This project aims to strengthen the evaluation of community-level interventions addressing access to food in low- and middle-income countries (LMICs) through exploring the extent and impact of multiple outcome reporting and developing a core outcome set (COS) for use in studies that could help address this issue.
Multiple outcome reporting, known to affect the utility of intervention research, also occurs in evaluations of food security interventions. One approach for dealing with this problem is to develop a core set of outcomes that should be measured in primary studies, something that has been successfully done in clinical research, but not yet in the food security domain. A search of the database for diet and nutrition interventions (3 February 2022) identified 17 ongoing COS studies; most aim to develop a COS to address a specific clinical condition (e.g., cancer). None related to food security was identified in the database.
The key objectives of this three-year project are to:
1. Identify and map all outcomes reported in primary studies assessing the effects of interventions aiming to improve food access and the extent the outcomes overlap, through a cross-sectional analysis of studies included in a systematic review;
2. Determine which outcomes matter to individuals living in food insecurity, through conducting interviews with affected individuals; and
5. Develop a core outcome set to be reported, as a minimum, in future effectiveness research on interventions addressing food access in LMICs, through a Delphi survey with relevant stakeholders.
Solange Durão, Health Systems Research Unit, South African Medical Research council (PI)
Prof Jimmy Volmink (Department of Global Health, Stellenbosch University) (Supervisor)
Scott Drimie (Southern Africa Food Lab, Stellenbosch University) (co-Supervisor)
Assoc Prof Ian Saldanha (Epidemiology Department, Johns Hopkins University)
Dr Sara Cooper (Cochrane SA, SAMRC)
Dr Marianne Visser (CEBHC, Stellenbosch University)
Denny Mabetha (Health Systems Research Unit, SAMRC)
Disease Category: Public health
Disease Name: Food insecurity
Age Range: 18
Sex: Either
Nature of Intervention: Other
- Clinical experts
- Consumers (patients)
- Epidemiologists
- Families
- Governmental agencies
- Policy makers
- Researchers
- Service commissioners
- Service providers
- Service users
- COS for clinical trials or clinical research
- Delphi process
- Interview
- Systematic review
This study will entail two phases in which the objectives will be addressed in a sequential fashion (Figure 3) using a variety of methods including a systematic review, a cross-sectional analysis of studies, qualitative interviews, and a Delphi survey.
The first phase of the project aims to identify an initial long list of outcomes. this will be done through a cross sectional analysis of studies included in a systematic review that informed this project, to identify and map the outcomes reported in the primary studies included in this review. Additionally, individuals living in food insecurity in two cities in LMICs - Cape Town, South Africa and Maputo, Mozambique - will be interviewed, to explore what outcomes are important to them and what language should be used when describing outcomes relevant for this group of individuals. participants will be recruited from food distribution points with the support of local community-based organisations.
The second phase aims to refine the long list of outcomes. This will be done through a Delphi survey with relevant stakeholders (researchers, policymakers, health and care professionals, funders) to rank the potential outcomes for the COS in order of importance and to determine consensus on the outcomes that should be included in the COS for effectiveness research on interventions addressing access to food in LMICs.
At the end of this project we will compile a core outcome set that should be reported, as a minimum, in future effectiveness research on interventions addressing access to food in LMICs.