title: Brief assessment of food insecurity accurately identifies high-risk US adults.
abstract: OBJECTIVE
  To facilitate the introduction of food insecurity screening into clinical settings, we examined the test performance of two-item screening questions for food insecurity against the US Department of Agriculture's Core Food Security Module.
  
  
  METHODS
  We examined sensitivity, specificity and accuracy of various two-item combinations of questions assessing food insecurity in the general population and high-risk population subgroups.
  
  
  METHODS
  2013 Current Population Survey December Supplement, a population-based US survey.
  
  
  METHODS
  All survey participants from the general population and high-risk subgroups.
  
  
  RESULTS
  The test characteristics of multiple two-item combinations of questions assessing food insecurity had adequate sensitivity (>97 %) and specificity (>70 %) for widespread adoption as clinical screening measures.
  
  
  CONCLUSIONS
  We recommend two specific items for clinical screening programmes based on their widespread current use and high sensitivity for detecting food insecurity. These items query how often the household 'worried whether food would run out before we got money to buy more' and how often 'the food that we bought just didn't last and we didn't have money to get more'. The recommended items have sensitivity across high-risk population subgroups of ≥97 % and a specificity of ≥74 % for food insecurity.
authors.affiliation: 1Department of Agricultural and Consumer Economics,University of Illinois,Urbana,IL,USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Gundersen
authors.affiliation: 2Feeding America,Chicago,IL,USA.
authors.forename: Emily E
authors.initials: EE
authors.lastname: Engelhard
authors.affiliation: 2Feeding America,Chicago,IL,USA.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Crumbaugh
authors.affiliation: 2Feeding America,Chicago,IL,USA.
authors.forename: Hilary K
authors.initials: HK
authors.lastname: Seligman
mesh_terms: D005006:Ethnicity; D005191:Family Characteristics; D005523:Food Supply; D006801:Humans; D009749:Nutrition Surveys; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D014481:United States
keywords: Food insecurity; Health disparities; Screening; Social determinants of health