VALIDATING THE EXPANDED FOOD SECURITY SCREENER AND HOME-DELIVERED MEAL PRIORITIZATION TOOL FOR ELIGIBLE INDIVIDUALS

Abstract

The Expanded Food Security Screener (FSS-Exp) is a screening tool for determining food insecurity risk based on individuals’ physical, economic, and social access to food. The FSS-Exp is the only tool that provides a simple and quick method for identifying which home-delivered meal (HDM) applicants are most vulnerable. However, further testing is required to determine the tool’s validity when compared with health and food-related measures associated with food security. Therefore, this study aimed to validate the FSS-Exp and HDM prioritization tool using concurrent and construct validity methods. To evaluate the concurrent validity, we examined the correlations between the FSS-Exp and other health and food-related tools such as SF-36, MOS-SSS, SWFL, SNAQ, and DST, which were associated with economic food insecurity and physical limitation To determine construct validity using the known-groups approach, we compared those health and food-related scores among participants grouped by different access barriers to food (priority levels). The results showed that the FSS-Exp correlated moderately (r=0.20 to 0.33) with other “gold standard” measures: SF-36, MOS-SSS, and SWFL. Furthermore, our results showed that individuals categorized as priority level A and B had significantly lower mean scores than priority level E for the SF-36 (HRQL) summary measures (p<0.05), SWFL (p<0.05), and the tangible social support ( p<0.01). Thus, the FSS-Exp was shown to be a valid measure in identifying and prioritizing older adults with physical and/or economic access to food, which is especially important for HDM programs with limited resources experiencing increased demand for services. For HDM programs which exist to serve vulnerable older adults, using the validated FSS-Exp tool can help identify those who are most vulnerable and in need of immediate service.