A Single Nutristep™ Question as a Food Insecurity Screening Tool
Bibliographic record
Abstract
Abstract BACKGROUND: Food insecurity could pose serious health risks, deficiencies, and be harmful to early children’s healthy growth and development. Many family health teams use the Nutrition Screening Tool for Every Preschooler (NutriSTEP™) as a tool to provide a fast, valid way to assess the eating habits of toddlers and preschoolers and identify individual kids at risk. Furthermore, the NutriSTEP™ questionnaire is being rolled out in Public Health Units in Ontario. OBJECTIVES: The objectives of this study were to assess the criterion and construct validity of the 1-item on the NutriSTEP™ questionnaire: “I have difficulty buying food I want to feed my child because food is expensive” for measuring food insecurity. DESIGN/METHODS: A cross-sectional study of healthy children, aged 18 months to 5 years, seen for primary care between June 2008 and January 2015 was conducted through the TARGet Kids! practice-based research network. A parent of each participant completed the NutriSTEP™ questionnaire for toddlers aged 18–35 months or for children aged 3–5 years. Parents also responded to the 2-item Food Insecurity Screen (which comes from the 18-item Household Food Security Survey). Criterion validity was evaluated by comparing the responses of the 1-item NutriSTEP™ to the 2-item FI Screen as a gold standard and testing the sensitivity, specificity, and likelihood ratios for a positive and negative result. Convergent validity (the correspondence between the 1-item screen and theoretically related variables) was assessed with multivariable logistic regression. RESULTS: 1174 children (mean age 37 months) were included: 53 (4.5%) children were categorized as food insecure. An affirmative response to the 1-item NutriSTEP™ had a sensitivity of 84.9% (95% CI: 72.4-93.3) and a specificity of 91.2 % (95% CI: 89.4- 92.8). A positive or food insecure NutriSTEP™ response is 9.6 times more likely to occur in a participant with a food insecure response than a food secure response to the FI Screen. A negative or food secure NutriSTEP™ response is 6 times less likely to occur in a participant with a food insecure response than a food secure response to the FI Screen. An affirmative response to the 1-item NutriSTEP™ was associated with increased odds of a low self-reported after-tax annual household income of $0 - $29,999 (adjusted odds ratio [aOR]: 7.6; (95% CI: 89.4- 92.8); P<0.001). CONCLUSION: Children who were food insecure were identified with the 1-item NutriSTEP™, suggesting that this single question may be an effective screening tool for food insecurity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.017 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".