Child-report food insecurity assessment measures: A scoping review.

Abstract

<h4>Background</h4>Experiences of household food insecurity are associated with a wide range of deleterious nutritional, developmental, psychological and social consequences for children. Children's distinct experiences of food insecurity, compared to adults, have been identified in diverse economic and cultural contexts. Yet historically, measurement of food insecurity in children has been predominantly reported by adult respondents on behalf of children, potentially underestimating prevalence and neglecting their unique perspectives. In response to this, child-report measures have been developed to assess food security status at both the individual and household level.<h4>Objectives</h4>To identify and characterise child self-report food insecurity assessment tools used globally, with particular interest in how children's perspectives have been included in measure development processes.<h4>Methods</h4>A scoping systematic literature review was conducted using PRISMA-ScR. Searches were conducted in four databases in January 2024 using keywords and MeSH terms. Data were extracted and synthesised relating to population and measure characteristics, validity and reliability metrics, and child involvement in measure development.<h4>Results</h4>A total of 169 papers employing child-report measures were included after screening. Most papers originated in North America, used a single-item and included children aged >12 years. Of the child-report measures identified (n = 33), most were not specifically validated in the population of use. Only a small number of included papers (n = 13) had the aim to specifically evaluate measure validity. The Child Food Insecurity Experiences Scale and Child Food Assessment Scale emerged as child-centred measures with comprehensive validity evidence.<h4>Conclusions</h4>Further child-centred validity testing, particularly with younger children (<12 years) is necessary to ensure validity of measures across age-groups and contexts. Ethical considerations when employing child-report measures, including how to best use tools across different child settings also warrant further exploration.