Revising the Spanish Translation of the U.S. Household Food Security Survey Module (S-FSSM) for Immigrant Parents with Low English Literacy Through Cognitive Interviews: The FAMILIA Scale

Higher rates of food insecurity have been observed among Hispanic immigrants, yet these individuals have traditionally been excluded from food insecurity survey development. The most common Spanish translated food insecurity scale—the Spanish Translation of the U.S. Household Food Security Survey Module (S-FSSM)—may not be capturing how Spanish-speaking immigrant parents conceptualize food insecurity. The purpose of this study was to gain insight into how Spanish-speaking immigrant parents with low English literacy conceptualize household food insecurity within the 18-item S-FSSM and to use this information to revise the S-FSSM instrument. Researchers conducted two rounds of cognitive interviews with Spanish-speaking adults at a community center in Houston, TX, USA (N = 19; Round 1: n = 9, October 2023; Round 2: n = 10, July 2024). Researchers used participants’ feedback to refine the S-FSSM. All participants were female (Rounds 1 and 2 = 100%) and most born in Mexico (Round 1 = 66.7%; Round 2 = 50%). In Round 1, eight items were combined to enhance cultural relevance and to add definitions. Follow-up questions were added to improve clarity. Two items were revised for relevancy, two items had no change, six items were deleted. In Round 2, modifications to wording occurred and one item was added. The revised scale, named Food Access Measure for Immigrant Latinos In America (FAMILIA), resulted in 17 survey items. Study findings suggested that the S-FSSM needed refinement to enhance relevancy for Spanish-speaking immigrant parents with low English literacy.