Using structured expert judgement elicitation to find pieces of the food insecurity puzzle
Despite living with an abundance of food and relative wealth, many Australians are faced with food insecurity - the limited or uncertain availability of households’ and individuals’ physical, economic, social access to sufficient, safe, nutritious and culturally relevant food in a socially acceptable way. [1]
Nationally, it is estimated that 4% of Australians are experiencing food insecurity, reporting they had run out of food and couldn’t afford to buy more. Not captured in this statistic are the many more Australians experiencing food insecurity; who face the anxiety and concern about not having enough money to put food on the table.
Responses to address food insecurity in Australia and other high income countries range from food relief initiatives, community food programs to social protection programs and policies. The dominant response is the provision of food relief through the charitable food sector; however this does not focus on the complex array of determinants of food insecurity. The nature and range of these determinants is one of the challenges in responding to food insecurity.
Program and policy-makers need reliable and relevant evidence on the determinants of food insecurity to inform effective strategies on how best to alleviate this in local contexts. However, due to cost, time and ethical considerations, producing the evidence to understand determinants of food security are limited.
Using Structured Expert Judgement (SEJ) Elicitation to inform evidenced based decisions
Dr. Sue Kleve, Senior Lecturer at Monash University in collaboration with Dr. Martine Barons from the Dept of Statistics at University of Warwick has recently used Structured Expert Judgement (SEJ) Elicitation as a novel method to obtain data on the various determinants of food security. Structured elicitation of experts’ opinion in pursuit of decision support is an increasingly important technique across areas affecting health. In their research, Dr Kleve and collaborators have used the Investigate Discuss Estimate Aggregate (IDEA) elicitation protocol, encouraging experts to Investigate and estimate individual first round responses, Discuss, Estimate second round responses, following which judgements are combined using mathematical Aggregation.
‘Gathering data on some determinants of
food insecurity can be a
challenge’ Says Dr
Sue Kleve. “If we can gather supporting evidence in a timely way this can
better predict the probability of household food security status and support
decisions on the best ways to address it”.
Helping to solve the missing pieces of the determinant puzzle to provide localised information
We began by selecting a wide mix of experts involved in knowledge and/or response generation related to specific determinants of food insecurity and/or population groups experiencing food insecurity in Victoria. his includes experts within the field of epidemiology, social service sector policymakers, public health nutrition and health promotion workers, social planner and peak bodies of food and material aid relief.
The group of experts were given questions related to a mix of scenarios including the missing information on key determinants of household food insecurity:
- Food cost
- Household income
- Physical access to food
Some examples of the questions experts
were asked to estimate include:
1) Out of 100 people with high equivalised disposable income and good physical access when food availability is good, how many will be food-secure?
2) Out of 100 people with moderate equivalised disposable income and good physical access when food availability is poor, how many will be food-secure?
In-confidence, each expert individually
used their experience and deep knowledge of food security to investigate and
provide estimates of the natural frequency out of 100 people for these
questions.
In the next step, all of the experts came together face-to-face to discuss and share their estimates for the same set of questions. They then repeated the process of estimation.
This process is used to reduce
potential biases- such as social biases to each expert's estimates; however,
discussions among the experts brings potential new perspectives of household
food security to the table.
An aggregate of all estimates was calculated from the data collected from the experts. Data of the consensus from all the experts were used as input for a food security decision support system. This system enables policymakers to understand which determinants have the strongest influence on household food security status and can help drive and advocate for effective policy changes.
Dr Kleve and Dr Barons’ recent paper outlines the use of SEJ and what they found.
- Consistent with being a primary determinant of food security status, experts provided data that supports disposable income having the strongest influence on food security status.
- Improvement on physical access, such as transportation and walkability to source food alone may provide additional health-promoting benefits; however, it is unlikely to have a strong effect on household food security.
- Improving access to food through a range of interventions such as food bank/pantry, food literacy or community food programmes will have limited improvement in ongoing household food insecurity.
Evidence gathered from this method
highlighted that interventions targeting disposable income - such as the
recent coronavirus supplement - are likely to be supportive of higher
levels of food security. This is supported by a recent national survey by the Australian Council of Social
Service (ACOSS) that showed the difference the coronavirus supplement payment
made to the health and wellbeing and food security of its recipients.
Broadening the use of SEJ to other complex issues within Public Health
With complex issues such as household food security, evidence-based decision-making is required. However, when evidence is absent, using SEJ may help us gather evidence to inform intervention decisions. SEJ elicitation could potentially be used to gather missing data for other complex issues within public health.
By applying this novel approach, we can
better understand the interactions of various determinants and capture missing
data to help inform future policies and interventions.
By Dr Sue Kleve
Dr Sue Kleve is a Senior Lecturer
(Public Health Nutrition) in the Nutrition Science and Dietetic programs in the
Dept of Nutrition, Dietetics and Food at Monash University. She is an
Accredited Practising Dietitian who came to Monash with over 20 years of
experience working as a public health and community nutritionist. It was
through this experience that she developed her interest in community and
household food insecurity and led her to her PhD exploring the existence and
experience of food insecurity in low-to middle income Melbourne households.
Sue’s research focus continues in the area of the existence and experiences of
food insecurity and responses to prevent and pathways out of food
insecurity. She is the convenor of the Australian Household Food Security
Research Collaboration, a member of Dietitians Australia and the Public Health
Association of Australia.
Publication information:
Kleve,
S., & Barons, M. (2021). A structured expert judgement elicitation
approach: How can it inform sound intervention decision-making to support
household food security? Public Health Nutrition, 24(8),
2050-2061. doi:10.1017/S1368980021000525.
Interested in studying with us?
We offer the Bachelor of Nutrition Science, Bachelor of Nutrition (Honours), Master of Dietetics and PhD opportunities.
Find us on Twitter:
@SueKleve
@MonashNutrition
@DrBarons
Reference:
1) Food and Agricultural Organization, Committee on World Food Security. (2012). Coming to terms with terminology. Geneva: FAO. Retrieved from www.fao.org/3/MD776E/MD776E.pdf
Image: Sourced from
Unsplash. Available from here.
Edited By Benjamin David, APD
