Mapping outcomes reported in primary studies of interventions addressing access to food in LMICs to inform a core outcome set

Article type
Authors
Durao S1, Visser M2, Mabetha D1, Cooper S3, Saldanha I4, Drimie S5, Volmink J2
1Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
2Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
3Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
4Center for Clinical Trials and Evidence Synthesis, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
5Southern Africa Food Lab, Stellenbosch University, Cape Town, South Africa
Abstract
Background
Multiple outcome reporting undermines the utility of intervention research. It has been demonstrated in food security intervention evaluations. Developing a core outcome set (COS) that should be measured in primary studies in the topic area can help address this issue. In a project aiming to strengthen the evaluation of community-level interventions addressing food access in low- and middle-income countries (LMICs), we are developing a preliminary list of candidate outcomes for the COS.

Aim
To map the outcomes reported in primary intervention research addressing food access. The eventual goal is to develop a COS.

Methods
We are currently examining 109 studies from a recent published systematic review on this topic. Two researchers are independently extracting data on the study characteristics and outcomes reported, including their definitions. We are mapping outcomes onto prespecified outcome categories, thereby building a taxonomy of outcomes related to interventions to promote access to food.

Results
The preliminary analysis of 21 (of 109) studies shows they were published from 1989 to 2023, with most (n = 11) published in 2017 and 2019. Most studies are cluster randomized controlled trials (n = 15) of adults (n = 10) in rural settings (n = 14) in Africa (n = 10) or Asia (n = 9). All studies included poor and vulnerable households. Most studies assessed interventions addressing increasing buying power (n = 15), including mostly conditional and unconditional cash transfers and income generation through agricultural interventions. Six studies assessed food vouchers and subsidies.
The 21 studies extracted reported 325 outcome instances and 83 unique outcomes. Anthropometric outcomes was the category with the highest number of reported unique outcomes (17 in 11 studies), followed by mortality outcomes (12 in 12 studies) and food intake–related outcomes (10 in 18 studies). None of the studies reported on adverse outcomes or functional status. The final analysis will be presented at the conference.

Conclusion
The outcomes identified will inform a final taxonomy of outcome categories and domains. This will, in turn, inform a Delphi survey with stakeholders, to be carried out in the next phase of this COS project.

Relevance to Patients: This COS project involves individuals living in food insecurity, which can ensure that it includes patient-relevant outcomes.