Food insecurity is associated with increased stress, symptoms of mental illness, and persistent health disparities. Women caregivers (referred to as mothers) may be at an increased risk because they often compensate for food shortages by reducing their own intake and make household food decisions. The current literature on the relationship between food security status and mental health in the U.S. lacks a clear framework for the relationship between these two phenomena. This dissertation describes three studies that aimed to explore the relationship between food security and mental health for mothers with low income in Virginia: (1) understanding differences in mental health outcomes by food security status (n=1,029), (2) a path analysis of a conceptual framework of the relationship (n=1,029), and (3) a thematic analysis of mothers' lived experiences with this relationship (n=29). An explanatory, sequential mixed methods design was employed with a cross-sectional survey informing semi-structured interviews. The survey (administered August-October 2021) was developed with previously validated measures of food security status, physical and mental health, symptoms of mental illness, behavioral food coping strategies, and social support. The interview guide was developed based on the findings of the survey and administered in May and June 2022. Collective findings of this series of studies suggested lower food security status was associated with negative mental health outcomes. However, there were no direct pathways from food security status to mental health outcomes. Social support and behavioral food coping strategies mediated the relationship between food security status and mental health outcomes. Mothers reported experiencing managing a variety of stressors associated with food insecurity. Mothers also indicated that stressors and coping strategies associated with managing food insecurity impacted their mental health. Future research should explore additional factors impacting household resiliency and strategies to reduce stigma associated with resource utilization. These findings can be built upon to develop screening tools and interventions to help improve food security and mental health status mothers with low income. / Doctor of Philosophy / Household food insecurity, where a household has insufficient access to safe, nutritious foods, is associated with a number of negative physical and mental health outcomes, including stress for members of the household. Food insecurity is not necessarily felt equally by all members of a household. Mothers may be at a greater risk because they often are responsible for household food decisions. Despite an association between food insecurity and mental health being discussed in the existing literature, there was little evidence to support how that relationship works and the other factors that may affect this relationship. This dissertation details three studies that were conducted to better understand the relationship between food security and mental health for Virginia mothers with low-income: (1) understand differences in mental health outcomes by food security status, (2) develop a framework for how factors are related in this relationship, and (3) explore mother's experiences with the relationship. A survey was developed and administered (August-October 2021) using previously tested measures of food security and mental health. The survey also included measures of factors that may have impacted the relationship, including physical health, social support, and behavioral food coping strategies, which are strategies used by people to stretch their available food resources. Interviews were conducted in May and June 2022. Findings suggest food security acts indirectly on mental health outcomes through social support and behavioral food coping strategies. Mothers reported managing multiple stressors associated with the experience of food insecurity that impacted their mental health. In the future, research should explore strategies to encourage resource utilization and identify ways to improve maternal mental health. Ultimately, interventions to improve food security and mental health for mothers with low income should be developed and implemented.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/114119 |
| Date | 16 March 2023 |
| Creators | Liebe, Rachel Antoinette |
| Contributors | Human Nutrition, Foods and Exercise, Misyak, Sarah A., Serrano, Elena L., Cook, Natalie Ebony, Hedrick, Valisa E., Adams, Leah M., Porter, Kathleen J. |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Language | English |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf |
| Coverage | Virginia, United States |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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