Journal List > Korean J Nutr > v.44(6) > 1043911

Kim, Hong, Kwon, and Oh: Development of Food Security Measures for Korean National Health and Nutrition Examination Survey


Given that household food security issues have become the concern of the Korean society, this study aimed to develop food security measures for the Korean population. Based on the literature reviews on previously developed food security measures, the 18-item US household food security survey module (US HFSSM) was adapted. The developed food security measures was assessed by qualitative validity method. It was evaluated and modified by face validity by expert focus groups belong to university, public health center, and government agencies and by cognitive interview by 40 subjects with low household income who live in an urban community and are participants in welfare programs of local districts. Then, it was reviewed and revised by the National Institute of the Korean Language and the advisory committee for nutrition survey of Korean National Health and Nutrition Examination Survey (KNHANES). The results showed that the developed questionnaire items were well adapted by expert focus groups and general subjects, showing the feasibility of measuring food security with the developed measures although there were discrepancies in some expressions of questionnaire items between experts focus groups and general subjects. The study to assess reliability and quantitative validity of the developed food security measures should be further needed to examine its application for KNHANES.

Figures and Tables

Fig. 1
The development procedure of food security questionnaire.
Table 1
Assessment of food security tools in non-domestic countries
Table 2
Process of development of food security questionnaire items for Koreans

1)US Household Food Security Survey Module 2)Questionnaire items revised by the result of face validity by expert focus groups 3)Questionnaire items revised by the result of cognitive interview 4)Questionnaire items revised by the review result of the National Institute of the Korean Language 5)Questionnaire items revised by the review result of Advisory Committee for nutrition survey of KNHANES. English versions of Revision 1-4 were not provided because the meanings of these items are identical in English

Table 3
General characteristics of participations in cognitive interview
Table 4
Food security questionnaire for Korean National Health and Nutrition Examination Survey

For 1~3, 9~11 items, response options were: (a) often, (b) sometimes, (c) never, (d) doesn't know or refuses to answer. For 4~8, 12~15 items except 4-1, 8-1, 13-1, response options were: (a) yes, (b) no, (c) doesn't know or refuses to answer. For 4-1, 8-1, 13-1 items, response options were: (a) almost every month, (b) some months but not every month, (c) only one or two months. All of the food security questions were recoded into 2 categories [(often/sometimes vs. never) or (yes vs. no) or (almost every month/some months but not very month vs. only one or two months)]. Each item was given a score of 1 if the answer pointed often/sometimes, yes or almost every month/some months but not very month, or 0 for the rest responses. An additive total score was created and were classified into four levels of food security: 1) food secure [score: 0-2 (households with children); 0-2 (households without children)]; 2) food insecure without hunger [score: 3-7 (households with children; 3-5 (households without children)]; 3) moderate food insecure with hunger (8-12; 6-8); and 4) severe food insecure with hunger (13-18; 9-10)


This work was supported by grants of the Korean Center of Disease and Control (Project No. 2010E0075600, Principal investigator Se-Young Oh).


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