Abstract| Volume 54, ISSUE 7, SUPPLEMENT , S4-S5, July 2022

O08 A Mixed Method Study of Whether Appalachian Ohioans Conceptualize Food Security in Alignment with the Prevailing Measure


      In the US, food security is monitored annually via the Household Food Security Survey Module (HFSSM). The measure focuses primarily on a household's monetary means. There is heightened interest in developing food security measures that embody more nuanced conceptualizations of household food security.


      To explore whether current conceptualizations of food insecurity among a rural Appalachian sample diverge from HFSSM constructs.

      Study Design, Setting, Participants

      A study recruitment postcard was mailed to all residential addresses in the Athens County region of Appalachian Ohio in late June 2020. Adult recipients were first invited to complete quarterly surveys, containing a demographic questionnaire and the HFSSM, for one year. Based on HFSSM-based food security categorizations, a purposively selected sub-sample of respondents were invited for in-depth semi-structured interviews (n = 16, May-June 2021). Our maximal variation sample included households demonstrating consistent food security (n = 7, 44%), transient insecurity (n = 5, 31%), and persistent insecurity (n = 4, 25%). Interviewees reflected on whether the HFSSM-based status aligned with how they would characterize their household's food security status.

      Measurable Outcome/Analysis

      Verbatim transcripts were coded in NVivo and themes identified via template analysis, a process that leveraged both a priori codes (based on HFSSM constructs) and emergent codes reflecting measure-diverging constructs.


      While individuals characterized their food insecurity experiences in partial convergence with the HFSSM measure (e.g., noting insufficient money for food), there were several diverging themes. Food security was primarily discussed through a communal, and notably non-monetary, lens in which food reciprocity (e.g., bartering), collective responsibility (i.e., thinking beyond one's own household), and resourcefulness (e.g., gardening) defined their food (in)security experience.


      This study demonstrates that food security may be conceptualized in ways that account for non-monetary assets and embody a communal ideology. The development and testing of a food security measure containing items in line with these constructs may be warranted for – and help to capture food insecurity more accurately in – rural regions where traditions of resourcefulness and reciprocity persist.


      NIH; The Ohio State University's Initiative for Food and AgriCultural Transformation; National Center for Advancing Translational Sciences; The Ohio State University's Office of Outreach and Engagement; Clinical Research Center/Center for Clinical Research Management of The Ohio State University Wexner Medical Center.


      Supplementary data related to this article can be found at