabic version of the HFIAS is a valid and reliable tool to assess food insecurity in rural Lebanon, lending further evidence to the utility of the HFIAS in assessing food insecurity in culturally diverse populations.

Household food insecurity is associated with a higher burden of obesity and risk of dietary inadequacies among mothers in Beirut, Lebanon

“…Findings from the present study show that almost 50% of interviewed households reported food insecurity with 42% suffering from moderate to severe food insecurity and 8% living with mild food insecurity. The prevalence of moderate to severe food insecurity among Beirut residents was found to be higher than that reported earlier by rural households in the Bekaa region and another semi-urban Southern Lebanese population (34% and 42%, respectively) [11, 12]. However, comparable food insecurity levels to those reported in Greater Beirut area were observed among urban communities within LMICs with rates ranging between 34.4% in Ho Chi Min City, Vietnam [49] to 74.6% in an urban area in Tamil Nadu, India [50] and 81% among urban households in Quito, the 2nd largest city in Ecuador [51].…”

“…The Arabic version of the HFIAS was also tested for criterion-related validity and showed strong and consistent associations with various household characteristics, including total number of children in the household, family monthly income, crowding index, educational levels of mother and father, and number of cars. In addition, the same tool was found to be significantly associated with anthropometric measures [11]. This 9-question scale produces a total score between 0 and 27 with higher scores indicating greater food insecurity [33].…”

“…However, the food security status of Lebanese households has not been adequately explored nor was the association between household food security and nutritional status of vulnerable groups, particularly mothers. To date, only two published studies in Lebanon, primarily validating the use of food security assessment tools showed that moderate to severe HFIS were as high as 34% and 42% among Lebanese households in the rural Bekaa region [11] and those in a semi-urban area in the South of Lebanon [12], respectively.…”

Nutrition security is an integral component of food security

“…In Lebanon, for example, the AFFSS determined that 42% of Lebanese citizens living in the south of the country were food and nutrition insecure, and 62% of Palestinian refugees living in Lebanon were food and nutrition insecure (Sayhoun et al 2014). Such elevated levels are relatively consistent with findings from the HFIAS, which showed that nearly 52% of Lebanese households in the Bekaa Valley are food and nutrition insecure (Naja et al 2014) (Table 1). …”

“…Both (a) and (b) were adapted by researchers at the American University of Beirut (AUB) from tools originally developed by the United States Agency for International Development (USAID). The AFFSS and HFIAS rely on survey responses, anthropomorphic measurements, and dietary intake information (Naja et al 2014;Sayhoun et al 2014). …”