ArticleNutrients2026
"That Would Give the Kids a Little Challenge to the Brain!" Co-Investigating the Child Food Insecurity Experiences Scale (CFIES) with School Aged Children: A Qualitative Cognitive Interview Study.
Article in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
objectivesHousehold food insecurity (FI) impacts child health and development. Children have distinct and unique experiences of FI, and child self-report measures are increasingly used. However, there is limited reporting of children's comprehension and engagement with these measures within local settings. The Child Food Insecurity Experiences Scale (CFIES) is a 10-item child self-report tool that is widely used, despite limited validity evidence. This study aimed to explore the face and content validity of the CFIES in an Australian context.
methodsWe used cognitive interviews with 25 children aged 8-12 years to document CFIES comprehension. Data were analyzed using inductive and deductive approaches.
resultsChildren demonstrated awareness of FI (even when food secure themselves) and displayed sophisticated understanding of its social ramifications. While the overall perception of the tool was generally positive, we uncovered that not all key terms or emotion words were universally understood, potentially impacting validity. Similarly, conditional clauses or question modifiers were sometimes overlooked. In addition, the 12-month response timeframe and the answering categories ("many times", "one or two times" or "never") proved challenging for some children. In addition to the item-specific impressions, children provided nuanced ideation across four broader themes, which may impact item interpretation and willingness to answer: perceptions of hunger; micro and macroeconomics affecting households; social identity and comparison; and caregiver protection dynamics. Children indicated the need to consider survey modality and ensure privacy.
conclusionsA global tool that reflects children's cross-cultural conceptualization of FI represents a pragmatic and feasible way to monitor change in FI across regions and may aid advocacy efforts. However, this study suggests the need for further modifications to the CFIES and the necessity to build rapport with communities and organizations that allow for the interpretation of the data within the contextual considerations.
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