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Depression has been linked to food security, particularly among low-income mothers. However, less is known about the relationship between CHAOS (Confusion, Hubbub, and Order Scale), a measure of family functioning such as timeliness and order, and varying levels food security. The purpose of this paper was to evaluate the relationship between depression, CHAOS, and sociodemographics on the level of food insecurity in a cross-sectional sample of low-income households with children, ages 0-18 years. Participants were recruited from low-income communities in a medium sized Midwestern city in the United States. Eligible participants were =19 years of age, a parent or primary caregiver to at least one child, and English- or Spanish- speaking. Survey items included participation in the Supplemental Nutrition Assistance Program (SNAP), food security, depression, CHAOS, and sociodemographics/family characteristics. Descriptives and Chi-square tests were conducted for all variables. Potential covariates were assessed (e.g., age, income, education, race/ethnicity, sex, SNAP participation, number of children and adults in the household, and marital status) and included in the final logistic regression model through backward elimination. All statistics were conducted using SAS (version 9.4, SAS Institute Inc., Cary, NC). Participants (N=252) were 75% female, 42% Non-Hispanic Black, 31% Non-Hispanic White, 12% Hispanic, and 15% other race categories. The mean number of children in households was 2.33 (SD=1.58), and half of the respondents reported earning =$10,000/year. Chi-Square tests showed univariate relationships between study variables and varying household food security levels. Those in the "high" and "medium" groups for depression and CHAOS were both more likely than the "low" groups to experience low or very low food security. Income and education were also related to food security, with low levels of education and low income being associated with low or very low food security. Age, sex, race/ethnicity, and marital status were not associated with food security status. The fully adjusted logistic regression models of depression and CHAOS accounted for 10% and 14% of the variance in food security, respectively (depression: (OR=0.31, CI=0.15-0.65; pp In the current study, CHAOS demonstrated a stronger relationship with food security than depression, when controlling for sociodemographics. CHAOS is a measurement that has not been tested widely among food insecure populations, but has been shown to be an influencing factor on child development, and might help explain some of the stress experienced by low-income families. Understanding more about the psychological aspects of food insecurity may help inform the development of tailored interventions to alleviate food insecurity in low-income households, and ultimately improve health, achievement and related outcomes in children.

Purpose: The purpose of this study was to examine relationships between monthly Supplemental Nutrition Assistance Program (SNAP) benefit duration (i.e., the number of weeks each month a participants' SNAP benefits provide food), and five primary outcome variables: food security, three hunger-coping behavior scales (rationing food supplies, financial strategies, making trade-offs), and physiological hunger symptoms, among a sample of families with children 0-18 years currently receiving SNAP benefits. Methods: Baseline survey data were collected as part of a community-based intervention to alleviate child hunger. Participants included in the analytic sample were current SNAP recipients, parents (or caregivers), and 19 years of age and older (n=161). The survey assessed sociodemographics, household characteristics, food and financial assistance use, food security, three hunger-coping behavior scales, diet intake frequency, and one physiological hunger symptoms scale. The three hunger-coping scales and the physiological hunger scale were dichotomized into a "high" group (if above the sample median score) and a "low" group (if at or below the sample median score). Sociodemographic and family characteristics were included as covariates. Logistic regression models were used to assess relationships between monthly SNAP benefit duration and the five primary outcome variables in this study. Results: Respondents were predominately mothers/female caregivers (78%), a majority reported annual family incomes below $10,000 (58%), and 80% were experiencing "low" or "very low" food security. The sample was 43% non-Hispanic black, 30% non-Hispanic white, 10% Hispanic/Latino, 17% American Indian or other racial/ethnic groups. Monthly SNAP benefit duration (M=2.8, SD=1.0) was not likely driven by allotment amount, because households' percent of the federal poverty line (a proxy measure for allotment amount) was not associated with the number of weeks each month that benefits lasted (p=0.36). After controlling for relevant sociodemographic variables and household characteristics, the more weeks each month participants reported their SNAP benefits lasting, the lower their odds of experiencing "low" or "very low" food security (OR=0.444, 95%CI=0.259-0.761; p Conclusions: These findings suggest that monthly SNAP benefit duration may be useful as a proxy for SNAP allotment adequacy in the context of food security and hunger. Families that were not able to make monthly benefits extend as long as other families were more likely to be food insecure and experience "high" levels of physiological hunger symptoms. While associations with hunger-coping behaviors were only significant in univariate analysis, they were in the direction expected and should be further examined in future studies as these behaviors may be exacerbate, buffer, or be symptoms of the experience of food insecurity and hunger among low-income families. Policies are needed to better tailor SNAP benefit allotments to the needs of disadvantaged families, and research and programming is needed to investigate ways these families can better utilize their current allotments as a potential path to address food insecurity and hunger.

Purpose To examine daily fruit and vegetable (FV) intake frequency by household food security status (high food security, marginal food security, low food security, and very low food security), and scores on three hunger-coping behavior scales (i.e., "rationing food supplies," "financial strategies," and "trade-off strategies"), and one physiological hunger symptoms scale among a very low-income population in the Midwestern United States. Methods Adult participants (aged 19 and older and caregivers to at least one child aged 0-18) were recruited from public libraries, food pantries, and other community locations to participate in a cross-sectional self-administered survey (n = 306). The primary outcome variable was daily FV intake frequency, measured from five items from the 16-item NYPANS dietary screener (fruit, green salad, carrots, other vegetables, and non-fried potatoes). These items were converted into daily frequencies and then summed. Daily FV intake frequency was also log transformed to meet statistical model assumptions. The main independent variables in this study were household food security (measured using the 6-item USDA Household Food Security Survey Module), scores on three 5-item hunger-coping behavior scales (max scores = 5), and one 5-item physiological hunger symptoms scale (max scores = 5). Potential sociodemographic and household characteristics (e.g., sex, age, race/ethnicity, education, income, marital status, food assistance, income assistance, food pantry use, household child to adult ratio, and automobile access) were assessed as potential covariates. Generalized linear models were used to assess the relationship between independent variables and daily FV intake frequency. Results 278 participants provided complete data for the outcome variable and were included in the sample. The sample was 73% female, 45% African American, 14% Hispanic, and 28% Caucasian. A majority of participants (60%) reported annual household incomes under $15,000. A high proportion of participants (42%) had very lowfood security, as compared to the national average of 6%. Participants reported consuming FV 2.40 times per day (SD=1.76) on average. Compared the high food secure group (In adjusted models), being in the "very low" food security group was associated with a 26% decrease, on average, in daily FV intake frequency (exp(ß)=0.74, 95%CI=0.61-0.88, p Conclusions Compared to the high food secure group, those in the "very low" food secure group reported a significantly lower mean daily FV intake frequency, but not those in the "low" food secure group. This emphasizes the need to examine the "low" and "very low" food secure groups separately when studying factors associated with diet. Engaging in hunger-coping behaviors and experiencing physiological hunger symptoms was associated with decreased daily FV intake frequency. It is not clear if the hunger coping-behaviors themselves directly lead to decreased daily FV intake frequency, or if they were a marker for food insecurity and associated economic distress. These constructs and relationships should be examined in future studies. Programs and policies, which seek to promote fruit and vegetable intake among low-income populations, should target the "very low" food secure as the most at-risk for low intake. Also, researchers and community organizations working with food insecure groups could potentially measure hunger-coping behaviors and hunger symptoms in a complementary fashion to traditional measures of food insecurity to gain more contextual information about the experiences of this population.

This pre-post study used a mixed-methods approach to examine the impact of a family-based weight management program among a low-income population. Smart Choices for Healthy Families was developed through an integrated research-practice partnership and piloted with 26 children and parents (50% boys; mean age = 10.5 years; 54% Black) who were referred by their pediatrician. Smart Choices included six biweekly group sessions and six automated telephone-counseling calls over 3 months. Children displayed reduced body mass index z-scores (p less than 0.05), increased lean muscle mass (p less than 0.001), and increased quality of life (p less than 0.0001). Follow-up interviews indicated that physicians valued the lay leaders' ability to provide lifestyle education, whereas lay leaders extended their reach to more community members. Parents wanted to become positive role models and found that the calls maintained focus on goals. Smart Choices shows promise to initiate weight management for children in low-income families. (Contains 1 figure and 3 tables.)

Abstract Background The reach and representativeness are seldom examined in worksite weight loss studies. This paper describes and illustrates a method for directly assessing the reach and representativeness of a internet-based worksite weight loss program. Methods A brief health survey (BHS) was administered, between January 2008 and November 2009, to employees at 19 worksites in Southwest Virginia. The BHS included demographic, behavioral, and health questions. All employees were blinded to the existence of a future weight loss program until the completion of the BHS. Results The BHS has a participation rate of 66 percent and the subsequent weight loss program has a participation rate of 30 percent. Employees from higher income households, with higher education levels and health literacy proficiency were significantly more likely to participate in the program (p's < .01). Conclusions Worksite weight loss programs should include targeted marketing strategies to engage employees with lower income, education, and health literacy.

The goal of the U.S. Department of Agriculture’s Supplemental Nutrition Assistance Program (SNAP) is to assist food insecure households by providing federally allocated funds to increase purchasing power and ultimately achieve a more nutritious diet; however, working poor households tend to be underserved by SNAP. This study identified factors associated with SNAP participation in a nationally representative sample of the working poor (adults with household incomes ≤ 130% of the poverty level who worked 27 or more weeks during the year). Data were from the 2012 American Community Survey. Multivariable logistic regression was used to examine independent factors associated with SNAP participation. Adjusting for all other factors and state of residence, those more likely to participate in SNAP included those who were women; younger; non-Hispanic black or Hispanic; separated/divorced; less educated; U.S. citizens; English-speaking; disabled; with no health insurance; on government health plan; moved within the past year; lived in household with no access to a vehicle; paid more for electricity; multigenerational; and those who had at least one child member or one or more elderly members (P < .05, for each). SNAP outreach and policy may be more effective by targeting the working poor, specifically segments of the population who are less likely to participate in SNAP. [ABSTRACT FROM PUBLISHER]