Rapid review on child food insecurity: challenges encountered

Article type
Authors
Aceves-Martins M1, Cruickshank M1, Fraser C1, Brazzelli M1
1Health Services Research Unit, University of Aberdeen
Abstract
Background: child food insecurity (CFI) is a multifaceted, socioeconomic problem involving difficulties accessing sufficient safe and nutritious food to meet children’s dietary requirements. In the UK, over 7 million children live in relative or absolute poverty and are, therefore, at risk of CFI. It is important to understand the prevalence of CFI, its impact on children’s health and well-being, and strategies undertaken to address it. We undertook a rapid review to determine the nature, extent and consequences of food insecurity affecting children (aged ≤ 18 years) in UK and other high-income countries.

Objectives: to describe the methodological challenges in conducting the rapid review on CFI.

Methods: we considered any types of study design from 1995 onwards and from specified high-income countries. Only studies focusing on CFI were eligible for inclusion. The timeline for the review was four months.

Results: due to the large number of potentially relevant abstracts (n = 757), we decided to select only those explicitly mentioning CFI. We included a total of 109 studies in this review (100 quantitative, 6 qualitative, 3 mixed-methods). Most studies were observational, mainly from the USA. Only five were from the UK. A further 30 potentially relevant articles identified by an updated search and by perusing the reference lists of included studies were not considered due to time constraints. A quantitative synthesis of studies’ results was not possible due to the observed heterogeneity between studies. Quality assessment was not conducted due to time constraints. We decided to focus on studies that adjusted their results for confounding factors.

Conclusions: this rapid review was commissioned by the Food Foundation as part of a national enquiry into CFI in the UK and urgent answers were sought. However, CFI is a complex socioeconomic issue characterized by multiple aspects. We identified a large number of studies that were heterogeneous and challenging to summarize. Rapid reviews are increasingly requested in informing policy but are very challenging, especially when the evidence base is multifarious and timeline is tight. Extensive groundwork, perhaps involving a variety of stakeholders and methodologists, to narrow the scope of rapid reviews and identify achievable aims and objectives is clearly needed. In addition, better guidance on how to summarize and present complex information is required.

Patient or healthcare consumer involvement: due to the nature of this project, no patients or healthcare consumers were involved.