Food security, defined as the capacity to acquire preferred food at all times, can manifest in many dimensions. Following a mixed methods approach used in India and Burkina Faso, we developed a 58-item experience-based measure in the Peruvian Amazon, based on investigator observations, relevant literature, and pre-testing with community field workers. The tool encompasses seven dimensions of food security and included measures of (1) food purchases, frequency of purchase, and location of acquisition, (2) food expenses, (3) coping mechanisms, (4) preparation of leftover food, (5) food safety (refrigerator access), (6) fishing intensity and (7) selling food. The survey was piloted among 35 randomly selected families from the Malnutrition Enteric Disease (MAL-ED) birth cohort in Santa Clara, Peru and the surrounding communities. Subsequently, based on a focus group discussion, a pile-sorting exercise, and pilot results, we reduced the survey to 36 items to be collected monthly among 203 MAL-ED households from November 2013 to January 2015. Validity and reliability were then assessed using principal component analysis and exploratory factor analysis, revealing four groups of purchase and coping strategy behaviors: (1) Sweets and sugary items, (2) Less preferred, (3) More preferred, and (4) Minimum meal. Internal consistency of the final 22-item scale had an acceptable cutoff of Cronbach’s α of 0.73. Criterion and construct validity of the factor groups revealed there were: (1) food purchase patterns that were distinctive to quality and quantity aspects of the Household Food Insecurity Access scale, (2) unique correlations of child’s intake of fats, animal source protein, fiber and other micronutrients, (3) household purchase patterns from the “more preferred” group (fish, red meat) associated with child’s weight-for-age. Food purchase and frequency, and context-specific behaviors at the household level can be used as surrogates for dietary intake patterns and nutritional status among children. Food purchase and frequency measurement is a quick, objective, non-intrusive survey method that could be used as an indicator for acute changes in household food security status with appropriate pilot testing and validation.

中文翻译：

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使用秘鲁亚马逊地区新开发和验证的工具，指示家庭食物获取不安全、儿童饮食多样性和摄入量以及营养状况的食物购买模式

粮食安全，即在任何时候都能获得首选食物的能力，可以体现在许多方面。遵循在印度和布基纳法索使用的混合方法方法，我们在秘鲁亚马逊地区开发了一个 58 项基于经验的测量，基于调查员观察、相关文献和社区现场工作人员的预测试。该工具包含粮食安全的七个维度，包括以下措施：(1) 粮食采购、采购频率和采购地点，(2) 粮食费用，(3) 应对机制，(4) 剩余食物的准备，(5)食品安全（冰箱使用），（6）捕鱼强度和（7）销售食品。该调查在秘鲁圣克拉拉和周边社区的营养不良性肠道疾病 (MAL-ED) 出生队列中随机选择的 35 个家庭中进行了试点。随后，根据焦点小组讨论、堆排序练习和试点结果，我们将 2013 年 11 月至 2015 年 1 月在 203 个 MAL-ED 家庭中每月收集的调查减少到 36 个项目。然后使用主成分评估有效性和可靠性分析和探索性因素分析，揭示四组购买和应对策略行为：（1）甜食和含糖物品，（2）不太喜欢，（3）更喜欢，以及（4）最少餐。最终 22 项量表的内部一致性具有可接受的 Cronbach α 临界值 0.73。因素组的标准和结构效度显示：(1) 与家庭食品不安全获取量表的质量和数量方面不同的食品购买模式，(2) 儿童摄入脂肪、动物源蛋白质的独特相关性，纤维和其他微量营养素，(3) 家庭购买模式来自与儿童年龄别体重相关的“更喜欢”组（鱼、红肉）。家庭层面的食物购买和频率以及特定于环境的行为可用作儿童膳食摄入模式和营养状况的替代指标。食品购买和频率测量是一种快速、客观、非侵入性的调查方法，通过适当的试点测试和验证，可用作家庭食品安全状况急剧变化的指标。家庭层面的特定情境行为可用作儿童膳食摄入模式和营养状况的替代指标。食品购买和频率测量是一种快速、客观、非侵入性的调查方法，通过适当的试点测试和验证，可用作家庭食品安全状况急剧变化的指标。家庭层面的特定情境行为可用作儿童膳食摄入模式和营养状况的替代指标。食品购买和频率测量是一种快速、客观、非侵入性的调查方法，通过适当的试点测试和验证，可用作家庭食品安全状况急剧变化的指标。