Adolescent and Parental Perspectives of Food Insecurity at Home and at School Among Adolescents Attending Junior High Schools in Cape Coast, Ghana.

Adolescent food insecurity (FI) is associated with negative health and development outcomes, but parents may be unaware of these experiences. In Ghana, adolescents without access to school meals may be at risk of FI and poor diet. We described adolescent FI at home/school, assessed parents' abilities to report on them, and determined how FI relates to diet quality. We randomly selected 187 adolescent (11-17 years)/parent pairs from 8 schools in Cape Coast. Adolescents and their parents responded to the Child Food Insecurity Experiences Scale and parents reported household FI. The Diet Quality Questionnaire was used to create 4 diet quality scores for adolescents only. We assessed differences in FI scores using t-tests and agreement using Cochrane's Q and Cohen's kappa. We used linear/logistic regression to assess the relationship between FI and diet quality. Half of adolescents reported several/many FI experiences at school (56.7%) and at home (53.5%). Parent and adolescent reports of FI at home did not differ, while reports at school did (30.5% vs. 56.7% p = 0.002). 40.2% of parents responded 'I don't know' about their child's FI at school and 11.2% of parents reported better FI than their child. Parental report of household FI was significantly worse than adolescents' self-reports (82.4% vs. 56.7%). Adolescent, but not parental, reports of FI at home and school were negatively associated with diet quality. Food insecurity is common and strongly related to adolescent diet quality, but parents are often not aware. Interventions are needed to address adolescent FI in this context, especially at school.