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The Brazilian Household Food Insecurity Measurement Scale (EBIA) has eight general/adult items applied in all households and six additional items exclusively asked in households with children and/or adolescents (HHCA). Continuing an investigation programme on the adequacy of model-based cut-off points for EBIA, the present study aims to: (i) explore the capacity of properly stratifying HHCA according to food insecurity (FI) severity level by applying only the eight ‘generic’ items; and (ii) compare it against the fourteen-item scale.
Latent class factor analysis (LCFA) models were applied to the answers to the eight general/adult items to identify latent groups corresponding to FI levels and optimal group-separating cut-off points. Analyses involved a thorough classification agreement evaluation and were performed at the national level and by macro-regions.
Data derived from the cross-sectional Brazilian National Household Sample Survey of 2013.
A nationally representative sample of 116 543 households.
In all households and investigated domains, LCFA detected four distinct household food (in)security groups (food security and three levels of severity of FI) and the same set of cut-off points (1/2, 4/5 and 6/7). Misclassification in the aggregate data was 0·66 % in adult-only households and 1·06 % in HHCA. Comparison of the scale reduced to eight items with the ‘original’ fourteen-item scale demonstrated consistency in the classification. In HHCA, the agreement between both classifications was 96·2 %.
Results indicate the eight ‘generic’ items in HHCA can be reliably used when it is not possible to apply the fourteen-item scale.
To conduct a systematic review aimed at identifying and characterizing the experience-based household food security scales and to synthesize their psychometric properties.
Search in the MEDLINE, LILACS and SciELO databases, using the descriptors (‘food insecurity’ OR ‘food security’) AND (‘questionnaires’ OR ‘scales’ OR ‘validity’ OR ‘reliability’). There was no limitation on the period of publication. All articles had their titles and abstracts analysed by two reviewers. The studies of interest were read in their entirety and the relevant information extracted using a standard form.
The initial bibliographic search identified 299 articles. Of these, the 159 that seemed to meet the criteria for inclusion were read fully. After consultation of the bibliographic references of these articles, twenty articles and five documents were added, as they satisfied the previously determined criteria for inclusion. Twenty-four different instruments were identified; all were brief and of easy application. The majority were devised in the USA. Forty-seven references reported results of psychometric studies. The instruments that presented the highest number of psychometric studies were the Core Food Security Measurement/Household Food Security Survey Module (CFSM/HFSSM) and the Self-Perceived Household Food Security Scale.
There are a number of structured scales available in the literature for characterization of household food insecurity. However, despite some psychometric studies already existing about the majority of the instruments, it is observed that, except for the studies of the CFSM/HFSSM, these are still restricted to appraisal of a few aspects of reliability and validity.
To investigate the role of severe physical violence during pregnancy (SPVP) between intimate partners in early cessation of exclusive breast-feeding (EBF).
A health services survey. The revised Conflict Tactics Scale was used to characterize SPVP; premature breast-feeding cessation was identified using a current status data approach, which was based on the information reported from food recall during the preceding 7 d. The cumulative hazard function was estimated by complementary log–log transformation models, which allowed the ensuing estimation of early breast-feeding cessation rates in different age groups and the ratio of rates of weaning between women exposed and not exposed to violence.
Five large public primary health-care facilities of Rio de Janeiro, Brazil.
The sample comprised 811 randomly selected mothers of children under 5 months of age who were waiting to be consulted.
SPVP is an independent risk factor of cessation of EBF since, after controlling for socio-economic, demographic, reproductive and lifestyle variables, women exposed to violence presented an incidence density that was 31 % higher than those who were not exposed (hazard ratio = 1·30, 95 % CI 1·01, 1·69).
The findings corroborate the hypothesis that SPVP is an important risk factor for EBF. This indicates the need for incentives to adequately train health-care personnel in dealing with lactating women in order to gain a broader view of breast-feeding beyond the biological aspects of lactation, including the maternal psychological dimension.
The literature on household-based measures of mental health in developing countries is limited. Much emphasis is currently placed on the physical well-being of mothers in relation to child care, yet their mental well-being receives little attention. The present study measures maternal mental health in the largest squatter settlement of Rio de Janeiro, Brazil. The proportion of mothers who were probable cases of mental ill-health was 36%.
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