A 2-Group Path Analysis of a Food Environment Conceptual Model by Food Security Status: Home Food Environment Variables Were Associated With Healthy Eating Index 2015 Component Scores for Total Vegetables Among Those With Food Security.

BACKGROUND

The Model of Community Nutrition Environments is a well-known conceptual model in public health nutrition, although few studies have tested the model as a valid representation of food environment-diet pathways. Further, no study has explored whether the model differs by food security status, despite documented disparities in food environments and diet for those experiencing food insecurity.

OBJECTIVE

To test the Model of Community Nutrition Environments by food security status using multigroup path analysis.

DESIGN

This secondary analysis of baseline data from a hybrid-effectiveness implementation trial, Healthy Homes/Healthy Families, which included a home environment survey and 2 unscheduled 24-hour dietary recalls, was merged with the US Department of Agriculture 2019 Food Access Research Atlas.

PARTICIPANTS/

SETTING

Participants recruited through 4 United Way 2-1-1 agencies in Georgia were eligible if they were aged 18 to 70 years, spoke English, and self-reported a body mass index ≥20. Baseline data collection occurred from October 2020 to December 2022 (N = 510 participants).

MAIN OUTCOME MEASURES: Main outcomes included Healthy Eating Index 2015 component scores for total fruits and total vegetables.

ANALYSES: Multigroup path analysis compared the unstandardized effects of pathways in the Model of Community Nutrition Environments for those who were food secure and food insecure.

RESULTS

The 2-group model had good global model fit (root mean square error of approximation = 0.000, comparative fit index = 1.000, Tucker-Lewis index = 1.000, standardized root mean square residual = 0.047). Home availability (b = .08 ± .04; P = .029) and accessibility (b = .68 ± .27; P = .012) of fruits and vegetables were positively associated with Healthy Eating Index 2015 scores for total vegetables among those with food security. No significant associations were found with either outcome among those with food insecurity. The food secure model explained more variance in the outcomes than the food insecure model (food secure: R2totalfruits = 0.20, R2total vegetables = 0.36; food insecure: R2total fruits = 0.10, R2totalvegetables = 0.06).

CONCLUSIONS

Additional mechanisms need to be added to the Model of Community Nutrition Environments to better explain food environment-diet pathways for those experiencing food insecurity.