Contributing Factors to Dietary Quality and Food Security in Low-Income Households with Children in the United States: A Scoping Review

BackgroundLow income and food insecure households are at risk of poor dietary quality and food insecurity. Especially in childhood, consuming a nutritionally adequate diet is an essential driver of health, growth, and development. Prior research has shown many household-level factors can present challenges to support the nutritional needs of the members of low income and food insecure households. ObjectiveThe aim of the scoping review is to identify the contributing factors to dietary quality and food security in U.S. households of school-aged children and synthesize the evidence. MethodsThe scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews (PRISMA-ScR) using search terms addressing food insecurity, low-income and dietary behaviors in the database PubMed (NCBI). Screening by 3 independent reviewers at the title, abstract, and full study phases identified forty-three studies included in the review. ResultsThe studies addressed six themes: parental behaviors, child/adolescent behaviors, food procurement behaviors, food preparation behaviors, and psychosocial factors. Most studies were cross-sectional (n = 40, 93%) and focused on parental behaviors (n = 24, 56%), followed by food procurement behaviors, and food preparation behaviors. ConclusionThe findings can be used to inform the development of future nutritional education interventions aimed at improving the dietary quality and food security in households with children. The themes identified were interrelated and suggest that providing parents with education on the following topics: 1) the importance of modeling positive eating behaviors in the home, 2) approaches to support and encourage positive feeding practices with their children, and 3) practical strategies to overcome barriers to purchasing and preparing foods of high nutrient quality. For example, delivering educational sessions on meal selection and preparation and improving nutritional knowledge hold promise to improve dietary quality among food insecure and low-income households.