Reducing Food Insecurity During COVID-19

Change in fruit & vegetable consumption

Self-reported consumption frequency of fruits, fruit juices, and vegetables in the past 30 days measured by 10-item Dietary Screener Questionnaire scale. Each item is scored from "never" to "6 or more times per day". Scoring algorithms convert frequency responses to cup equivalent estimates of average daily dietary intake for fruits and vegetables, using an age and gender coefficient. The higher the score the more daily dietary intake for fruits and vegetables.

Time frame: Baseline, monthly for 12 months post-enrollment

Depression Symptoms

Assessed by the Quick Inventory of Depressive Symptoms (QIDS SR-16). This scale is a 16-item self-report measure of depressive symptoms over the past 7 days. Each item is scored 0-3 (0 = no presence of the symptom; 3 = high burden of the symptom), yielding a total score range of 0 to 27. Because of its wide scoring range, the QIDS can be used to detect depressive illness in populations with low symptoms. Lower scores reflect less depressive symptoms.

Time frame: Baseline, monthly for 12-months post-enrollment

Symptom Relief

Assessed by the Beck Anxiety Inventory (BAI). This scale is a 21-item self-report measure the severity of self-reported anxiety. Each item is scored 0-3 (0 = not at all; 3 = severely - it bothered me a lot), yielding a total score range of 0 to 63. The lower the score the less self-reported anxiety.

Time frame: Baseline, monthly for 12-months post-enrollment

Changes of behavioral activation for depression

Assessed by the Behavioral Activation for Depression Scale (BADS). This 25-item self-reported measure is used to track changes weekly in the behaviors hypothesized to underlie depression and specifically targeted for change by behavioral activation. The BADS subscales include activation, avoidance/rumination, work/school impairment, and social impairment. Each item is scored 0-6 (0=not at all; 6=completely), yielding a total score range of 0 to 150. High scores indicate greater levels of activation. For all the subscores, high scores are consistent with the subscale name.

Time frame: Baseline, every 6 months during 12 month post-enrollment

Perceived Stress

Assessed by Perceived Stress Scale (PSS). This 14-item psychological instrument measures the perception of stress and the degree to which situations in one's life are appraised as stressful. Each item is scored 0-4 (0=never; 4= very often). The scores is obtained by first reversing the scores on items 4, 5, 6, 7, 9, 10, and 13 and then summing the reverse coded items with the rest of the items. The scores can range from 0 to 40 with higher scores indicating higher perceived stress.

Time frame: Baseline, every 6 months during 12 month post-enrollment

Social Support

Assessed by Social Adjustment Scale Self-Report (SAS-SR). This 54-item measure examines social and role functioning in six areas: work; social activities; relationships with family; spouse or partner; parent; member of family unit. Items are rated on a 5-point scale. Seven mean scores are generated, six-role areas and one overall means. The mean scores are converted into standard T-scores on the SAS-SR Profile Form. Higher scores indicate greater impairment of functioning.

Time frame: Baseline, every 6 months during 12 month post-enrollment

Medical outcomes social support

Assessed by Medical Outcomes Survey Social Support (MOSSS). This 18-item tool comprises 4 functional support scales (emotional/informational, tangible, affectionate, and positive interaction) and an overall social support index. Each item is scored 0-5 (0=none of the time; 5=all of the time). The higher the overall social support index the more support.

Time frame: Baseline, every 6 months during 12 month post-enrollment

Mastery Control

Assessed by Pearlin Mastery Scale (PMS). This 7-item tool measures the extent to which an individual regards their life chances as being under their personal control rather than fatalistically ruled. Each item is scored 1-4 (1=strongly agree; 4=strongly disagree) and the values are added. The scores can range from 7 to 28 with higher scores reflect greater mastery.

Time frame: Baseline, every 6 months during 12 month post-enrollment

Self-Esteem

Assessed by Rosenberg's Self-Esteem Scale (RSES). This 10-item self-report likert scale evaluates an individual's self-esteem. Each item is scored from strong agree to strongly disagree. The higher the sum of the scores, the higher the self-esteem.

Time frame: Baseline, every 6 months during 12 month post-enrollment

Unmet needs

Assessed by WE CARE. This 12-question screening tool assesses needs in 6 domains: parental educational attainment, employment, child care, risk of homelessness, food security, and household heat and electricity. Individuals respond with "Yes", "No", or "Maybe later". Those with unmet needs are provided with a locally developed community resource information sheet.

Time frame: Baseline, every 3 months during 12 month post-enrollment

Self-Reported Food Assistance Program Participation

Self-reported participation in food assistance programs including Electronic Benefits Transfer (EBT), Food Stamps/Supplemental Nutrition Assistance Program (SNAP).

Time frame: Baseline, every 6 months during 12 month post-enrollment

Change in Self-Reported Health Status

Self-reported health status measured by a report of health status as excellent, very good, good, fair, or poor and measured by 3-item CDC Healthy Days module for a disarticulation of physical and mental health.

Time frame: Baseline, monthly for 12-months post-enrollment

Maternal attitudes and safe infant care practices

Assessed by the Pregnancy Risk Assessment Monitoring System (PRAMS). The survey Identifies groups of women and infants at high risk for health problems, monitors changes in health status, and measures progress towards goals in improving the health of mothers and infants.

Time frame: Baseline, every 6 months during 12 month post-enrollment

Impact of COVID-19

The Epidemic - Pandemic Impacts Inventory (EPII) + 4-item self-report of the impact of the pandemic on financial capacity and food purchasing/acquisition patterns. The EPII is newly developed, thus, scoring procedures will be determined by future research.

Time frame: Baseline, every 3 months during 12 month post-enrollment

Program Experience

Assessed by 4-item USDA program experience questions. The questions ask about firm type use, dose of program usage, health education, and program satisfaction.

Time frame: 6 months post-enrollment, 12 months post-enrollment

Change in adult acute healthcare utilization

Claims data composite measure (all cause hospital admissions and ED visits; Total number of all-cause ED visits; Total number of all-cause discharges from IP).

Time frame: Baseline, every 6 months during 12 month post-enrollment

Total adult patient-level cost of care

Measured via claims data

Time frame: Baseline, every 6 months during 12 month post-enrollment

Child healthcare utilization

EPIC chart abstractions (number of office visits, hospitalizations, missed appointments, immunization rates)

Time frame: Baseline, every 6 months during 12 month post-enrollment

Child weight

EPIC chart abstractions (weight for age)

Time frame: Baseline, every 6 months during 12 month post-enrollment

Child height

EPIC chart abstractions (height for age)

Time frame: Baseline, every 6 months during 12 month post-enrollment