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Measuring Food Security and Evaluating the Impact of an Educational Intervention on Food Security and Nutrition among Rural Farmers in El Salvador: A Mixed Method
Study
by
Rafael Antonio Quijada Landaverde, B.S.
A Thesis
In
Agricultural Education
Submitted to the Graduate Faculty of Texas Tech University in
Partial Fulfillment of the Requirements for
the Degree of
MASTER OF SCIENCES
Approved
Amy E. Boren-Alpízar, Ph.D. Chair of Committee
Matt Baker, Ph.D.
John Rayfield, Ph.D.
Sarahi Morales, Ph.D.
Mark Sheridan Dean of the Graduate School
August, 2019
Copyright 2019, Rafael Antonio Quijada Landaverde
Texas Tech University, Rafael Antonio Quijada Landaverde, August 2019
ii
ACKNOWLEDGEMENTS
First, I want to thank God because He has been exceedingly faithful and has been
with me at every stage of this journey.
To my parents, for your love, respect, and unconditional support. Nothing I have
accomplished in my life would have been possible without you. I dedicate this
achievement to you with all my love.
To my siblings, with the example that you set, you always drive me to be a better
person and to work hard to achieve all the goals I set for myself.
To my supervisor, Dr. Amy Boren-Alpízar, thank you for the opportunity to
work with you during my Master's program. Working under your supervision has been
one of the most satisfying and positively challenging experiences of my life. You always
encourage me to expand my personal and professional limits in the pursuit of excellence.
Thank you for being a role model and an amazing mentor.
To Dr. Matt Baker, Dr. John Rayfield, and Dr. Sarahi Morales, thank you for
your advice and support during this research project. You have been great mentors and
role models in my personal and professional life
To the faculty and staff of the Department Agricultural Education and
Communications, thank you for your education and example.
Texas Tech University, Rafael Antonio Quijada Landaverde, August 2019
iii
To my fellow graduate students, you make this department an excellent place to
work. I feel very lucky to have had the opportunity to know all of you and very proud to
have shared with you during my graduate school program.
To my friends at Texas Tech University, thank you for your friendship and
companionship always. Lubbock would not have been the same without you.
Finally, to my lifelong friends Julian, Andrea U, Andrea L, Jason, Eder, Anny,
Ronnie, Caro, Anastasia, Coki, Coco, Diego, and Kristen your friendship is one of the
most valuable things that I have and that I always keep with me.
This research was a journey full of learning, and personal and professional
growth.
Thank you, Texas Tech University. I will keep my Guns Up until the day I die.
Texas Tech University, Rafael Antonio Quijada Landaverde, August 2019
iv
TABLE OF CONTENTS
ACKNOWLEDGEMENTS ............................................................................................ ii
LIST OF TABLES .......................................................................................................... vi LIST OF FIGURES ...................................................................................................... viii
CHAPTER I ..................................................................................................................... 1
INTRODUCTION ........................................................................................................ 1
Overview ........................................................................................................................ 1
Country Background ...................................................................................................... 3
Statement of the Problem ............................................................................................... 6
Research Purpose ........................................................................................................... 8
Research Objectives ....................................................................................................... 8
Limitations of the Study ............................................................................................... 12
Basic Assumptions ....................................................................................................... 13
Definition of Terms ...................................................................................................... 13
CHAPTER II ................................................................................................................. 16
THEORETICAL FRAMEWORK ........................................................................... 16
Food and Agriculture Organization Food Security Theoretical Framework ............... 16
Educational Efforts towards Food Security and Nutrition ........................................... 24
Theoretical Framework for Nutritional Education Programmes .................................. 24
The Theory of Planned Behavior ................................................................................. 37
Adult Education Theory-Community-based learning .................................................. 39
CHAPTER III ................................................................................................................ 41
METHODOLOGY ..................................................................................................... 41
Research Design ........................................................................................................... 41
Population ..................................................................................................................... 47
Data collection .............................................................................................................. 48
Instrumentation ............................................................................................................. 51
Data analysis ................................................................................................................. 56
CHAPTER IV ................................................................................................................ 61
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RESULTS .................................................................................................................... 61
Qualitative Results ....................................................................................................... 61
Educational Intervention .............................................................................................. 83
Quantitative Results ..................................................................................................... 87
CHAPTER V ................................................................................................................ 113
CONCLUSIONS AND RECOMMENDATIONS ................................................. 113
Discussion .................................................................................................................. 126
Recommendations for Practitioners ........................................................................... 128
Recommendations for Future Research ..................................................................... 130
REFERENCES ............................................................................................................ 132
APPENDICES ............................................................................................................. 147
APPENDIX A- IRB APPROVAL LETTER ................................................................ 147
APPENDIX B-INTERVIEW QUESTIONS (ENGLISH VERSION) .......................... 148
APPENDIX C-INTERVIEW QUESTIONS (SPANISH VERSION) .......................... 151
APPENDIX D- WATER ANALYSES REPORT ......................................................... 154
APPENDIX E- RESEARCH INSTRUMENT (SPANISH VERSION) ....................... 157
APPENDIX F-RESEARCH INSTRUMENT (ENGLISH VERSION) ........................ 165
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LIST OF TABLES
1. Food Insecurity Duration Classification .................................................................... 20
2. Integrated Food Security Phase Classification (IPC) ................................................ 21
3. Advantages and disadvantages of face-to-face and mass media approaches ............. 32
4. Comparison between qualitative and quantitative research ....................................... 42
5. Mixed method study characteristics ........................................................................... 43
6. Knowledge test structure ............................................................................................ 53
7. Attitudinal and perceptions instrument structure ....................................................... 55
8. Reliability coefficient scores on the research instrument ........................................... 58
9. Academic resources used on the educational intervention ......................................... 84
10. Learning modules summary of activities ................................................................... 85
11. Summary of participant’s gender ............................................................................... 87
12. Summary of farmer’s educational level ..................................................................... 89
13. Summary of farmer’s age ........................................................................................... 90
14. Summary of household’s family head and composition ............................................ 92
15. Summary of farmers house and agricultural land ownership ..................................... 93
16. Farmers’ Food Insecurity Experience Scale (FIES) score ......................................... 95
17. Group differences for treatment and control knowledge pretest and posttest scores . 98
18. Group differences for treatment and control attitudes and perceptions pretest and posttest scores ........................................................................................................... 101
19. Differences for experimental and control group in knowledge scores ..................... 106
20. Group differences for experimental and control group pretest and posttest scores . 109
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21. Differences on intentions of adoption between experimental and control group ..... 112
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LIST OF FIGURES
1. Map of El Salvador. ..................................................................................................... 4
2. Food security elements’ interrelations ..................................................................... 19
3. Four dimensions of food security interactions. ......................................................... 22
4. Life cycle approach ................................................................................................... 28
5. The Theory of Planned Behavior. ............................................................................. 38
6. The Theory of Planned Behavior applied to this research project. ........................... 39
7. Conceptual Model of Mixed Methods Research ....................................................... 41
8. Procedural diagram: embedded mixed method study ............................................... 44
9. Research study timeline. ............................................................................................ 60
10. Transportation systems in El Salvador. ..................................................................... 66
11. Local water source in the community. ..................................................................... 72
12. Local water source in the community. ..................................................................... 72
13. Latrines structures. ................................................................................................... 74
14. Agricultural chemical storage at rural households. ................................................... 76
15. Front page of informative manual. ........................................................................... 86
16. Certificate of participation. ........................................................................................ 86
17. Educational level of participants. ............................................................................. 88
18. Age of the participants. ............................................................................................. 90
19. Participants’ House and Agricultural Land Ownership. .......................................... 93
20. Farmers’ Food Insecurity Experience Scale (FIES) Score. ..................................... 94
21. State of Food Security and Nutrition on the Food Insecurity Experience Scale. ...... 95
Texas Tech University, Rafael Antonio Quijada Landaverde, August 2019
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22. Knowledge scores for experimental and control group pretest and posttest. ............ 97
23. Differences between pretest and posttest scores in experimental group ................. 100
24. Differences between pretest and posttest scores in control group ........................... 103
25. Pretest knowledge scores in classification by grade for experimental and control group. ....................................................................................................................... 105
26. Posttest knowledge scores in classification by grade for experimental and control
group ........................................................................................................................ 105 27. Pretest attitude and perception scores for experimental and control group. ........... 107
28. Posttest attitude and perception scores for experimental and control group. .......... 110
29. Map of poverty distribution by department in El Salvador ..................................... 126
Texas Tech University, Rafael Antonio Quijada Landaverde, August 2019
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CHAPTER I
INTRODUCTION
Overview
According to the Food and Agricultural Organization [FAO], beginning in 2017
the improvements seen in global food security over the last decade begin to decline. The
number of people living in food insecurity increased from 804 million in 2016, to almost
821 million in 2017. ((FAO, International Fund for Agricultural Development [IFAD],
United Nations International Children's Emergency Fund [UNICEF], World Food
Programme [WFP], Word Health Organization [WHO], 2018). Worldwide, phenomena
like climate change, demographic growth, and environmental degradation are
complicating the food security and nutrition situation (Spiertz, 2012). In 1996, FAO
defined food security as:
Food security exists when all people at all times have physical, social and
economic access to sufficient, safe and nutritious food to meet their dietary needs and
food preferences for an active and healthy life (FAO, 2003).
Eliminating food insecurity is a global goal shared across a variety of
organizations and institutions (Meade & Karen, 2017). Chen, Bolling and Hollanders
(2016), suggested that integrated approaches to address the food security and nutrition
crisis are the most effective. In 2015, the United Nations (UN) developed the 2030
Agenda and The Sustainable Development Goals (SDGs). The SDGs are 17 ambitious
objectives to enhance prosperity and security for all people. Indeed, achieving these goals
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requires the participation across disciplines and organizations. The second SDG: End
Hunger, Achieve Food Security and Improve Nutrition and Promote Sustainable
Agriculture, seeks to eliminate food insecurity, eradicate all forms of malnutrition, and
ensure access to food for all people (UN, 2018).
The current trend in global statistics issues a clear warning that if no changes are
made, the global goals for eradicating hunger by 2030 will not be achieved (FAO et al.,
2018). Reducing hunger and malnutrition has benefits in education, health, and economic
performance. Individuals who do not eat adequately have lower levels of productivity and
are more prone to diseases, thus diminishing their quality of life (Poulsen, McNab,
Clayton, & Neff, 2015; Davis, 1996). Women, children, and indigenous populations are
especially affected by food insecurity and undernourishment (IFAD, 2015). Jyoti,
Frogillo, and Jones (2005) found that food insecurity affects schoolchildren’s academic
performance, weight gain, and social skills.
In Latin America, malnutrition and lack of food are not the only two causes of
food insecurity. In 2017, the Latin American region had 32.3 million people living in a
state of undernourishment (FAO et al., 2018). Recent trends in Latin America indicate
that while undernourishment is still an issue in the region, another problem has emerged.
People have become increasingly overweight and obese, which affects populations of all
ages and socioeconomic conditions (Uauy, Albala, & Kain, 2001). In 2017, for the first-
time people outnumbered those in a state of malnutrition in Latin America (Davies &
Ribaut, 2017). The incorporation of the Latin American region into more competitive
global markets has generated an increase in the consumption of ultra-processed foods
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with high levels of sugar and fats; at the same time, the consumption of food produced
locally has decreased (FAO, Pan-American Health Organization [PAHO], WHO, 2017).
The difference in nutritional benefits between local and non-local foods has not been
studied in depth. However, non-local food requires additional preservatives and
processing that reduce its quality and nutritional value (Edwards-Jones, 2010).
Additionally, local foods contribute to reduce the environmental degradation and
greenhouse gas emissions, as well as providing an opportunity for the economic growth
of small farmers (Edwards-Jones, et al., 2008).
Country Background
El Salvador’s 12-year civil war, which ended in 1992, left more than 70,000
people dead, created deep scars in the citizenry, and fomented intense political
polarization that is still seen today (Congressional Research Service [CRS], 2018). High
levels of poverty and crime, resulting from the political and economic fallout of the civil
war, persist even today (Wilkerson, 2008). As a result, thousands of Salvadorians migrate
every year. Until 2012, 2.8 million Salvadorians were living abroad; of those migrants,
90% migrated to the United States, looking for a better life (Ramos, et al., 2013).
El Salvador borders the Pacific Ocean in the south, Guatemala in the west and
Honduras in the north. The land extension of El Salvador is 21,000 km² (Figure 1). Its
size is about the size of Slovenia or a little smaller than the state of Massachusetts in the
United States (CRS, 2018). The geographical position of El Salvador increases its
vulnerability to natural disasters and the effects of climate change. The country does not
have an emergency system and timely response to these natural phenomena.
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Figure 1. Map of El Salvador.
The Salvadorian economy is the third best economy in Central America. With a
GDP of almost 52 million dollars, El Salvador grows by approximately 2.32% annually.
Based on the Global Bank GDP Country Rank from 2017, El Salvador is 106 out of 195
countries. (Global EDGE, n.d). El Salvador's GDP is composed mainly of agriculture,
livestock, forestry and fishery, manufacturing and mining, commerce, restaurants, and
hotels. The latter has seen the most rapid growth in recent years. Despite the growth in
some productive areas in El Salvador, there is still poor overall economic growth in the
country. This problem has affected the reduction of poverty and social disparities,
especially in rural areas (Word Bank, 2018).
In El Salvador, 38% of the population live in rural areas and 57% were
categorized as poor or extremely poor (Habitat for Humanity, 2017; World Bank, 2015).
In many Salvadorian regions, poor people live without access to electricity or running
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5
water (National Council on Food and Nutrition Security [CONASAN], 2011). At the
national level, poverty fell from 39% to 30%, between 2000 and 2013. This national
improvement was mainly due to an 18% reduction in rural poverty (IFAD, 2015).
In El Salvador, the reduction of poverty has not been as significant as in other
countries of Latin America (WB, 2015). Poverty in El Salvador undermines households'
food insecurity; 106,419 Salvadorian households are at risk of becoming food insecure
(WFP, 2018). The urgency and necessity of interventions to address food and nutrition
security is based on current levels of malnutrition in the country. At least 15% of children
under 5 years of age are stunting and 28% of pregnant women are anemic (WFP, 2017).
In El Salvador, despite the multiple governmental and non-governmental efforts
to address food insecurity, there still exist many food deficiencies throughout the national
territory. Until 2017, El Salvador reported 42,840 households, representing 214,000
people, living in a state of chronic food insecurity. Farmers and their families are the
most affected by food insecurity (WFP, 2018).
Many of the economic and social conditions that promote food insecurity and
malnutrition in developing countries could be addressed with appropriate education and
agricultural interventions (De Mauro & Burchi, 2007). Societies with low education
levels are characterized by low productivity, high unemployment rates, and low earning
capacity (FAO, 2005). In the design and implementation of interventions or projects
seeking to improve access to basic food requirements for proper human development,
capacity building is one of the most effective investments (FAO, 2011).
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Educational programs for small farmers about food security and nutrition reduce
vulnerability and improve resiliency, especially for the most fragile developing
economies (FAO, 2011). FAO recognizes training as an essential catalyst for addressing
food insecurity and malnutrition (FAO, 2011; FAO, 2005). The education of rural
farmers has a positive effect on food production and consumption behaviors. In addition,
the effects of knowledge on nutrition and food security affect future generations by
allowing them to develop in healthier ways (FAO, 2011; Davis, 1996; Ayners &
McCalla, 1996).
According to Sahyoun, Pratt and Anderson (2004), adults can develop or improve
their knowledge, skills, and abilities related to food security and nutrition by participating
in programs with an appropriate design and facilitation process. Adult participation in
educational opportunities has been one of the principal areas of study for the adult
education field. Time and cost are the two principal reasons why adults do not participate
in educational programs (Merriam, Cafarella, & Baumgartner, 2007).
Statement of the Problem
The problem this study addresses is the importance of the design and evaluation
of educational programs in food security and nutrition for small farmers. Several studies
have evaluated the significance and impacts of agricultural and development
interventions (Feder, Murgai, & Quizon, 2005; Soon & Baines, 2012). However, not all
agricultural and development interventions managed to improve the conditions they
address. The agricultural and development interventions that also invest in human capital
(nutritional education, food safety, and gender) have an enhanced probability to improve
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participants’ life conditions (Berti & Krasevec, 2004). In rural areas, the lack of
information on nutrition and the state of food security limit the approach to the problem.
With very few sources of reliable and accurate information, the design process of
educational programs is very restricted. Educational programs often focus on transfer of
knowledge and not on the particular community’s socio-economic conditions and needs
(Sandoval & Carpio, 2016).
In the past, the nutritional component in many rural and agricultural development
projects could be understood with the popular slogan "If you give a man a loaf of bread,
you feed him for a day. If you give him a hoe, you feed him for life” (Luven, 1982). The
nutritional component is represented by the delivery of bread and is a solution that
temporarily remedies food security and nutrition problems. In contrast, the delivery of the
hoe was a long-term solution, by representing the inputs that allowed farmers to improve
their agricultural production and subsequently increase their income. However, currently
rural and agricultural development projects need to supply inputs; and educate the
population in order to improve their self-sufficiency and sustainability of program
outcomes. Therefore, the slogan appropriate to our times would be "If you give a man a
loaf of bread, you will feed him for a day, if you give him a hoe and teach him how to use
it, you feed him for life”.
More investment is needed in educational programs on food security in order to
improve the small farmers’ life systems. Education is one of the most reliable ways to
improve levels of food security and reduce the vulnerability of rural communities in
developing countries (Mustiya, Ngware, Kabiru & Kandala, 2016; Maes, Hadley,
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Tesfaye, Shifferaw, &Tesfaye, 2009). In rural areas, educational programs combined
with the appropriate adult participation improve agricultural production, generating an
impact on food security and nutrition status.
Research Purpose
For this mixed method study, the purposes were:
• Qualitatively identify the state of food security, food choices, nutritional attitudes,
and barriers to access food, perceived among small farmers in rural El Salvador.
• Quantitatively measure the impact of an educational program on farmers’
knowledge, attitudes, and perceptions on how to improve their food security and
nutritional status.
Research Objectives
The following research objectives were created and used to guide this research
study:
Qualitative
1. Identify food security knowledge, attitudes, and perceptions of the local
small farmers.
Quantitative
2. Describe farmers from the rural community in El Salvador.
3. Illustrate the current food security and nutrition situation.
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4. For treatment and control group:
Determine whether there is a statistically significant difference in
knowledge of food security and nutrition of small farmers between pre-test
and post-test. Hypothesized (at α = .05) as follows:
H0: There will be no significant difference in knowledge of food security
and nutrition of small farmers between pre-test and post-test (µtreatment pre-
test - µtreatment post-test = 0); (µcontrol pre-test - µcontrol post-test = 0).
H1: There will be a significant difference in knowledge of food security
and nutrition of small farmers between pre-test and post-test (µtreatment pre-
test - µtreatment post-test ≠ 0); (µcontrol Pre-test - µcontrol post-test ≠ 0).
5. For treatment and control group:
Determine whether there is a statistically significant difference in attitudes
and perceptions toward food security and nutrition in the small farmers
between pre-test and post-test. Hypothesized (at α = .05) as follows:
H0: There will be no significant difference in attitudes and perceptions
toward food security in the small farmers between pre-test and post-test
(µtreatment pre-test - µtreatment post-test = 0); (µcontrol pre-test - µcontrol
post-test = 0).
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H1: There will be a significant difference in attitudes and perceptions
toward food security in the small farmers between pre-test and post-test
(µtreatment pre-test - µtreatment post-test ≠ 0); (µcontrol pre-test - µcontrol
post-test ≠ 0).
6. For pre-test and post-test:
Determine whether there is a statistically significant difference in
knowledge of food security and nutrition of small farmers between
experimental and control group. Hypothesized (at α = .05) as follows:
H0: There will be no significant difference in knowledge of food security
and nutrition of small farmers between treatment and control group
(µexperimental pre-test - µcontrol pre-test = 0); (µtreatment post-test -
µcontrol post-test = 0).
H1: There will be a significant difference in knowledge of food security
and nutrition of small farmers between treatment and control group
(µtreatment pre-test - µcontrol pre-test ≠ 0); (µtreatment post-test - µcontrol
post-test ≠ 0).
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7. For pre-test and post-test:
Determine whether there is a statistically significant difference in attitudes
and perceptions toward food security and nutrition of small farmers between
treatment and control group. Hypothesized (at α = .05) as follows:
H0: There will be no significant difference in attitudes and perceptions
toward food security and nutrition of small farmers between treatment and
control group (µtreatment pre-test - µcontrol pre-test = 0); (µtreatment post-
test - µcontrol post-test = 0).
H1: There will be a significant difference in attitudes and perceptions
toward food security and nutrition of small farmers between treatment and
control group (µtreatment pre-test - µcontrol pre-test ≠ 0); (µtreatment post-
test - µcontrol post-test ≠ 0).
8. For the experimental group:
Determine whether there is a statistically significant difference in
Intentions of Adoption toward food security and nutrition in the small farmers
between the experimental group and control group. Hypothesized (at α = .05)
as follows:
H0: There will be no significant difference in intentions of adoption
toward food security in the small farmers between the experimental and
control groups (µexperimental post-test - µcontrol post-test = 0).
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H1: There will be a significant difference in intentions of adoption toward
food security in the small farmers between the experimental and control
groups (µexperimental post-test - µcontrol post-test ≠ 0).
Limitations of the Study
The following limitations should be taken in to consideration when reading this
research study:
• The researcher was born and raised in the same local community as the research
participants. The previous relationship between the researcher and the participants
could lead to some kind of bias in the results.
• Due to the nature of the study, purposive sample and intact groups were used.
Random sampling and/or random assignment of the participants in the group was
impossible because of logistical issues and the nature of the sample. Therefore,
results are limited to the participants of the study.
• Participants belong to a specific community in rural El Salvador. Therefore,
differences may be found with farmers in other communities in El Salvador
because of characteristics specific to other locations.
• For the pilot test, participants were not similar to those of the research population.
Therefore, differences in reliability scores may have been found if participants
had been small rural farmers.
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Basic Assumptions
The following assumptions were identified as potential determinants regarding this
study:
• The researcher assumed that the participants met the FAO definition for small
farmers.
• The participants completed and answered the research instrument and interview
questions honestly and accurately according with their own knowledge,
perceptions, or preferences.
• In the qualitative section, the researcher was the human data collection
instrument.
• The participants are representative of the whole community.
Definition of Terms
Attitude
According to Allport (1935), “a mental and neural state of readiness, organized
through experience, exerting a directive and dynamic influence upon the individual's
response to all objects and situations with which it is related” (as cited in Schwarz &
Bohner, 2001, p.2)
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Behavior
According to the United Nations Education Science and Culture Organization
(UNESCO) (2000, P. 9), “Behavior can be defined as the way in which an individual
behaves or acts. It is the way an individual conduct himself/herself. The behavior could
be either good or bad (appropriate or inappropriate according to the society).
Climate Change
The National Aeronautics and Space Administration (NASA) (2019) states that
“Climate change refers to a broad range of global phenomena created predominantly
by burning fossil fuels, which add heat-trapping gases to Earth’s atmosphere. These
phenomena include the increased temperature trends described by global warming, but
also encompass changes such as sea level rise; ice mass loss in Greenland, Antarctica, the
Arctic and mountain glaciers worldwide; shifts in flower/plant blooming; and extreme
weather events”.
Hunger
“A weakened condition brought about by prolonged lack of food” (Merriam-Webster
dictionary, 2019).
Innocuous
“Producing no injury” (Merriam-Webster dictionary, 2019).
Knowledge
“Facts, information, and skills acquired through experience or education; the
theoretical or practical understanding of a subject” (Oxford dictionary, 2019).
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Nutrition
According to the WHO (2019), “Nutrition is the intake of food, considered in
relation to the body’s dietary needs”.
Malnutrition
“Faulty nutrition due to inadequate or unbalanced intake of nutrients or their
impaired assimilation or utilization” (Merriam-Webster dictionary, 2019).
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CHAPTER II
THEORETICAL FRAMEWORK
The contributions of the theoretical framework to a social investigation are: (1)
the metaphoric and literal bases of the generation of new knowledge, (2) to sustain and
strengthen the justification of the research, the problem statement, and the relevance of
the study, and (3) to facilitate the literature review, the methodology design and the
information analysis process (Grant & Osanloo, 2014). For this research study, the
theoretical framework used: (1) the FAO Food Security Theoretical Framework, (2) the
FAO Framework for Nutrition Education Programmes, (3) the Theory of Planned
Behavior, and (4) the adult education theory.
Food and Agriculture Organization Food Security Theoretical Framework
According to the United Stated Department of Agriculture (USDA) food, security
is defined as:
Food security for a household means access by all members at all times to enough
food for an active, healthy life. At a minimum, this includes the ready availability
of nutritionally adequate and safe foods, and the assured ability to acquire
acceptable foods in socially acceptable ways, that is, without resorting to
emergency food supplies, scavenging, stealing, or other coping strategies.
(Research Triangle Institute, 2014, p.1).
When people do not experience food security in their lives, they face a situation of
food insecurity defined by the USDA as "limited or uncertain availability of nutritionally
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adequate and safe foods or limited or uncertain ability to acquire acceptable foods in
socially acceptable ways” (RTI International, 2014, p.3).
A situation of food insecurity is generated by a combination of elements known
as risk factors (RTI international, 2014). Following are some of the risk factors that may
determine food and nutrition security at the household level:
§ Low socio-economic status (SES): Troy, Miller and Olson (2011) define
SES as “ownership of, control over, or access to economic resources and
the social standing or influence associated with those resources” (p. 29)
the family income can predict the family's food and nutritional security
status (RTI International, 2014). However, other elements must also be
considered (education, health status, among others). Families in the lower
socio-economic levels are more vulnerable to food insecurity; and an
income source does not guarantee the reduction of the food insecurity
problem (McIntyre, Bartok, & Emery, 2012).
§ Household composition: The relationship between food and nutrition
security and household composition varies depending on the presence of
children, women as head of household, and coexistence of multiple family
generations living in the same space. People are more likely to experience
food insecurity in those households where there are children (Coleman-
Jensen 2013, Nord, 2009). In the case of the head of household,
households with single women as heads of households are more vulnerable
to food insecurity and nutrition problems compared to households with
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male or couples as a head of household (Nord, 2009). Women usually
have lower economic incomes than men do, especially in developing
economies (Matheson & McIntyre, 2014).
The dynamics of multigenerational families cohabiting in the same house
affects family members in different ways (Zillah & Gunderson, 2018). In
this type of household, the coexistence between children and grandparents
reduces the food insecurity for children and increases that of grandparents
(Zillah & Gunderson, 2018).
§ Poor health status: The connection between health status and food security
is bidirectional. When analyzing a population’s food security status, the
state of health should be analyzed with caution since it can be both
indicator and a consequence of food insecurity (RTI International, 2014).
The health status of an individual affects other aspects of daily life, such as
performance in productive activities, which subsequently reduce economic
income (Weiser, et al., 2011).
§ Social capital: RTI International (2014) defines social capital as
“the tangible and intangible benefits or resources available to individuals
by virtue of their membership and participation in social networks or
social groups, such as families, churches, or communities” (p. 12).
Access to social capital allows families to seek better opportunities,
as well as access to resources and social assistance (Martin, Rogers, Cook,
& Joseph, 2004). Households with good social capital are better at coping
with situations of food shortages (RTI International, 2014). Figure 2
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shows the interactions of multiple factors that affect food security at the
household level.
Figure 2. Food security elements’ interrelations (RTI International, 2014).
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In assessing the situation of food insecurity in a specific population, duration and
severity are mainly used as defining features of this problem (FAO, 2008). Based on the
duration of the food insecurity crisis, two main categories are identified: (1) chronic food
insecurity, and (2) transitory food insecurity (FAO, 2008). Table 1 summarizes the
characteristics of the classification of food insecurity according to the duration of the
problem.
Table 1
Food Insecurity Duration Classification Chronic Food Insecurity Transitory Food Insecurity
Is... Long-term or persistent Short-term and temporary
Occurs when … People are unable to meet their minimum food requirements over a sustained period.
There is a sudden drop in the ability to produce or access enough food to maintain a good nutritional status.
Results from… Extended periods of poverty, lack of assets and inadequate access to productive or financial resources.
Short-term shocks and fluctuations in food availability and food access, including year-to-year variations in domestic food production, food prices, and household incomes.
Can be overcome with…
Typically, long-term development measures also used to address poverty, such as education or access to productive resources, such as credit. They may also need more direct access to food to enable them to raise their productive capacity.
Transitory food insecurity is relatively unpredictable and can emerge suddenly. This makes planning and programming more difficult and requires different capacities and types of interventions, including early warning capacity and safety net programs.
Note. Taken from FAO (2008).
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The Integrated Food Security Phase Classification (IPC) was developed in a joint
effort of different cooperation and research organizations and is based on the intensity of
food and nutritional insecurity (IPC Global Partners , 2008). The IPC is a classification
tool that uses a globally-recognized language and seeks to improve the credibility and
veracity of food security information around the world (FAO, 2008). The IPC mainly
allows the timely selection of the nature, urgency, and dimension of the intervention and
the necessary help to eradicate the problem. Table 2 shows the IPC categories.
Table 2
Integrated Food Security Phase Classification (IPC) IPC classification Indicators
Generally food secure - Crude mortality rate - Malnutrition prevalence - Food access/ Availability - Water access/ Availability - Coping strategies - Livelihood assets
Chronically food insecure Acute food and livelihood crisis Humanitarian emergency
Famine/ Human catastrophe Note. Taken from IPC Global Partners (2008).
In the search to ensure food security in rural communities, the four dimensions of
food security, (1) availability, (2) access, (3) utilization, and (4) stability, must be
achieved (Simon, 2012). Figure 3 illustrates the relationship among the four dimensions
of food security and their interactions in the generation of the concept.
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Figure 3. Four dimensions of food security interactions (Simon, 2012).
Food availability.
The World Food Programmed defines food availability as “The amount of food
that is present in a country or area through all forms of domestic production, imports,
food stocks, and food aid” (2009, p.170). In this dimension, agricultural production and
food imports are the defining features (Simon, 2012). Food availability must be adaptable
to changes in agricultural production patterns, population growth, and environmental
deterioration (Leroy, Ruel, Frongillo, Harris, & Ballard, 2015).
Food access.
The concept of food access became relevant worldwide after the food crisis in
Niger in 2005 and the global crisis of food prices in 2008. Dimensions of food access
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include the: (1) physical, (2) economic, and (3) social aspects (Simon, 2012). When
analyzing access to food, it is generally reduced to a financial and economic analysis.
However, the WFP defines access to food as "the ability of a household to acquire an
adequate amount of food regularly through a combination of purchases, barter, loans,
food assistance or gifts" (2009, p.170).
Food Utilization.
The third dimension of food security is food utilization. This dimension frames
people’s food preferences and nutrition-related decisions. Additionally, food utilization is
related to food processing and consumption standards, water access, and sanitation
(Simon, 2012). Within the concept of food security and nutrition, this dimension is
represented in the phrase "safe and nutritious food, which meets their dietary needs”
(FAO, 2008).
Food stability.
The last dimension of food security is the related to appropriate use of food and
resources. This dimension measures the stability of a person’s food security status over
time; specifically exploring food availability, people’s access to food, and their food
utilization over the long term (Simon, 2012). This dimension is influenced by political
instability, economic changes, such as unemployment, and climate variability (FAO,
2012).
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Educational Efforts towards Food Security and Nutrition
Educational efforts to reduce food insecurity should seek to include all
dimensions of food security (FAO, 2012). Education can help improve the state of food
and nutrition security and unhealthy behaviors related to food at home (Farrell, 2013).
Research by Olumakaiye and Ajayi (2017) showed that education could reduce levels of
malnutrition and food insecurity. Some of the main topics addressed in the interventions
include family nutrition, family gardening, and family finances (Simon, 2012).
At the global level, the great unknown in terms of educational programs on food
and nutritional security is where the work should be focused. Some professionals
advocate for work with groups that are currently, or at risk of becoming, food insecure;
others advocate for work with healthy groups to help them maintain their good nutritional
status (Smith & Smitasiri, 1997). Looking to provide a guidance for the educators on
food security and nutrition, FAO in 1997 developed the Framework for Nutritional
Education Programmes (Smith & Smitasiri, 1997).
Theoretical Framework for Nutritional Education Programmes
This theoretical framework seeks to use science-based knowledge to disseminate
and promote proper nutrition, as well as to prevent health consequences derived from the
lack of nutritious foods (Smith & Smitasiri, 1997). The FAO Theoretical Framework for
Nutritional Education Programmes encourages the educator to teach the participants the
best way to use the available food and resources. In addition, the educator should prepare
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the participants for the prevention of food shortages or access to inadequate food
resources (Smith and Smiasiri, 1997; Barth-Eide, Alfredsson and Oshaug, 1996).
In 1985, Gussow and Eide (as cited in Smith & Smitassiri, 1997) proposed that
the role of a nutrition educator is "one that helps people in any social, economic, or
political circumstance meet their need for nutritious food." To fulfill this task, the
nutrition educator must consider a great diversity of strategies that address the main
factors that limit the population’s access to adequate food and influence their feeding
patterns. This theoretical framework includes two sections. The first one, a framework for
planning nutrition education programmes and the second, a framework for the
implementation of nutrition education programmes.
A framework for planning nutrition education programmes.
This theoretical framework proposes an approach beyond communication activities
(Smith & Smitasiri, 1997). Nutrition educators must implement a broader approach that
adapts and responds to the context of the communities (Barth- Eide, Alfredsson, & Oshaug,
1996). The components of this theoretical framework are: (1) nutrition issues, (2) target
groups, (3) environments and sectors, and (4) methods; all converge on the concept of food
supply. The food supply is at the center of this theoretical framework because it must be
considered in all educational programs aimed at improving the nutritional condition of
people (Smith & Smitasiri, 1997).
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Food supply.
When analyzing the food supply for a specific community, three factors must be
considered: (1) the nature of the supply, (2) access by people, and (3) cultural factors that
determine the community’s food choices (Smith & Smitasiri, 1997). A nutritional
education program must efficiently incorporate these elements. In addition, educational
programs are obliged to adapt to changes in food production patterns, including new food
trends and the incorporation of technology in the production, processing, and
consumption of food (Atkinson, et al., 2010).
With the passing of time, the nutrition education interventions stopped focusing
solely on the maximization of the benefits derived from the use of food resources and
progressed towards topics such as breastfeeding, food production at home, and
development of technologies for the storage and preparation of foods (Smith & Smitasiri,
1997).
Nutrition issues.
Although not all educational interventions follow a standard process, it is
recommended to start with the identification of the problems that are sought to be
minimized or eliminated in the population (Contento, 2008). Educational interventions
should be strengthened with research and evaluation as tools for the collection, analysis,
and interpretation of information (Liquori, Koch, Contento, & Castle, 1998). In order to
ensure that an intervention has the necessary elements, data collected by government
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monitoring agencies must be incorporated into consumer trends and preferences (Smith
& Smitasiri, 1997).
The educator must know the main characteristics of the sources of food supply
and the community characteristics (Hamm & Bellows, 2003). This information will allow
the intervention to promote sustainable strategies that ensure the sustainability of food
sources over time. The intervention must consider the subgroups of the population and
the respective economic, social, and cultural variables that influence them. In addition,
barriers that may affect access and selection of food in the home should be identified.
Finally, it is essential that before the execution of an intervention, the resources of
infrastructure, economic, and social capital be quantified. For many rural communities,
these factors enhance vulnerability to malnutrition and food insecurity.
Target groups.
The identification of the target groups of interest should be made at the beginning
of the planning of the intervention. The following target groups’ classification is
recommended:
1. Population subgroups - Life cycle approach: An adequate evaluation of the
specific nutritional needs for each subgroup of the population could facilitate
the process of identifying the intervention’s target groups (Contento, 2008).
Using the Life Cycle Approach, the needs assessment for each subgroup is
facilitated. Figure 4 shows the characteristics that should be used to classify
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the subgroups under this approach (Smith & Smitasiri, 1997). This model
recommends the following stages (Smith & Smitasiri, 1997):
Stage 1: Prenatal maternal and infant stage.
Stage 2: Adolescence.
Stage 3: Adulthood.
Figure 4. Life cycle approach (Smith & Smitasiri, 1997).
2. Population subgroups - Special needs: For the intervention to be effective,
those variables that indicate a "special" subgroup must be integrated. In many
cases, these variables could be cultural identity (Anguaya, 2015), human
immunodeficiency diseases (Loevinsohn & Gillespie, 2003) and other types of
diseases, among others. In other circumstances, variables such as migration,
Older
Middle Age
Families
Adolescence
Maternal/Infant
Childhood
Pre-birth
Physical Social
Structural Psychological
Genetic
Nutritional status
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disability, unemployment, and poverty must also be considered (RTI
International, 2014).
Once the primary target groups have been identified, it is time to identify the
secondary target groups. A secondary target group is one that makes it possible to fulfill
the objectives of the intervention and facilitates the carrying of information to the
primary groups (Smith & Smitasiri, 1997). The members of the secondary groups must
be trained for the execution of the educational intervention (Smith & Smitasiri, 1997).
Finally, tertiary groups must be identified and reached. The members of a tertiary
group are at different political and administrative levels and are those who support the
progress and development of educational interventions in their work (Smith & Smitasiri,
1997).
Settings and sectors.
This model is multisector in nature and allows the interaction of multiple key
actors in the search for a common good (Smith & Smitasiri, 1997). Allowing the
integration of multiple sectors potentially increases the spectrum and impact of a nutrition
education intervention (Contento, 2008). The diversity of actors in an intervention
encourages the creation of cooperative relationships and generates a multidisciplinary
environment with greater possibilities for the development of appropriate measures for
the nutritional needs of the groups of interest (Kangalawe, 2012).
According to Glanz and Mullis (1988), in order to cultivate long-term
relationships between multiple organizations, an environment of collaboration and
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negotiation must be built where the parties converge into a positive debate in the search
for solutions.
Methods.
Education and communication methods.
The target groups and their context determine the selection of educational
methods that should be used for the dissemination of information (Andrien, 1994). In the
process of selecting educational methods, this theoretical framework recommends the
incorporation of the PRECEDE model (Smith & Smitasiri, 1997). This model facilitates
the identification of factors that determine the behavior of the members of a group. The
model includes: (1) predisposing factors (knowledge, preferences, etc.), (2) enabling
factors (available resources, capacities, etc.), and (3) reinforcing factors (pressure from
different social actors) (Smith & Smitasiri, 1997). The PRECEDE model has been used
in a wide variety of dissemination and education efforts on health and nutrition-related
issues (Salehi & Haidari, 2011). The information obtained from the PRECEDE model
will be used to plan the educational methods and strategies to be implemented in the
intervention.
Selection of channels.
Throughout history, nutrition education interventions have used face-to-face
education, either in groups or individually, as their education methodology (Smith &
Smitasiri, 1997). However, they have been strongly criticized in terms of effectiveness
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and efficiency in the use of resources. Because of this deficiency, mass media is proposed
as a methodology for the nutritional knowledge diffusion (Smith & Smitasiri, 1997).
Nutrition is not composed of a single behavior. It is a series of behaviors that
must be modified to ensure a change in nutritional status (Smith & Smitasiri, 1997).
Face-to-face methodologies have been evaluated as being more effective in generating
changes in nutritional behaviors (Gordon, Graves, Hawkes, & Earkin, 2007). However,
the mass communication media have also shown good results by promoting the adoption
of one behavior at a time with simple messages in marketing campaigns (Wakefield,
Loken, & Hornik, 2010). Table 3 identifies some advantages and disadvantages for each
of the communication channels in nutrition education interventions.
Research and evaluation.
During the planning of the educational intervention, adequate methods for the
evaluation of the intervention should be considered (Rossi, Lipsey and Henry, 2019).
Gathering prior information relevant to the intervention is vital for selection of target
groups, education methodologies, and the generation of objectives and a work plan
(Smith & Smitasiri, 1997). For the intervention, continuous evaluation is recommended
in order to make appropriate modifications to maximize impact. A final evaluation of the
intervention results, which explores the suitability of the intervention for replication, is
indispensable (Rossi, Lipsey & Henry, 2019).
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Table 3
Note. Taken from Smith & Smitasiri (1997).
Training and management.
The training programs for each target group should be designed and prepared in
conjunction with the educational intervention. An appropriate training process on the
theoretical and logistical aspects of the program affects the target groups’ performance
(Smith & Smitasiri, 1997).
Advantages and Disadvantages of Face-to-Face and Mass Media Approaches Advantages Disadvantages Face -to-face • Interactive
• Reliable • Provides social support • Allows for personalizing • Allows for modelling • Appropriate sequencing easy • Follow-up easy
• Expensive • Penetration weak • May encourage
dependency • May not be
acceptable to many people
Mass Media • Cheap per contact
• Large numbers reached • More acceptable for many
people • May stimulate self-initiated
change • Potential for further
development through modem technology
• Weak engagement of users
• Unreliable • Dilution of content • Follow-up difficult
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A framework for the implementation of nutrition education programmes.
Composed of: (1) decision, (2) development, and (3) dissemination, this
theoretical framework guides those in charge of educational programs through the
process of implementation and execution (Smith & Smitasiri, 1997). One of the
advantages of this theoretical framework is adaptability and flexibility, especially in the
context of developing countries, where the situation of food and nutrition security is
generally more challenging (Smith & Smitasiri, 1997).
The Decision-Development-Dissemination Approach is used for this theoretical
framework and is defined as:
A holistic and systematic framework for implementing an action-oriented
program, with the emphasis on the decision process necessary to direct the work
in the right direction, the arts of program development, and the importance of the
diffusion process, in order to maximize the nutritional change, as well as increase
the sustainability of the program (Smith & Smitasiri, 1997).
This theoretical framework arises from the need for a practical guide to overcome
a problem presented for years: ineffective nutritional education. To improve the
performance of nutrition education programs, this theoretical framework is divided into
three stages (Contento, 2008). Below are the three stages of this model.
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Phase one: The decision process.
The starting point of any nutrition education program should be a sound decision
process. At this stage, decision makers must have the conviction that nutrition education
is a viable and effective strategy to solve the problems identified. For this, they must
consider at least the following two essential elements (Smith & Smitasiri, 1997):
• Causes: You must understand the elements that are generating the current
problem and if you really need the investment in a nutrition program.
• Changer(s): To understand this element, you need to consider if there are
individuals capable of managing the expected change from the educational
intervention.
Many researchers report the failure of nutrition education programs to properly
address this first stage. In addition, due to lack of confidence in nutrition education
programs by decision makers, the progress of these programs has been impeded (Smith &
Smitasiri, 1997). There are factors beyond the control of the implementers of nutrition
education programs that potentially affect them. According to Israel and Tighe (1984),
the success or failure of many nutrition education programs is linked to national policies
and the availability of resources to promote these initiatives.
Phase two: The development process.
Once it is established that nutrition education is the appropriate methodology to
address the problem, the theoretical model suggests a process of creative development
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committed to the quality of the intervention. In this process, three important aspects must
be considered (Smith & Smitasiri, 1997).
1. Evaluation: It is important to collect prior information about the context
for the development of the program.
2. Analysis: The data referring to the topics relevant to the program such as
the food sub-center, the food preferences, and the levels of income in the
community, among others. They must be subjected to a rigorous and
ethical data analysis process.
3. Creative action: The developers of the problem must apply relevant
methodologies and increase the commitment of the participants. In
addition, all the resources and activities proposed should be aimed at
generating a change in the nutritional behavior of the participants.
Phase three: The dissemination Process.
In this last phase of the theoretical framework, the authors emphasize the diffusion
process. This last process is important for the fulfillment of the objectives set for the
educational program and is comprised of two elements: (1) management/control and (2)
monitoring/evaluation (Smith & Smitasiri, 1997).
These two areas of action are essential in any nutrition education program. In addition
to an adequate planning process, nutrition programs need a system that ensures
compliance with the issues raised from the beginning. It is therefore necessary, an area of
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management and control for the program. Smitasiri (1994) suggested that the three
characteristics that ensure the functioning of a management and control system in an
educational intervention are:
• Support staff
• Good collaborators
• The flexibility of management/control itself
There is an interconnection between effective management and control and the
monitoring and evaluation process. During the course of the entire intervention, the
implementers must be able to identify the changes that are occurring in the target groups.
A systematic evaluation must be undertaken to facilitate the obtaining of
information (Rossi, Lipsey & Henry, 2019). The evaluation of the program should
promote the active participation of all the stakeholders of the program. In addition, a
combination of qualitative and quantitative evaluation methods will give the decision
makers the pertinent program information (Rossi, et al., 2019).
Finally, it is important that the implementers of these interventions understand that
while the Decision-Development-Dissemination Approach is a generic framework for
educational interventions, it needs the integration of two other elements: (1) the
promotion of the changes achieved, and (2) training needs for future implementation.
This theoretical framework is a tool for people or organizations interested in
promoting nutrition education initiatives. It is important to emphasize that the nutrition
education interventions seek a change in the eating behavior of the participants (Smith &
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Smitasiri, 1997). A multidisciplinary approach will make it easier to achieve the
behavioral changes that are expected after the program (Contento, 2008). The theory of
planned behavior (Ajzen, 2006) is a useful theory to understand the process of change in
the behaviors of an individual.
The Theory of Planned Behavior
The Theory of Planned Behavior (TPB) seeks to explain “the individuals’ intention to
perform a given behavior; intentions are assumed to capture the motivational factors that
influence behavior” (Ajzen, 1985, p. 181). An individual’s actual behavior is stimulated
by the individual’s intentions to behave in a particular way (Ajzen, 1991). The intentions
of behavior are a function of three elements that are described below (Ajzen, 2006):
1. Attitude of an individual towards the behavior: “Is the degree to which
performance of the behavior is positively or negatively valued”.
2. Subjective norms: “Subjective norm is the perceived social pressure to engage or
not to engage in a behavior”.
3. Behavior control: “People's perceptions of their ability to perform a given
behavior. Drawing an analogy to the expectancy–value model of attitude, it is
assumed that perceived behavioral control is determined by the total set of
accessible beliefs about the presence of factors that may facilitate or impede
performance of the behavior”. Figure 5 presents a graphic representation of the
TPB.
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Figure 5. The Theory of Planned Behavior (Ajzen, 2006).
It is important to know the decision process that leads farmers to make decisions
on issues related to food security. By knowing this decision process and farmers'
perceptions of the problems related to food and nutrition security, possible changes in
behavior can be understood more concretely. In addition, it is important to know the
opinions that others have about food and nutrition security and how they affect the
individual’s perceptions (Ajzen, 1991). TPB has been widely used to predict the behavior
of individuals in health-related issues. Murnaghan, Blanchard, Rodgers, La Rosa, and
McQuarrie (2010) demonstrated the use of TPB in the prediction of behaviors related to
physical activity and diet. Figure 6 presents the TPB for this research study.
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Figure 6. The Theory of Planned Behavior applied to this research project.
Adult Education Theory-Community-based learning
This research study used a community-based learning opportunity for the delivery of
an educational intervention. Educational opportunities in a community setting use a wide
variety of educational methodologies (Merriam, Cafarella, & Baumgartner, 2007). A
diversity of local and international organizations, such as churches and community
centers, develop educational opportunities on various topics of interest to participants
(Merriam, et al., 2007).
In adult education, participants seek to meet the information needs on relevant issues
that are potentially generating some kind of problem (Smith & Sobel, 2010). One of the
main objectives of community education programs is adapting the educational approach
Intervention effect:
Pretest and posttest difference on attitudes and knowledge on food security and nutrition test.
Food security and nutrition attitudes and knowledge
Predict behavior
Perception on food security and nutrition
Gender Food taboos
Attitudes and perceptions toward food security and nutrition.
Knowledge and attitudes on food
security and nutrition
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to fit within the context of the social reality experienced by the participants. Mainly these
programs intend to collaboratively generate the improvement of the participants’ living
conditions; thus, the engagement of community members is a critical component of
community education programs.
Community educators promote education and training as an effective methodology
for the empowerment of participants in solving community problems (Smith & Sobel,
2010). Programs for adults in community settings tend to be flexible in aspects such as
resource management and programming (Merriam, et al., 2007).
Community-based adult education programs have been constantly questioned on the
sustainability and effectiveness of content promotion (Smith & Sobel, 2010). In this
aspect, the design, implementation, and evaluation of community-based educational
programs should be conducted in consultation with the participants, considering their
needs and characteristics in the creation, execution, and evaluation of the program
(Merriam, et al., 2007).
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CHAPTER III
METHODOLOGY
Research Design
For this study, the methodology used was an exploratory sequential mixed-
methods research design (Creswell & Plano, 2011). Mixed methods research is the third
methodological movement and can be defined as the intentional integration of qualitative
and quantitative research approaches to understand a social phenomenon (Haight &
Bidwell, 2016; Creswell & Plano, 2011). Johnson, Onwuegbuize, and Turner (2007)
define mixed-methods as the class of research that combines quantitative and qualitative
techniques, approaches, and language into a single research approach. The third
methodological movement is perceived as the opportunity to take advantage of the
strengths of both qualitative and quantitative methods (Figure 7).
Figure 7. Conceptual Model of Mixed Methods Research (Ivankova, 2015).
Mixed
Qual Quan
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Qualitative and quantitative research differ in many important ways (Table 4).
Qualitative research allows us to investigate the participants’ opinions, attitudes, and
behaviors using their words and/or researcher observations (Creswell & Plano, 2011).
Shweder (1996) states that qualitative research seeks to gather different perspectives
paying close attention to the complexity of the details and using the researcher as a
human instrument (Creswell & Plano, 2011). Quantitative research, however, seeks to
identify relationships between variables and then generalize the results to the largest
possible population. (Creswell & Plano, 2011). Shweder (1996) described quantitative
research as the methodology focused on objective data and argued that the main
difference between qualitative and quantitative research is the object under study.
Table 4
Note. Taken from Haight and Bidwell (2016).
Comparison Between Qualitative and Quantitative Research
Quantitative Methodology Qualitative Methodology Both Methodologies Research questions address observations and ideas of a specific phenomenon
Research questions address with values the behavior of the research variables
Employ logical arguments
Emphasize the objective Emphasize the subjective Are empirical: based on deliberate, careful; observations
Methodological emphasis on sampling, measuring, calculating and abstracting
Methodological emphasis on interpretation, schematization contextualization, and exemplification.
Incorporate safeguards to minimize biases and strengthen inferences
Social inquiry= Scientist Social inquiry=interpreter Employ interpretation
Are concerned with broader implications of empirical findings
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Mixed methods research approach has particular methodological characteristics.
These characteristics distinguish the design and implementation of mixed method
research from other approaches. The four characteristics include: (1) the number of
qualitative and quantitative strands (all the research stages), (2) Sequence or timing
(concurrent, sequential, multi-strand combination), (3) Priority or weighting is the
strands’ relative importance in the research study (equal priority, quantitative priority,
qualitative priority), and (4) Integration or mixing is the level interaction between
quantitative and qualitative methods to answer the research questions (combining,
connecting, merging) (Creswell & Plano 2011; Ivankova, 2015). Table 5 presents the
characteristics of the mixed methods approach used in this research study.
Table 5
Note. Adapted from Ivankova (2015).
Mixed Method Study Characteristics.
Characteristic Description Strand This research study has one qualitative and
one quantitative strand. The qualitative strand led to the quantitative strand
Sequence or timing Sequential: The qualitative data collection preceded the quantitative data collection
Priority or weighting Equal priority for qualitative and quantitative strands
Integration or mixing Connecting- the quantitative data collection was based on the qualitative data collection and analysis
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Pothukuchi (2004) emphasizes the relevance of community food assessments and
community characteristics identification to address community food security. Ahmed and
Del Ninno (2002) state that programs on food security and nutrition that integrate the
community’s socio-economic characteristics in the design and implementation phase
procedures are more likely to be successful. For this reason, this study used embedded
mixed methods as its research design. Figure 8 illustrates the embedded mixed method
design for this research project.
Figure 8. Procedural diagram: embedded mixed method study, adapted from Ziegler (2004).
Qual: Interviews
17 Small farmers
Quant: Quasi-Experimental Design
Control Group Experimental Group
Farmers n=48
Farmers n= 54
Intervention Pre-test Post-test
Educational intervention and research instruments design
Draw inferences
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Qualitative Strand
During the qualitative phase of this study, face-to-face interviews were conducted
with small farmers. Interviews were performed to gather information about the food
security situation, food choices, and nutritional attitudes, and barriers to access food
perceived among the participants. Interviews allow researchers to understand the
phenomenon, situation, or research objective from the participants’ point of view
(Fortune, Reid, & Miller, 2013).
Additionally, two community leaders were interviewed. The community leaders
are the representatives of the community when dealing with investment entities and
public administration offices.
Other qualitative information was collected through observation protocols and
information recording. After each interview with the farmers and each visit to their
homes, reflective memos were written. The memos are research tools for the registration
of information generated in the reflective process between the researcher and the
research, the data and participants of the study (Birks, Chapman & Francis, 2008).
Memos serve as a reminder and assist in the process of writing the qualitative results
(Miles, Huberman & Saldana, 2014). Memos could include but are not limited to
reflections of the research process stages, aspects that exist (or not) in the collected data
and additional information that would be useful to the research results (Miles, Huberman
& Saldana, 2014).
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Quantitative Strand
This research study used a non-equivalent control group design, in the quantitative
phase. The non-equivalent research design compares individuals who are not randomly
assigned among the control and experiment groups (Frankel, Wallen, & Hyun, 2015).
The control group was constructed using matching. Matching refers to the selection
process of the control group participants based on the similarity of the research criteria,
drawing comparisons between the groups. While randomization is still a superior method
of subject assignment to avoid bias, matching can help build reliable control groups
(Stuart & Rubin, 2008). Matching was used to reduce the bias when comparing groups
(Rossi, et al., 2019). In areas like the one in this study, there are no farmers' records,
complicating the recruitment of participants. Since there was no systematic way to ensure
the number and identity of participants, researchers determined that matching would
allow the control group to be generated effectively. Matching should ensure that all the
social, economic or any characteristic that may affect the results should be present in both
groups. For this study, the control group did not receive the experimental treatment
(Frankel, et al., 2015).
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Population
Target Population
The target population is the larger population to which a researcher would like to
generalize the results (Frankel, et al., 2015). For this mixed method, study the target
population was small farmers in El Salvador. Although there does not exist a globally
accepted definition of small farmer, the FAO (2015) defines small farmers as “… small
farmers are all the farmers producing on less than 2 hectares…” In El Salvador, the last
agricultural census (2007-2008) stated that 82% of the farmers met the small farmer
definition, which includes approximately 325,044 farmers.
It is common, for a target population is not to be accessible because frames for the
target population are unavailable. The population to which the researcher is able to gain
access is known as the accessible population (Frankel, et al., 2015). In this study, the
accessible population were small farmers living in rural Chalatenango, El Salvador.
Qualitative sample.
For the participants’ selection, purposive sampling was used. The idea behind
purposive sampling is to focus on people with particular characteristics who will be able
to participate in the research (Etikan, Abubakar Musa, & Sunusi Alkassin, 2015). For this
study, the participants were seventeen farmers from Chalatenango, El Salvador.
Participants volunteered to participate in this study.
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Quantitative sample.
A non-probabilistic convenience sample was obtained using a variety of outreach
strategies. Farmers from rural communities in Chalatenango, El Salvador were invited to
participate in the study and volunteered to complete the research instruments.
Data collection
The Institutional Review Board (IRB) at Texas Tech University approved all the
procedures used to conduct this research project as research project IRB2018-917
(Appendix A).
Qualitative- Data Collection
The qualitative section of this study used face-to-face interviews with the
participants. Seventeen interviews were conducted in order to explore the food security
situation, food choices and nutritional attitudes, and barriers to accessing food perceived
by the farmers. The interviews lasted an average of 25 minutes, were administered in
Spanish, and were audio-recorded with the participants’ permission.
The recruitment of the participants included an initial visit to their houses to
introduce the research project and ascertain their willingness to participate in the study.
On the first visit, the investigator set a date and time based on the participant's preference
for the interview.
For the interviews, the researcher visited the participants’ homes to make them
feel comfortable. According to Bevan (2014), and consistent with Seidman (2006, p. 19),
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research participants’ behavior is more meaningful when “placed in the context of their
lives and the lives of those around them”.
Quantitative- Data Collection
In the quantitative section, farmers who participated in the qualitative phase were
invited to participate in the quantitative phase. For the recruitment of the participants,
ACOPIDECHA de R.L., a farmers’ organization, assisted the researcher. House-to-house
invitations, phone calls, flyers, and a formal invitation letter were used to invite the
participants. Farmers were asked to meet on a particular day and time to participate in the
educational intervention.
The experimental farmers group received an educational intervention developed
from the qualitative findings. The educational intervention and the materials were
designed based on the necessities identified by the participants. The four-hour
intervention included the following activities: presentations, teamwork activities, and
practice exercises. An informative manual was designed in Spanish and provided to the
participants as a summary of the intervention’s content.
An instrument comprised of four sections was used in the study. The sections in
the study instrument included: (1) demographic information, (2) the FAO Food Insecurity
Experience Scale, (2) knowledge section, and (3) attitudinal section. The instrument was
administered before and after the educational intervention as a pre-test and post-test to
measure the impacts of the educational intervention on food security and nutrition among
small farmers in rural El Salvador. The pre-test instrument was administered to the
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participants at least three days before the intervention. The post-test was distributed to the
experimental group after the educational intervention and for the control group at a date
and time set by the participants. The control group received the educational intervention
after they completed the post-test instrument as compensation for their participation in the
research project.
Prior to the implementation of the study, the participants were informed that their
participation in the study was voluntary and that they would not receive any economic
compensation for their participation. In addition, participants were informed that they
could stop completing the instrument at any time if they did not feel comfortable. In
addition, the participants were provided with the researcher’s contact information and the
research details.
A folder with the informative manual, a pen, and a notebook were provided for
the participants. Participants received an identification code in their notebook to use when
completing the instruments. These procedures were followed to assure anonymity. The
participants were not asked for any identification information except for the identification
code on the research instrument.
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Instrumentation
Qualitative Instrument
Interview questions.
The farmers’ interview included questions about: (1) family structure and
demographics, (2) water and sanitation, (4) agricultural production, (5) food security, and
(6) food preferences. The interview questions sought to explore farmers’ knowledge on
food security and nutrition, food choices, and barriers to accessing food. The food
preferences questions were designed using the FAO Dietary Guidelines for Salvadorian
Families (FAO, 2012).
Quantitative Instrument
The FAO Food Insecurity Experience Scale.
In 2015, FAO designed the Food Insecurity Experience Scale (FIES). This
instrument was tested for three years in 140 countries and proved a reliable and valuable
tool to generate information about the food insecurity perceived by the individual
respondent and the respondent’s household as a whole. The FIES provides statistical data
to measure the state of food security at the individual and household levels (FAO, 2015).
Knowledge test.
The knowledge instrument (true/false, and multiple- choice questions) was based
on food security and nutrition information. The knowledge test content corresponded to
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the educational intervention curriculum; in other words, the knowledge instrument tested
participants only on the information they were provided during the educational
intervention. The 25-item instrument was divided in three sections: (1) food security and
nutrition at home, (2) drinking water treatments, and (3) food production. See Table 6 for
some question’s examples.
Attitudinal test.
The attitudinal instrument was developed based on findings from the qualitative
section of the research study (Table 7). The 47-item instrument used a five-point Likert
type scale using the following terms: (1) strongly disagree, (2) disagree, (3) neutral, (4)
agree, and (5) strongly agree. The attitudinal instrument was divided in six research
constructs in the pre-test and post-test and one construct exclusively for the post-test.
Several studies have supported effectiveness of research constructs in operationalizing a
concept (Bagozzi & Edwards, 1998; Edwards, 2001). The constructs included in the
instrument, as well as a definition of each construct, are the following:
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Table 6
Knowledge Test Structure
Section Number of items Type of question Examples Food security and nutrition at home
Nine items True or false A balanced diet helps prevent diseases and reduce medical expenses at home. When we prepare food at home, we must clean the instruments we use.
Drinking water treatments
Nine items Multiple choice How long should water for human consumption boil to kill bacteria in it? A. 1 minute B. 3 minutes C. 5 minutes D. 10 minutes An advantage of filtering water is: A. Simple to apply B. Cleans all types of water C. The water lasts a long time after filtering it D. The high economic cost
Food production
Seven items Multiple choice A home garden allows the family to: A. Buy more food in the market B. Availability of food throughout the year C. Having more money for the family D. Have better cleaning conditions to prepare food
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Community The community construct measures attitudes towards individual participant’s
concern about food and nutrition security at the community level.
Education This construct measures the attitudes towards nutritional education and the family
capacity for food security and agricultural production.
Food Choices Consumption culture construct measures the participants’ attitudes towards the
consumption patterns, food choices, and food preferences at home.
Food safety This construct measures the attitudes towards the safe production and preparation
of food at home, as well the implications of consuming contaminated or dirty food.
Water treatments The water treatments construct measures attitudes towards the ways of treating
water at home and the differences between water treatments available.
Agricultural production This construct measures the farmer’s attitudes and perceptions toward their food
production, resources availability and agricultural capacities.
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Intentions of adoption The intentions of adoption constructs measure the farmers’ wiliness to implement
the knowledge and process though during the educational intervention.
Table 7
Attitudinal Instrument Structure Construct Number of
questions Examples
Community Three items • I am willing to exchange food products with other members of my community.
• I'm not interested in feeding my community
Education Seven items • Workshops on clean food production are not important to me
• I know what a balanced diet is
Food choices Seven items • I feel better when I eat healthy and clean • The taste of food is more important than
the nutritional benefits
Food safety Eleven items • The worst thing that can happen when you eat a contaminated food is to get sick
• The storage temperature of food is not important in my house
Water treatments
Six items • Water treatments are very complicated • Contaminated water is not a risk to my
family
Agricultural production
Seven items • I have the right resources to produce food at home
• I'm not interested in producing food in my house
Intentions of adoption
Six items • I am going to implement the processes learned about cleaning food
• I will establish a family garden
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Data analysis
Qualitative data
The recordings of the interviews with the seventeen farmers were transcribed
manually. For the data analyses, coding was implemented to identify common patterns
and similarities in the participants’ experiences. Ivankova (2015) claims that coding is the
methodological stage in qualitative research that allows the researcher to extract meaning
from data units and to gather them into groups or categories. For this research study,
descriptive and concept coding methods were used. According to Miles, Huberman and
Saldaña (2014), descriptive coding labels ideas, sentences, or paragraphs with a word or
short quotation. In concept coding, a concept is defined as “(a)n idea or mental image
which corresponds to some distinct entity or class of entities, or to its essential features,
or determines the application of a term (especially a predicate), and thus plays a part in
the use of reason or language”(Oxford dictionary, 2019). The four dimensions of food
security: (1) availability, (2) access, (3) utilization, and (4) stability were used as concepts
for the coding process.
Quantitative Data
Quantitative data was collected using a paper-based research instrument and
entered in Excel spreadsheet. The Statistical Package for Social Science (SPSS®) was
used for the statistical analyses. The negative stated questions were recoded. Descriptive
statistics were performed to describe the research population and the state of food
security in the community. For the educational intervention evaluation, the participants’
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scores in attitudinal and knowledge tests were compared. Dependent t-test (objectives 4
and 5) comparing experimental and control group and Independent t- test (objectives 6, 7,
and 8) comparing the pretest and posttest. The alpha level was set at a = 0.05 level of
significance, a priori. The final instrument reliability was measure using a post-hoc
reliability analysis.
Validity.
Validity is defined as “the degree to which evidence and theory support
interpretations of test scores entailed by proposed uses of the test” (Ary, Jacobs, &
Soresen, 2006, p.235). A panel of experts composed of committee members and other
professionals considered experts in the research field reviewed the instrument and
recommended modifications in wording, structure, and content.
Reliability.
Reliability refers to a measurement of consistency degree. Rossi, Lipsey and
Henry (2019) define reliability as the extent to which a research instrument produces the
same results in multiple uses, to determine if what is being measured has not changed
across uses. A pilot test of the instruments was performed at Texas Tech University in
January 2019. Thirty native speakers of Spanish with an agricultural and food security
academic background and familiar with El Salvador’s socio-economic conditions
participated in the pilot test.
A post-hoc reliability analysis was performed to evaluate the instruments’ internal
consistency when delivered to the population. The experimental group (n= 52) was used
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to conduct the reliability post-hoc analysis. For both statistical analyses, Cronbach’s
alpha coefficient was calculated to identify the instruments’ reliability.
According with George and Mallery (2003, p.231) for a new research instrument,
Cronbach's alpha reliability coefficient > .7 is considered acceptable. In the pilot test, the
constructs community, education, food safety, water treatments and adoption intentions
and the knowledge test were good (> .8). The constructs food choices and agricultural
production were acceptable (> .7). In the Post-hoc reliability analysis, the values varied.
The constructs community, water treatments, and intentions of adoptions and the
knowledge test were good (> .8). The constructs food choices, education, food safety, and
agricultural production were acceptable (>.7). Table summarizes 8 the Cronbach’s alpha
reliability values for the pilot test and post-hoc analysis of the study.
Table 8
Note.1 Measurement: Cronbach’s alpha
Reliability Coefficient Scores1 on the Knowledge and Attitude and Perception Test Construct Pilot test Post-hoc
Community .83 .81
Food choices .72 .77
Education .82 .79
Food safety .87 .78
Water treatments .84 .86
Agricultural Production .73 .74
Intentions of adoption .87 .85
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Trustworthiness.
In qualitative research, trustworthiness refers to the level of confidence that the
researcher has set in the results based on the research design, participants and research
context (Ary, Jacobs, & Soresen, 2006). Triangulation of data was accomplished using
the following sources of information: (1) farmer’s interviews, (2) literature, (3)
community leader interviews, and (4) observational analysis.
Research subjectivity statement.
It is common in qualitative research for the researcher to issue a statement about
him/herself to clarify any potential areas of bias in the research. In the spirit of
transparency (Dowling, 2005), I issue the following statement: I was born and raised in
the community under study. I have known many of the families in the community for
most of my life. I am well versed in agricultural issues in the study area, having spent a
great deal of my life there. Seeing the community’s needs firsthand inspired me to
explore solutions. I have keen investigative interests in food security and adult education,
both of which seem appropriate for working with this community. I have had professional
and research experience in different developing countries, which has opened my eyes to
the training needs of rural community members. All of these factors contributed to my
desire to identify and understand barriers in access to food and participants' perceptions
of food security and nutrition in my home community. Figure 9 presents a timeline for
the research study.
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Figure 9. Research study timeline.
Experimental group Control group
Qualitative strand
Face-to-face interviews
Nov. 05-10/2018
Quantitative strand
Pretest Feb. 07/ 2019 Feb. 08/2019
Educational intervention Feb. 11/ 2019 Feb. 12/ 2019
Posttest Feb. 11/ 2019
Feb. 12/ 2019
Educational intervention
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CHAPTER IV
RESULTS
Qualitative Results
Research Objective One
Identify food security and nutrition knowledge, attitudes, and perceptions of the local
small farmers.
Seventeen farmers participated in the interview process during October-November
2018. Among the farmers, nine (52%) were male and eight were female (48%). For the
data analysis, the emerging themes were divided using the FAO Four Dimensions of
Food Security theoretical framework: (1) availability, (2) access, (3) utilization and, (4)
stability (Napoli, De Muro, & Mazziotta, 2011). Participants received pseudonyms to
protect their identity.
Food availability - emerging themes
Food availability is the longest-standing food security dimension and focuses on
the balance between population and food. Agricultural production and trade (Burchi &
De Muro, 2016) primarily influence this dimension. The following themes emerged in the
food availability dimension of food security:
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Agricultural production theme.
The agricultural production theme refers to the annual production rates and the
elements that affect agricultural production and, consequently, the state of food security
and nutrition. Farmers' food security depends not only on the amount of food available,
but also on the diversity and quality of these foods. For example, Jose stated that the food
preferences at home influenced the family’s agricultural production decisions. The main
foods in the Salvadorian diet are grains, vegetables, and dairy products. Principal crops
for small farmers in El Salvador include corn, beans, and some vegetables, with limited
animal protein intake. Although the diversity of food in the diet is only part of the
farmers’ nutritional status, it is an indicator of the nutritional quality of the diet. Jose said:
“…I always produce the same crops. Implementing crop rotation is complicated. What
we need to produce is the corn for tortillas…” Raquel said: “…I do not know exactly how
much area he cultivates [her husband]. However, every year we sow the same crop…”
Ramiro said: “…I have harvested the same crops every winter [rainy season] ...”
The poor agricultural production rates in El Salvador are also affected by the lack
of arable land. In El Salvador, after several agrarian reforms, farmers compete against
rapid urbanization and environmental degradation for the available land (Vargas, 2003).
The availability of agricultural land especially affects small farmers. Carlos mentioned:
“…I only have a small space to produce. I have to look for someone to lease me land in
order to produce the amount [of grain] needed in my home…” The lease payment of
agricultural land is a high expense for rural farmers Carlos shared that the price of 0.7
hectares is up to $ 50.00/month. However, there exists other payment methods less
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stressful for the farmers. Carlos said: “…I pay at the end of the harvest season with 2 or 3
quintals (qq) [1qq = 220lb] of my corn production. This payment is better than having to
pay each month. Sometimes you do not have the money…” Jose said: “…I plant 2.8
hectares each year. Part of the land that I am using is rented. The payment is 5 quintals
of corn from my production…” Although when paying with agricultural production, the
payment is higher. This method of payment reduces the constant economic pressure in
rural households. Farmers mention that this payment method is more flexible and
convenient.
The lack of arable land is not the only agricultural related problem identified by
farmers. Pests and diseases are also affecting agricultural production. Changes in the
biological and chemical interactions between crops, pests, diseases, and their natural
enemies have affected tropical countries like El Salvador (Cilas, Goebel, Babin, &
Avelino, 2016). Fidel said “… there are pest or diseases that we do not know how to
treat, and they are stronger [more resistant] every season…” Managing the changes in
agricultural pests and diseases adds an additional expense for small farmers. One of the
participants shared that fertilizers and agricultural chemicals are expensive and they
difficult to find them in the local stores. Lorenzo said: “…It depends on how strong the
pests and diseases are, I have to buy agricultural chemicals. This year, I used two
products. However, I make an effort not to apply chemical products in my agricultural
production…”
Many farmers’ agricultural production depends on government aid. According to
the Ministry of Agriculture and Livestock (MAG) in 2018, 412,775 people benefited
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from the "Agricultural Package Program", which delivers seeds and agricultural
chemicals to small agricultural producers classified in the lower thresholds of poverty
(General Direction of Agricultural Economics, 2018). Participants receive the agricultural
package every year prior to the start of the planting season. The Agricultural Package
Program uses state offices, city halls, and schools as distribution centers for packages.
Antonio shared “… This year I applied to my crops the agricultural chemicals that were
delivered to us in the mayor's office…” Lourdes said: “… We buy fertilizers and other
chemical products that my dad knows to fight pests…” In spite of government aid, the
complexity of new agroecosystems forces farmers to buy agricultural chemicals. Jose
mentioned “…In this harvest I used 20-20-20 (fertilizer) and a couple of bags of fertilizer
that they gave me [government]…”
Food access -emerging themes
Food access is the second food security and nutrition dimension and refers to the
economic, natural, and human resources available to produce and purchase food. This
dimension is especially critical for rural communities in lower- and middle-income
economies (Cordero-Ahiman, Santellano-Estrada, & Garrido, 2017). The following
themes emerged from the food access dimension of food security:
Access to markets theme.
The access to market theme refers to the economic, social and geographic
limitations that farmers face to access appropriate markets and agricultural inputs stores.
Farmers associate their limited access to markets with the deficient transport systems
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available in the rural areas of El Salvador. According with Ajiiboye and Afolayan (2009),
farmers with access to appropriate transport systems are more willing to improve their
productivity and income and, reduce the poverty level in their communities. Ramiro
mentioned that “…The buses are very old and do not work constantly ...” (Figure 10) for
farmers in El Salvador, travel to the closest market represents an investment of both time
and money. Lidia mentioned “…We go to the market three times or less per year…”
Angelica said: “… We do not go to the market very often. Agricultural activities do not
allow us to travel constantly…” Raquel mentioned “… It is not worth traveling 45
minutes to the market. The bus system does not work, and the expense is very high…”
Ana said: “…I have to invest two to three dollars to be able to go to the market. I can use
that money to buy food…” In the research area, the closest markets are between 30-45
minutes away. Farmers recognize that the foods that can be obtained in the market are
more diverse compared to those available in the community. Lidia mentioned “…I would
like to go [to the market]. There are more things [food] there. But I do not have money to
be able to go very often…”
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Figure 10.Transportation systems in El Salvador.
Despite the difficulties in accessing markets, farmers find other local sources of
food supply. However, food diversity is limited, and prices tend to be higher (Sustainable
Development Solutions Network [SDSN], 2015). For the context of this research project,
a “local store” is a small commercial establishment with limited food availability. These
local stores usually distribute products with a longer shelf life, including bread, noodles,
rice, among others. However, they do not market animal protein and perishable vegetable
foods. Ramiro mentioned “…My wife goes [to the market], but not very often. It is not
worth spending to get there. We get the food we need at the local store…” Maria said:
“…here [in the local store] are the basic foods to survive…” For some community
members the price rate differences between the local store and the market are not
substantial. Carlos said: “…We never go to the market. Everything you need [food] is in
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the community local store and the prices are almost the same...” Independent food sellers
carry the more necessary food to the communities alleviating the food access situation.
These independent food vendors use freight vehicles and generally transport fruits and
vegetables from the main markets to rural communities. However, this alternative is
partial solution to the problem. The communities do not have all the food necessary for
an appropriate diet. Rocio mentioned “…I do not go to the market. Everything I need at
my home I buy in the cars that sell vegetables...” The food merchants who go to the
community take advantage of the families' needs. Prices are sometimes much higher
compared to the local market. Angelica said: "... There are some things [food] that I do
not buy because they are too expensive; they [food merchants] take advantage..."
Income and purchasing power theme.
In El Salvador, the poverty rate of rural farmers is 22% and their principal source
of income is agricultural production (FAO, 2018). Carlos said: “…We live with what we
produce in the field. It's a poor life but we survive…” Farmers’ economic condition is
characterized by low purchasing power and low-income rates (FAO, 2018). This theme
explores the economic situation and its conditioners, among rural farmers in El Salvador.
Farmers in the study used words like poor, scanty, and oppressive to describe their
economic conditions.
The farmers’ economic situation is one of the principal themes addressed during
the interviews and emerged almost immediately for every farmer. Participants described
their economic situation as difficult, complicated, and getting worse and worse. When
participants were asked about their income, the following quotes emerged:
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Ramiro said: “… My income is definitely not enough to purchase food for my
family…”
Antonio stated: “…I always need money in my house. However, you learn to live
with what you have…”
Flor mentioned: “…Money is not enough. We have been hungry because we had
no money to buy food…”
Ramiro, Antonio and Flor’s cases are not unique or exclusive; they are simply
more statements to provide evidence of the farmers’ limited availability of economic
resources. When there is not enough money, families are forced to feed themselves with
diets low in nutritional value. Ana said: "... I buy what I can, I try to save money as much
as I can, and sometimes it's time to make sacrifices ..."
The households’ purchasing power is not the only thing affected by limited
economic resources; their agricultural production is also affected. When asked how their
economic situation affects their agricultural production, participants shared:
Fidel said: “…I have many expenses at my house. At the end of the month, I have
very little money to invest in agricultural production…”
Armando mentioned that “…All agricultural inputs are very expensive. I do not
have enough money to treat pests and diseases in crops...” Antonio said: “…If any
unforeseen event happens, may God help us because that month will be difficult…”
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Poverty is visible and palpable in these rural homes. When visiting them, it was
evident how the lack of economic resources affects all the activities of the family
members. It was shocking to observe children with observable deficiencies in physical
and intellectual development. Children are stunted and are not at the appropriate
educational level for their age.
Women invest most of their time in household activities and appear to be so
consumed in daily life struggles that it wears on their physical health and well-being. The
women appeared haggard and were visibly in poor nutritional condition. Men appear
much older than their years, probably due to the effects of outdoor work in the
agricultural field. Their skin is burned and dry. Often, they appear stooped from constant
bending over. In addition, their deficient nutritional state is visibly evident in their small
stature and thin frames.
Houses in the community are dilapidated structures, susceptible to climate effects,
and in some cases actually represent a danger to people. When taking a 360-degree view
of these families there is not one aspect of their lives that is not affected by their poverty.
Food utilization – emerging themes
Food utilization is the third food security dimension and refers to both an
individual’s knowledge of proper food preparation and consumption, as well as the actual
sanitary conditions necessary to safely consume and produce food. This dimension’s
principal indicator is the people’s health status (Tandon, et al., 2017). The following
themes emerged in the food utilization dimension:
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Drinking water treatments theme.
Access to clean and safe drinking water is one of the non-food factors that are
relevant to ensure appropriate food utilization (Tandon, et al., 2017). This theme refers to
the water access limitations face by farmers in rural El Salvador. At the same time, the
consequences for people derived from the inadequate quality and quantity of drinking
water. This theme comprises the limitations on drinking water access and the
implementation of water treatments by rural farmers in El Salvador.
The lack of appropriate water sources was a common theme that arose during the
analysis of the farmers’ interviews. For some families, the principal water source are
wells they have at home. Many development initiatives have been working with this
community to provide wells and latrines in the homes of the poorest people. However,
many families are still missing these basic services, obliging them to carry water from a
small, local river.
During the research, water samples from the two local rivers (Figures 11 and 12)
and a home well were taken by the researcher and subsequently sent to an independent
water analysis laboratory. The results indicate that water consumed by the participants
does not meet the Salvadorian Regulation for Drinking Water (SRDW) parameters. The
SRDW states that drinking water must be zero colony-form units (CFU) of total
coliforms per 100 ml of water (National Council for Science and Technology
[CONACYT], 2001). The three analyzed water samples present higher CFUs numbers
per 100 ml of water and are not appropriate for human consumption (Appendix C). The
implementation of water treatments is crucial to improve the drinking water quality.
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To describe their water sources, participants used adjectives like it [water] has
very bad odors, it tastes strange and it is dirty. When participants were asked if the water
is treated before consumption at their house, the following quotes emerged:
Raquel mentioned “…The water is consumed without any treatment. We store it
in containers to keep it fresh and free of trash…”
Angelica said: “…We do not have anything to treat the water. We consume the
water as it comes out of the well…”
Ramiro “…The water we drink tastes awful. However, treating it takes a lot of time and
sometimes money…”
In the community, the local public medical center promotes educational
campaigns on drinking water treatments, to train families on the appropriate
implementation of these treatments. However, participants insist that they lack
knowledge on this topic. Armando said: “…In my house we do not treat the water
because we do not know how to do it...” Fidel mentioned “…I have always been worried
about the water we are consuming. However, I have no idea how to change it…”
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Figure 11. Local water source in the community.
Figure 12. Local water source in the community.
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It is necessary to promote the education of rural families in the area of water
sanitation. The physical appearance of water is only one of the elements that must be
evaluated to ensure safe consumption. For many participants, the water’s transparent
appearance is sufficient to consume it.
Food safety theme.
Food safety and sanitation are important components of food security and
nutrition. Knowledge of the adequate conditions for food production, processing, and
consumption has a central role to play in reducing foodborne diseases that directly affect
the state of food security (Adebowale & Kassim, 2017). This theme explores the food and
sanitary conditions and practices implemented by households in rural areas of El
Salvador.
In households, there was an evident lack of sanitation that is aggravated by the
deficient sanitary infrastructure available. For the most part, participants perform their
physiological needs in structures (latrines) (Figure 13-A and 13-B) that use ashes to treat
excrement and avoid odors. Many of the participants built these latrines through the
investment of international development institutions. However, some of these latrines are
not in good condition. They were built inappropriately, with poor materials, and without
considering location with respect to other areas of the house. At the farmers’ homes,
latrines are located at short distances from places where food is processed or drinking
water is obtained. The proximity of these places is a potential source of cross -
contamination and represents a health risk for people.
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Figure 13. Latrines structures.
During the interviews, I was able to observe the distribution of spaces in the
participants’ houses. Some farmers have their latrines located very close to the wells that
supply the drinking water. The construction of these houses is driven by the location of
water wells so that they are near the places where daily cleaning activities are carried out
(washing dishes, clothing, and food) to facilitate the carrying of water. The close location
of the latrines to the cleaning stations is not a healthy practice. The latrines have been
built with underground structures for the storage of excrement. These underground
structures often connect with the groundwater sources that supply the family well.
Other members of the community live in even more severe sanitary conditions.
When asked about sanitary structures (latrines), participants said they did not have one at
home. Fernando said: "... We do not have a latrine, we do our needs [physiological
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needs] in the forest, but at night it is dangerous, and we prefer to do it close to the house
..."
Conducting interviews in some of these households was challenging and
uncomfortable. The presence of odors of human waste pervaded the environment and was
almost unbearable. I find it difficult to understand how these families manage to live their
daily lives in these environments.
Combined with the limited sanitation infrastructure, farmers still maintain cultural
practices that are not safe and represent food contamination risk. Many of the agricultural
chemical inputs that are used by the participants are stored in the home (Figure 14).
Families maintain a constant exposure to these products. Many households store the
product in closed places and within reach of children. The high value that agricultural
chemical inputs have for these families forces them to take care of these precious
possessions at all costs, regardless of putting their health at risk.
While asking about the agricultural products they use, a participant pointed to his
house referring to the chemicals he stored inside. I looked at a stack of chemical bags
inside the house, very close to the kitchen. This was not an isolated case; many farmers
stored agricultural products near the places where they prepare and consume food.
The management of waste from agricultural chemicals is another sanitation
problem for these farmers. In the yards, it is easy to identify containers of fertilizers and
pesticides used for other activities despite having the symbols of risk of poisoning. Plastic
containers are reused by children to play and sometimes by families for the storage of
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drinking water. The bags of fertilizer are used for the storage of seeds, fruits, or animal
feed. Farmers are not using proper disposal practices for these materials.
Figure 14. Agricultural chemical storage at rural households.
Garbage is also generating another potential risk to people's health. Along with all
the chemical waste, there was a large amount of organic and inorganic waste scattered in
the contours of the houses. There was a lot of food waste in decomposition, generating
bad odors, and serving as lodging for insects that transmit diseases. Plastic bags, bottles,
and cans are everywhere and are used by farm animals to play.
Many farm animals are also affected by the contamination of their food sources
and exposure to sources of poisoning. For the participants, the loss of farm animals
increases economic pressure by reducing their sources of food.
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Another inappropriate cultural practice relates to the interactions of families with
farm animals. Participants allow their animals (especially dogs, cats, and poultry) to enter
the house and move freely, even though the places where food is prepared. The
interaction of these animals with external environments and their presence in the home is
accompanied by a notorious lack of cleanliness and hygiene practices, especially on
surfaces where food is handled.
Cleaning and hygiene are at first sight inadequate and represent a risk for people.
The dilemma is generated when farmers are asked to affirm or reject, according to their
own experience, the phrase "I do not have the sanitary conditions to prepare food
properly." Most respondents (82%) answered false or not at all to the question,
indicating that they did have the necessary sanitary conditions to prepare food – although
observations of the food preparation areas suggested otherwise.
Family nutrition theme.
Nutrition problems affect populations differently. While the majority of
nutritional problems are found in places of extreme poverty, malnutrition also affects
many who have adequate access to food. The relevance of studying family nutrition lies
in the complexity of nutritional problems and the specifications for each stage of human
development. The nutritional requirements for each family member are different and
require special care. This topic explores the attitudes and behaviors related to the
nutrition of family members.
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Although humans share eating habits, we have different preferences for food; this
is also a component of nutrition. However, the participants do not seek to satisfy the
dietary preferences of their members. These families should prioritize the amount of food
on the quality or satisfaction of individual tastes. Flor said: "... I'm looking for food that
everyone can afford ... In my house we all eat what is available ..." Armando said: "... My
wife knows what she buys for the house ... Foods are always bought cheap ... "Ana
mentioned that: " ... you cannot buy a lot of food, what you buy is for everyone, although
not everyone likes it ...”
When asked about the needs and food preferences of each member of the family,
the participants described it with phrases, such as: we all eat the same thing, what there is
for each one is for everyone, and what is bought is for everyone. Limited access to
markets, little knowledge about nutrition, low availability of water, among many other
factors, influence the purchase of food in homes.
The participants demonstrated that on the nutritional content of the food, they
evaluate the price, quantity, and accessibility. Fidel said "... One is content with what is in
the market, if there is no more, what can be done ..."
Until 2018, the El Salvador basic food basket cost in rural areas was $141.43 per
person per month. Using the food items listed in the Basic Salvadorian Basket (Cortes,
2018) and the Dietary Guidelines for Salvadorian Families (FAO, 2012), a list of foods
contextualized to the region of study was created.
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Participants were asked to select five food items from the list that are always
present in their family diet. The most frequently selected foods were tortillas, beans, rice,
vegetables, and bread. When identifying the food items that are never consumed at home,
participants selected meat, dairy products, fish, processed meats, and snacks. It was
predictable that animal proteins would be located in food items with less frequency of
consumption.
Food Stability- emerging themes
Food stability is the last food security and nutrition dimension and seeks to ensure
the food security component “for all people at all times”. Food stability requires
multidisciplinary approaches that protect, conserve, and promote sustainable food
systems. The following themes emerged in the food utilization dimension context:
Climate change theme.
Climate change is a global problem that mainly affects the most vulnerable
populations. The most affected by the vulnerability of agriculture to climate change will
be those whose income and sources of food are directly linked to agriculture (Mengistu,
2011).
Adaptation and mitigation of climate change requires a combination of knowledge
and resources that is often not available to farmers (Mengistu, 2011). Anguaya (2015)
established that rural communities generally do not have scientific knowledge about
climate change. However, the need to understand changes in climate and to prevent
negative impacts has forced rural dwellers to develop an empirical knowledge about this
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phenomenon. This theme explores the farmers’ knowledge on climate change and the
perceived impact on agricultural production.
When asking the participants to define the concept of climate change, the
following answers emerged: I do not know what climate change is, I do not understand
that [climate change,] and /or I cannot [define]. A lack of scientific knowledge and
training on climate change is evident in the participants. However, by addressing the
question in a different way, consulting the farmers if they had observed several changes
in the climate patterns during the last years, the following answers emerged:
Antonio said: "... If the weather changes a lot, for example, there are years where
it rains a lot and others where the droughts are very long ..."
Jose mentioned that "... Before, the weather changed year after year ... now, the
changes are in the same year, we do not know at times what is going to happen, and we
have to be prepared for whatever ..."
Angelica said: "... Changes in climate are felt and affect us a lot, sometimes
during the winter [rainy season] there are very long periods of drought that cannot be
predicted ..."
Farmers in rural El Salvador know that climate change exists and are experiencing
its impacts on their agricultural production. The availability of water was one the
principle elements linked to climate change that emerged during the interviews.
Participants are dealing with long droughts and limited water availability for agricultural
production. In 2018, the governments of El Salvador, Honduras, and Guatemala reported
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281,000 hectares of corn and beans were lost due to drought, affecting 21 million people
(FAO, 2018). This drought aggressively affected rural producers. Participants commented
that the drought of 2018 was very long and more intense than in previous years.
Maria said: “…The droughts here are very hard. We have lost everything
[agricultural production] …” Rosa mentioned “…This year [2018] we could not do
anything [to prevent the losses] ... The plantation was sold to produce fodder, but we ran
out of food ...”
The loss of agricultural production due to the lack of water generates high levels
of economic pressure and stress in farmers, affecting their quality of life. The participants
expressed how the loss of food affects them emotionally and prevents them from living a
full and healthy life. Angelica said “…Sometimes you cannot do anything. We have to
wait and then decide how to get ahead. The situation is sad ...”
Multi-dimension-emerging-themes
Some emerging themes do not fit exclusively into a single dimension of food and
nutrition security. The transversal nature of some aspects of the four dimensions led to
the generation of a category called multi-dimension. The emerging theme in this category
is:
Women participation theme.
In developing economies, women represent approximately 43% of the agricultural
labor force (FAO, 2011). In Latin America, women account for at least 45% of the
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household food production (FAO, 2011). The achievements of women in the agricultural
field have been accomplished despite the rampant inequality in the distribution of land,
access to information, and little social recognition (Sraboni, Malapit, Quisumbing, &
Ahmed, 2014). This theme explores women’s participation and decision power in family
agricultural production and family diet of rural households in El Salvador.
It was not until I began to ask about the family agricultural production, when
female participants’ answers were principally: I do not know, I could not answer, and my
husband knows that. In spite of the evident lack of knowledge about the technical,
productive, and economic aspects of their own farming system, women work in
production and contribute to food production. Raquel “…I helped him at work
[agricultural production]. But he is the one who makes the decisions…” Flor mentioned
“… I always work with my husband. Children also help us especially during the
evenings…” Lidia said: “…He knows how he manages things [agricultural production]. I
do not get involved in that…”
While the participation of women in agricultural production is limited exclusively
to "helping her husband," food choices and the decision-making process for family
feeding and nutrition related issues are women’s responsibilities. At the participants’
houses, the women take care of the family diet and decide how to distribute the family
budget among all the family needs. In Lorenzo's house, his wife is in charge of the
selection and purchase of food, he mentioned, "... my wife takes care of buying the food;
she knows the places that are cheaper to buy ..." Fidel said: “…I give the money to her
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[wife] and she decides what to buy and where to buy. We have to eat what she chooses
[he laughs] …”
Educational Intervention
A four-hour educational intervention was designed for community members
based on the findings from the qualitative data. Three learning modules were developed
to present the intervention content to the participants. Each learning module was built
using other interventions, projects, or reports. A detailed list of academic materials used
in the intervention are presented in Table 9.
The educational intervention structure included: (1) introduction, (2) important
concepts related to the topic, and (3) practice activities. The practice activities sought to
strengthen the farmers’ understanding of the topic and increase their engagement. A post-
test was administered at the end of the educational intervention. Table 10 summarizes
the practice activities per module.
The learning modules were facilitated in a PowerPoint format. The educational
intervention content was compiled in an informative manual designed (Figure 15) and
developed by the researcher in Spanish. Food security and nutrition experts supervised
and revised the informative manual prior to its use. The manual sought to provide an
information source for farmers and a reference for use of the information at home. Based
on the high level of community illiteracy, the informative manual was designed with
diagrams and images facilitating farmers’ understanding.
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Table 9
Participants received a snack package in the middle of the educational training
and were provided with lunch at the end. Participants that completed the educational
training received a certificate of participation (Figure 16).
Academic Resources Used on the Educational Intervention Module Materials Module #1 Food nutrition at home
Dietary Guidelines for Salvadorian Families (FAO ,2012) Eating recommendations for Salvadorian Families (FAO, n.d) Food Safety on the Farm (National Sustainable Agricultur Coalition, 2009) Guidelines for Assessing nutrition-related knowledge, attitudes and practices (Macias & Glasauer, 2014).
Module #2 Water treatments
Water Treatment Manual: Disinfection (Enviromental Protection Agency [EPA], 2011) Guidelines for Drinking-water Quality (WHO, 2016)
Module #3 Agricultural production
A Vegetable Garden for all (FAO, 2014)
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Table 10
Learning Modules Summary of Activities Module Activities Module 1. Family Nutrition
Group activity: Classify food items. Food safety preparation procedures. Components of a balanced diet.
Module 2. Drinking Water Treatments
Example: Would you drink this water? Three water containers with different contamination were presented. Farmers were invited to choose which they would drink. Group activities:
1. Water filtration 2. Water boiling 3. Chlorination
Farmers were divided in three groups and rotated among the practice stations.
Module 3. Family Agricultural Production
Group activity: Family garden. Farmers were divided in five groups and materials were provided to build one of the following structures:
1. Raised bed garden 2. Vertical garden 3. Barrel garden 4. Plastic bottles garden 5. Bio-intensive garden
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Figure 15. Front page of informative manual.
Figure 16. Certificate of participation.
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Quantitative Results
Research Objective Two
Describe farmers from the rural community in El Salvador.
Research objective two sought to describe farmers who participated in the
quantitative phase of this study. Farmers’ demographic characteristics collected in the
study-included gender, educational level, and income, among other characteristics. One
hundred and four participants completed the research instrument, 54 farmers comprised
the experimental group (pre-test and post-test), and 48 made up the control group (pre-
test and post-test).
For the experimental group, there were more males (n = 40) than females (n =
14). Control group followed the same tendency, having more males (n = 29) than females
(n = 19). Overall both groups were composed mainly of males (n = 69) rather than
females (n = 33). The groups’ gender distribution is summarized on Table 11.
Table 11
Summary of Participants’ Gender Experimental Group
(n = 54) Control group
(n = 48)
Characteristic f f % f f %
Male
40
74
29
60
Female 14 26 19 40
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In the research study, the illiteracy rates were 17% and 33% for the experimental
and control group respectively. Overall, 26 farmers were illiterate (25%). For the
experimental group, farmers’ education was predominantly elementary (59%), followed
by no schooling (18.6%), high school (15%), technical school (3.7%), and university
(3.7%). In the control group, the largest number of farmers had elementary education
(50%), followed by no schooling (23%), high school (21%), and university (6%). In
general, farmers’ educational level was elementary (54.5 %), followed by no schooling
(21%), high school (18%), university (4.5%) and technical (2%). Figure 17 and Table 12
summarize farmer’s education levels.
Figure 17. Educational level of participants.
0
5
10
15
20
25
30
35
No schooling Elementary Hihg school Technical University
Farmers' Educational Level
Experimental Group Control Group
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Table 12
Summary of Participants’ Educational Level
Experimental Group
(n = 54) Control Group
(n = 48)
Characteristic f f % f f %
Did not go
10
18.6
11
23.0
Elementary 32 59.0 24 50.0
High school 8 45.0 10 21.0
Technical 2 3.7 0 0.0
University 2 3.7 3 6.0
Overall, the participants’ age was predominantly between 31-40 years (24.5%),
and 41-50 (24.5%), followed by 51-60 years (16.7%), 19-30 years (14.7%), 61-70 years
(13.7%) and 81-90 years (1%). For the experimental group, the age of farmers was
distributed as follows: 31-40 years (24%) and 41-50 years (24%), followed by 51-60
years (16.7%), 19-30 years (16.7%), 61-70 years (11.1%), 71-80 (5.6%), and 81-90
(1.9%). For the control group, farmers’ age was 31-40 years (25%) and 41-50 years
(25%), followed by 51-60 years (16.7%), 61-70 years (16.7%), 19-30 years (12.5%), and
71-80 (5%). Figure 18 and Table 13 summarize participants’ age.
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Table 13
Summary of Participants’ Age Experimental Group
(n=54) Control Group
(n = 48) Age f f % f f %
19-30
9
16.7
6
12.5 31-40 13 24.0 12 25.0 41-50 13 24.0 12 25.0
51-60 9 16.7 8 16.7 61-70 6 11.1 8 16.7
71-80 3 5.6 2 5.0
81-90 1 1.9 0 0.0 Note. Age (years)
Figure 18. Age of the participants.
0
2
4
6
8
10
12
14
19-30 31-40 41-50 51-60 61-70 71-80 81-90
Age of the Participants
Experimental Group Control Group
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Of the study population, 78 (76.5%) households had a male family head and 24
(23.5%) a female. For the experimental group, 42 (77.8%) households had a male as a
family head and 12 (22.2%) were headed by females. The control group follows the same
tendency, with 36 households (75%) having a male family head and 12 (25%) headed by
females. Of the 104 households represented in the study, the majority were composed of
five members (28.5%), followed by six members (22.5%), four members (14.7%), seven
members (10.8%), eight members (8.8%), three members (4.9%), 10 members (2.9%), 12
members (2.9%), nine members (2%), 11 members (1%), and 13 members (1%). For the
experimental group, the family composition was as is follows: five members (31.5%),
followed by six members (20.4%), four members (14.8%), seven members (13%), eight
members (5.5%), 12 members (5.5%), three members (3.7%), nine members (3.7%), and
10 members (1.9%). For the control group the family composition was as is follows: five
members (25%), followed by six members (25%), four members (14.6%), eight members
(12.5%), seven members (8.3%), three members (6.2%), 10 members (4.2%), 11
members (2.1%), and 13 members (2.1%). Table 14 provides an overview of the
households’ family composition.
In this study, there were 73 (71.6%) participants who lived in their leave in a
house and 29 (28.4%) that lived in a home that does not belong to them. Among
participants in the experimental group, 38 (70.4%) are owners of their house and 16
(29.6%) rent or take care of another person’s house. For the control group, 35 (73%)
farmers owned their homes and 13 (27%) are considered tenants.
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Table 14
Summary of Households’ Family Head and Composition
Experimental Group (n = 54)
Control Group (n = 48)
Characteristic f f % f f % Family head
Male 42 76.5 36 75.0 Female 12 26.5 12 25.0
Household composition1 3 2 3.7 3 6.2
4 8 14.8 7 14.6
5 17 31.5 12 25.0
6 11 20.4 12 25.0
7 7 13.0 4 8.3
8 3 5.5 6 12.5
9 2 3.7 0 0.0
10 1 1.9 2 4.2
11 0 0.0 1 2.1
12 3 5.5 0 0.0
13 0 0.0 1 2.1 Note: 1Family Composition (number of people in the household).
In the study population, just over half of the participants are owners of
agricultural land (57.8%). In the experimental group, the majority of farmers (64.8%) are
owners of agricultural land. In the control group, however, only half (50%) of the farmers
are agricultural landowners. Figure 19 and Table 15 present the summary of descriptive
statistics for farmers’ house and agricultural land ownership.
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Table 15
Summary of Households’ House and Agricultural Land Ownership
Experimental Group
(n =54) Control Group
(n = 48)
Characteristic F f % f f %
House ownership
Yes 38 70.4 35 73.0 No 16 29.6 13 23.0
Agricultural land ownership Yes 35 64.8 24 50.0
No 19 35.2 24 50.0
Figure 19. Participants’ House and Agricultural Land Ownership.
0
5
10
15
20
25
30
35
40
House Ownership Agricultural LandOwnership
No House Ownership No Agricultural LandOwnership
Participants' House and Agricultural Land Ownership
Experimental Group Control Group
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Research Objective Three
Illustrate the current food security and nutrition situation.
Research objective three sought to explore the current food security and nutrition
situation among the research study participants. In this section of the study, participants
were asked to answer the eight questions of the Food Insecurity Experience Scale (FIES).
Overall, the FIES score was M = 4.5. For the experimental group, farmers’ FIES score
was M = 4.3, compared with M = 4.6, for the control group. Based on the FIES food
security and nutrition classification, the population in the study falls under the moderate
to severe food insecure classification. Figures 20 and 21, and Table 16 summarize the
FIES results for the study.
Figure 20. Farmers’ food insecurity experience scale (FIES) Score.
0
2
4
6
8
10
12
14
0 1 2 3 4 5 6 7 8
Farmers' Food Insecurity Experience Scale (FIES) Score
Experimental Group Control Group
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Figure 21.State of Food Security and Nutrition on the Food Insecurity Experience Scale (FIES).
Table 16
Farmers Food Insecurity Experience Scale (FIES) Score.
Experimental Group (n = 54)
Control Group (n = 48)
Score f f % f f %
0
1
1.9
3
6.3 1 4 7.4 3 6.3 2 5 9.2 3 6.3 3 9 16.7 5 10.4
4 10 18.5 4 8.3
5 7 13.0 8 16.6
6 10 18.5 12 25.0
7 3 5.6 7 14.5
8 5 9.2 3 6.3
Mildly Food Insecure
Moderately Food Insecure
Severely Food Insecure
8
0
Food Secure
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Research Objective Four
For experimental and control group:
Determine whether there is a statistically significant difference in knowledge on
food security and nutrition of small farmers between pre-test and post-test. Hypothesized
(at α = .05) as follows:
H0: There will be no significant difference in knowledge on food security and
nutrition of small farmers between pre-test and post-test (µexperimental pre-test -
µexperimental post-test = 0); (µcontrol pre-test - µcontrol post-test = 0).
H1: There will be a significant difference in knowledge on food security and
nutrition of small farmers between pre-test and post-test (µexperimental pre-test -
µexperimental post-test ≠ 0); (µcontrol Pre-test - µcontrol post-test ≠ 0).
Experimental Group.
For the experimental group, homogeneity of variance was not violated, as
assessed by Levene’s Test for Equality of variance (p = .514) (Field, 2018). The
knowledge scores were higher for posttest (M = 20.78, SD = 2.30) than pretest (M = 7.93,
SD = 2.31), a statistically significant difference t (106) = -28.97, p < .001.
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Control Group.
Homogeneity of variance was not violated, as assessed by Levene’s Test for
Equality of variance (p = .325). Although the knowledge scores were higher for posttest
(M = 8.40, SD = 2.89) than pretest (M = 8.19, SD = 2.50), there was no statistically
significant difference t (94) = -.208, p = .706. See Table 17 and Figure 22.
Figure 22. Knowledge scores for experimental and control group pretest and posttest.
Pretest PosttestExperimental Group 7.93 20.78Control Group 8.19 8.4
0
5
10
15
20
25
Participants' Knowledge Scores
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Table 17
Group Differences for Experimental and Control Knowledge Pretest and Posttest Scores
Pretest
Posttest
Group M SD M SD t Df p Experimental
7.93
2.37
20.78
2.30
-28.97
106
<.001*
Control 8.19 2.50 8.40 2.89 -.20 94 .706 Note: 1Score: 0-25. *p < .05
Research Objective Five
For experimental and control group:
Determine whether there is a statistically significant difference in attitudes and
perceptions toward food security and nutrition in the small farmers between pre-test and
post-test. Hypothesized (at α = .05) as follows:
H0: There will be no significant difference in attitudes and perceptions toward
food security in the small farmers between pre-test and post-test (µexperimental pre-test -
µexperimental post-test = 0); (µcontrol pre-test - µcontrol post-test = 0).
H1: There will be a significant difference in attitudes and perceptions toward food
security in the small farmers between pre-test and post-test (µexperimental pre-test -
µtreatment post-test ≠ 0); (µcontrol pre-test - µcontrol post-test ≠ 0).
A dependent-samples t-test was conducted for the experimental and control
groups to determine if there were differences in attitudes and perceptions between pretest
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and posttest scores for each construct. The attitude and perception scores per construct
per each level of testing were normally distributed. Distribution was assessed by
skewness and kurtosis between -2 and +2, which are considered acceptable in order to
prove normal univariate distribution (Field, 2018). This followed up by visual inspection
of the distribution shape.
Experimental Group.
In the experimental group, the Community construct, farmers’ attitudes and
perceptions were higher for posttest (M = 4.14, SD = .68) than pretest (M = 3.26, SD =
.63), a statistically significant difference t (106) = - 6.9, p < .001.
On farmers’ scores on the Food Choices construct, there was an increase in scores
from posttest (M = 3.64, SD = .32) to pretest (M = 3.21, SD = .59), statistically significant
difference t (106) = -4.6, p < .001.
In the Education construct, there was an increase in scores from posttest (M =
4.13, SD = .71) to pretest (M = 3.38, SD = .60), statistically significant difference t (106)
= -6.2, p < .001.
The Food Safety construct Levene’s Test for Equality of variance did not meet
the assumption of homogeneity of variance (p = .03). The corrected t-test was used not
assuming homogeneity of variance. There was an increase in scores from posttest (M =
4.01, SD = .47) to pretest (M = 3.43, SD = .62), statistically significant difference
t (99.05) = -7.3, p < .001.
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For the Water Treatments construct, there was an increase in scores from posttest
(M = 3.70, SD = .43) to pretest (M = 3.44, SD = .79), statistically significant difference t
(106) = -4.6, p = .035.
In the Agricultural Production construct, there was an increase in scores from
posttest (M = 3.16, SD = .36) to pretest (M = 3.14, SD = .41), no statistically significant
difference t (106) = .215, p = .830. See Figure 23.
Figure 23. Differences between pretest and posttest scores in experimental group (1 = SD, 2 = NSD).
00.5
11.5
22.5
33.5
44.5
Community1 Food choices1 Education1 Food safety 1 Watertreatments1
Agriculturalproduction2
Constructs Scores for Experimental Group
Post Pre
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Control Group.
For the control group, there were no statistically significant differences in
constructs between pretest and posttest scores (Figure 24). In the Community construct,
there was a decrease in scores from pretest (M = 3.31, SD = .86) to posttest (M =3.18, SD
= .87), no statistically significant difference t (94) = .99, p =.321; Food Choices construct
pretest (M = 3.25, SD = .62) to posttest (M = 3.37, SD = 0.68), no statistically significant
difference t (94) = -.91, p = .364; Education construct pretest (M = 3.49, SD = .74) to
posttest (M = 3.64, SD = .55), no statistically significant difference t (94) = -.34, p =.735;
Food Safety construct pretest (M = 3.70, SD = .78) to posttest (M = 3.63, SD = .69), no
statistically significant difference t (94) = .95, p =.924; Water Treatments pretest (M =
3.56, SD = .66) to posttest (M = 3.51, SD = .71), no statistically significant difference t
(94) = .60, p = .55, and Agricultural Production construct pretest (M = 3.12, SD = .38) to
posttest (M = 3.21, SD = .43), no statistically significant difference t (94) = -.10, p = .819.
Table 18 summarizes experimental and control group attitudes test scores.
Table 18
Group Differences for Experimental and Control Attitudes Pretest and Posttest Scores
Pretest
Posttest
Group M1
SD M1
SD
t
df
p
Community
Experimental 3.26 .63 4.14 .68 -6.9 106.00 <.001*
Control 3.31 .86 3.18 .87 .99 94.00 .321
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Table 18 continued
Food choices
Experimental 3.21 .59 3.64 .32 -4.6 106.00 <.001*
Control 3.25 .62 3.37 .68 -.91 94.00 .364
Education
Experimental 3.38 .60 4.13 .71 -6.2 106.00 <.001*
Control 3.49 .74 3.64 .55 -.34 94.00 .735
Food safety
Experimental 3.43 .62 4.01 .47 -7.3 99.05 <.001*
Control 3.70 .78 3.63 .69 .95 94.00 .924
Water treatments
Experimental 3.44 .79 3.70 .43 -4.6 106.00 .035*
Control 3.56 .66 3.51 .71 .60 94.00 .550
Agricultural production
Experimental 3.14 .41 3.16 .36 .215 106.00 .830
Control 3.12 .38 3.21 .43 .103 94.00 .819 Note. Likert type scale: (1) Strongly Disagree (2) Disagree (3) Neither in disagreement nor in agreement (4) Agree (5) Strongly Agree; *p < .05
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Figure 24. Differences between pretest and posttest scores in control group
Research Objective Six
For pre-test and post-test:
Determine whether there is a statistically significant difference in knowledge on
food security and nutrition of small farmers between experimental and control group.
Hypothesized (at α = .05) as follows:
H0: There will be no significant difference in knowledge on food security and
nutrition of small farmers between experimental and control group ((µexperimental post-
test – µexperimental pre-test) – (µcontrol post-test - µcontrol pre-test) = 0).
2.8
2.9
3
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
Community Food choices Education Food safety Water treatments Agriculturalproduction
Constructs Scores for Control Group
Pre Post
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H1: There will be a significant difference in knowledge on food security and
nutrition of small farmers between experimental and control group ((µexperimental post-
test – µexperimental pre-test) – (µcontrol post-test - µcontrol pre-test) ≠ 0).
The difference between pretest and posttest knowledge score for each group was
calculated. Using the difference in knowledge scores, an independent-samples t-test was
conducted to compare experimental and control group, to determine if there were
differences in knowledge scores. Knowledge scores per each level of testing were
normally distributed. Distribution was assessed by skewness and kurtosis between -2 and
+2, which are considered acceptable in order to prove normal univariate distribution
(Field, 2018); followed up by visual inspection of the distribution shape.
Homogeneity of variance was violated, as assessed by Levene’s Test for Equality
of variance (p <. 001). The corrected t-test was used not assuming homogeneity of
variance. The difference in knowledge scores were higher for experimental group (M=
12.85 SD = 3.23) than control group (M = .21, SD = 1.84), there was statistically
significant difference t (85.90) = 2.45, p = . <. 001. See Table 19.
Scores were classified in five grade categories (Excelent = 20-25, Very good =
15-19, Good= 11-15, Defficient= 6-10, and low = 0-5) and the average for each score.
Figures 25 and 26 summarizes the differences between pretest and postest score.
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Figure 25. Pretest knowledge scores in classification by grade for experimental and control group.
Figure 26. Posttest knowledge scores in classification by grade for experimental and control group.
0
10
20
30
40
50
60
Experimental Group Control Group
Pretest Knowledge Scores for Experimental and Control Group
Low
Defficient
Good
Very good
Excelent
0
10
20
30
40
50
60
Experimental Group Control Group
Posttest Knowledge Score for Experimental and Control Group
Low
Defficient
Good
Very good
Excelent
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Table 19
Differences for Experimental and Control Group in Knowledge Scores
Experimental
Control
Test M SD M SD t df p Score
12.85
3.23
.21
.07
2.45
85.90
<. 001*
Note. *p < .05
Research Objective Seven
For pre-test and post-test:
Determine whether there is a statistically significant difference in attitudes and
perceptions toward food security and nutrition of small farmers between experimental
and control group. Hypothesized (at α = .05) as follows:
H0: There will be no significant difference in attitudes and perceptions toward
food security and nutrition of small farmers between experimental and control group
((µexperimental post-test – µexperimental pre-test) – (µcontrol post-test - µcontrol pre-
test) = 0).
H1: There will be a significant difference in attitudes and perceptions toward food
security and nutrition of small farmers between experimental and control group
((µexperimental post-test – µexperimental pre-test) – (µcontrol post-test - µcontrol pre-
test) ≠ 0).
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The difference between pretest (Figure 27) and posttest (Figure 28) attitudes and
perception score for each group was calculated. Using the difference in attitudes and
perceptions score, an independent-samples t-test was conducted to determine if there
were differences in attitudes and perceptions on pretest and posttest scores, between
experimental and control group for each construct. Normality was assessed in each
construct for each level of testing. Attitudes and perception scores were normally
distributed, as assessed by skewness and kurtosis between -2 and +2, which are
considered acceptable in order to establish normal univariate distribution (Field, 2018).
An additional visual inspection of the distribution shape was performed.
Figure 27. Pretest Attitude and Perception Scores for Experimental and Control Group.
2.8
2.9
3
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
Community Food choices Education Food Safety WaterTreatments
Agriculturalproduction
Prestest Attitudes and Perception Scores
Experimental Group Control Group
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For the difference in attitudes and perceptions scores, all the constructs scores
except Agricultural Production construct were higher for the experimental group than
the control group. The Community construct in Levene’s Test for Equality of variance
did not meet the assumption of homogeneity of variance (p <0.001). The corrected t-test
was used not assuming homogeneity of variance. The scores were higher for
experimental group (M = .88, SD = .47) than control group (M = .13, SD = .05), a
statistically significant difference t (86.56) = -1.68 p <0.001.
For the Food Choices construct, Levene’s Test for Equality of variance did not
meet the assumption of homogeneity of variance (p <0.001). The corrected t-test was
used not assuming homogeneity of variance. Scores were higher for the experimental
group (M = .43, SD = .26) than the control group (M = .12, SD = .04), a statistically
significant difference t (80.35) = -2.79, p <0.001.
For Education construct scores, Levene’s Test for Equality of variance did not
meet the assumption of homogeneity of variance (p <.001). The corrected t-test was used
not assuming homogeneity of variance. Score was higher for the experimental group (M
= .75, SD = .29) than the control group (M = .15, SD = .08), a statistically significant
difference t (86.22) = -.97, p <0.001.
In the Food Safety construct, Levene’s Test for Equality of variance did not meet
the assumption of homogeneity of variance (p <.001). The corrected t-test was used not
assuming homogeneity of variance. Scores were higher for experimental group (M = .58,
SD = .31) than control group (M = .07, SD = .02), a statistically significant difference t
(88.96) = -.68, p <0.001.
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In the Water Treatments construct, Levene’s Test for Equality of variance did not
meet the assumption of homogeneity of variance (p <.001). The corrected t-test was used
not assuming homogeneity of variance. Scores were higher for the experimental group
(M = .26, SD = .18) than the control group (M = 0.05, SD = <.01), a statistically
significant difference t (96.44) = -2.607, p <.001.
There was no statistical significance in the Agricultural Production construct between
experimental and control group. See Table 20.
Table 20
Group Differences for Experimental and Control Group Pretest and Posttest Scores
Experimental
Control
Group M
SD
M
SD
t
df
p
Community .88 .47
.13 .05 -1.6 86.56 <.001*
Food choices .43 .26
.12 .04 -2.7 80.35 <.001*
Education .75 .29
.15 .08 -.97 86.22 <.001*
Food safety .58 .31
.07 .02 -.68 88.96 <.001*
Water treatments
.26 .18
.05 <.01 -2.6 96.44 <.001*
Agricultural production
.02 .01 .09 .03 .19 94.77 .725
Note. *p < .05
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Figure 28. Posttest Attitude and Perception Scores for Experimental and Control Group.
Research Objective Eight
For the experimental group:
Determine whether there is a statistically significant difference in Intentions of
Adoption toward food security and nutrition in the small farmers between the
experimental group and control group. Hypothesized (at α = .05) as follows:
H0: There will be no significant difference in Intentions of Adoption toward
food security in the small farmers between the experimental and control groups
(µexperimental pre-test - µcontrol pre-test = 0); (µexperimental post-test - µcontrol post-
test = 0).
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
Community Food choices Education Food Safety Water Treatments Agriculturalproduction
Posttest Attitudes and Perception Scores
Experimental Group Control Group
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H1: There will be a significant difference in Intentions of Adoption toward food
security in the small farmers between pre-test and post-test (µexperimental pre-test -
µcontrol pre-test = 0); (µexperimental post-test - µcontrol post-test = 0).
An independent-samples t-test was conducted to determine if there were
differences in Intentions of Adoption on posttest scores, between the experimental and
control groups. Normality was assessed in each construct for each level of testing.
Attitudes and perception scores were normally distributed, as assessed by skewness and
kurtosis between -2 and +2, which are considered acceptable in order to stablish normal
univariate distribution (Field, 2018). An additional visual inspection of the distribution
shape was performed.
Posttest Scores.
For posttest scores, Intentions of Adoption scores were higher for the
experimental group than the control group. The Intentions of Adoption construct in
Levene’s Test for Equality of variance did not meet the assumption of homogeneity of
variance (P= .001). The corrected t-test was used not assuming homogeneity of variance.
The scores were higher for experimental group (M = 4.15, SD = .71) than control group
(M = 3.64, SD = 1.12), a statistically significant difference t (78.02) = 2.69, p =.007. See
Table 21.
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Table 21
Differences on Intentions of adoption between experimental and control group
Experimental
Control
Group M SD M SD t df p
Posttest
4.15
.71
3.64
1.21
2.76
78.02
.007*
Note. *p < .05
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CHAPTER V
CONCLUSIONS AND RECOMMENDATIONS
Research Objective One
Identify food security and nutrition knowledge, attitudes, and perceptions of the
local small farmers.
Conclusions and Implications.
Food availability was influenced by family agricultural production. In these rural
areas, food production is static and centered on a limited number of crops. There is no
variability of crops produced year after year and the implementation of alternative crops
was perceived as complicated, costly and inefficient [to feed the family].
Although agricultural production is based on a small number of crops, production
levels remain low and insufficient to supply the national food demand. The Salvadorian
agricultural sector contributes 16% to the country's Gross Domestic Product (GDP) (WB,
2017) and 19% of the national employment (WB, 2018). However, it is depleted by the
lack of available agricultural land and the high costs of agricultural inputs. Like other
agricultural problems, the lack of land affects mainly small rural communities. Farmers
must use a high percentage of their agricultural income to pay for the use of land leased
for agricultural production. Added to this is the high cost of fertilizers and the lack of
commercialization facilities for these products.
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Many farmers depend on the agricultural and economic aid of public and private
entities. The Government of El Salvador, through the Ministry of Agriculture, expects to
support 422,477 farmers with an agricultural package that includes: (1) seeds, (2)
fertilizers, and (3) pesticides (Government of El Salvador, 2019). Farmers have access to
this benefit after a series of processes to identify if their level of poverty is appropriate to
receive it. However, it is not enough to meet the farmers’ agricultural production needs.
As Carlos said "... It is not enough [agricultural package], we have many pests and
diseases that are affecting us ..." Agricultural production demands from the producers
require an economic investment that sometimes cannot be covered by the family budget.
Referring to their economic situation, some interviewees said it is hard, difficult
and very worrying. Farmers do not have the income to cover all their family's needs and
experience a constant variability in their monthly income that generates worry and
insecurity. Faced with a reduction in money available, families invest less in food and
allocate funds for other family needs and unforeseen events. The lack of economic
resources deprives farmers of access and consumption of a varied and appropriate diet for
each member of the family.
For rural families in El Salvador, accessing markets is also a constant challenge.
With long travel distances and public transportation systems, traveling to the market for
the purchase and possible sale of food is economically unsustainable. Definitely,
investment in market and road infrastructure in rural communities would substantially
benefit rural families (UC, 2008).
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Any initiative that seeks to improve the state of food and nutrition security
requires the intervention of multiple disciplines for effective approach and
implementation (Karunasagar & Karunasagar, 2016). A fundamental discipline to ensure
food security is hydrology, especially in rural areas; access to sources of clean water for
consumption is a daily problem. Many farmers do not have access to the quantity and
quality of water for the development of a healthy lifestyle. The families supply the
household water needs mainly from family wells and nearby rivers and streams with free
access. However, in most cases, this water does not meet the minimum microbiological
parameters to ensure safe consumption. Neither of the water sources to which the
communities are exposed meet the minimum requirements established by the national
drinking water regulation for safe consumption. Investing in water treatments is an
expense that farmers perceive as high and unnecessary. Nevertheless, it could reduce the
levels of diseases transferred by the ingestion of contaminated water.
The available water in the community that is consumed by local residents is
characterized by bad odors and flavors, and by an evident coloring derived from the
mixture of physical materials. Awareness of the relevance of clean water and the
promulgation of home water treatments as a way to reduce disease and mortality levels
should be a priority in rural communities where public water distribution systems are far
from being a reality.
In many rural communities, women are mainly responsible for the family water
and food supply issues. The active participation of women in the decision-making
process for the problems related to the family health and nutrition is crucial to ensure
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food security. Several studies have shown that women are more likely to work to solve
the problems of food and water shortages at home (Kalasooriya & Chandrakumara, 2014;
Ramachandran, 2007; Quisumbirng & Meizen-Dick, 2001). When the male respondents
were questioned about the purchase and preparation of food at home, they unanimously
agreed that it was their wives’ responsibility. The same happened when interviewing the
female interviewees about who decides the agricultural production of the house; they
confirmed that male were responsible for those decisions.
Women in developing economies, such as El Salvador, generate a high percentage
of agricultural production and are an essential part of the labor force (Raney, et al., 2001).
Despite all the women’s contributions, in Salvadorian rural communities, women
continue to play a secondary and accompanying role to men. Definitely, the approach to
food security requires the continuing and equal inclusion of women in roles of decision-
making, planning, and execution of agricultural activities and food processing.
The production and processing of clean and healthy foods requires a series of
principles and processes to ensure quality. In participants’ households, the lack of proper
positioning of the latrines generates an unsanitary environment and poses a risk for the
families. Latrines have been built without considering their position related to the other
areas of the house, increasing the chances of cross contamination through water, air, or
human contact.
In the rural communities of El Salvador, there are still people without access to a
decent and safe latrine. Open defecation is still practiced by people who do not know or
ignore the health consequences. The practice of open defecation exposes families to
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enteric pathogens and intestinal parasites, increasing the levels of mortality and morbidity
especially in children and the elderly (Sara & Graham, 2014). Galan, Kim and Graham
(2013) state that an estimated 1.7 million cases of diarrhea per year are registered in
children under five years of age worldwide (Galan, Kim, & Graham, 2013).
It was easy to notice the presence of animal and human excrement, as well as
trash around the rural houses. The accumulation of garbage and the mixture of bad odors
coming from the decomposition of garbage and the latrine are indicators of the poor
sanitation state in which these families live. Most rural communities in the world lack
access to municipal solid waste management (Taboada, Armijo, Aguilar, & Ojeda, 2010)
(Zrate, Slotnick, & Ramos, 2008). Proper disposal of solid waste could have a positive
influence in the community’s health, environmental quality, and sustainable development
(Henry, Yongsheng, & Jun, 2006)
Regarding agricultural chemicals, there are no adequate disposal processes.
Bottles or plastic bags that were not designed for the storage of chemicals are often used
for chemical storage purposes, creating a poisoning risk for families. The storage of
highly dangerous chemicals in unsuitable containers inside the home exposes family
members to these products, creating a human health hazard. Not only are the chemicals
being stored inside the house, sometimes they are placed near the kitchen or food
preparation places. The main reason for this practice is to protect them from theft.
With respect to farm animals (poultry and pigs) and pets (dogs and cats), most of
the activities related to these animals occur outdoors. However, the animals are allowed
to circulate without restriction through the house, including areas for food preparation
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and consumption. There are no limitations in the interactions between humans and
animals. The animals are contributing to the construction of a continuous unhealthy
environment.
Although in all the houses visited there were farm animals suitable for human
consumption, the diet of these families consists mainly of seeds, vegetables, and fruits.
The imbalance in the elements that make up the diet is mainly due to the availability of
resources. The families produce poultry and pigs for commercialization and not for
family consumption. For these families, the priority is to buy high-yield, abundant, and
cheap foods. There is no interest in satisfying the tastes and preferences of each member
of the family and less in understanding what the nutritional requirements are for each
one. The fluctuations in prices and the low availability of food are limitations for these
families to achieve a state of food security.
The prices and availability of food are strongly affected by climate change, which
also affects the productive aspects of the lives of these farmers, limiting the available
water resources and altering the patterns of agricultural production (Paavola, 2008;
Misselhorn, 2005; O'Brien & Leichenko, 2000; O'Brien, et al., 2004).
For these farmers, the term climate change does not make any sense and they are
unable to define it formally. However, farmers perceive the effects and experience the
consequences of climatic variations on a daily basis.
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Research Objective Two
Describe farmers from the rural community in El Salvador.
Conclusions and Implications.
Overall, in the control and experimental group, there were more males (n = 69)
than females (n= 33). For this research study, differences in scores by gender were not
included.
The distribution of farmers’ educational level was similar between the control and
experimental groups. The majority of the participants had accomplished some level of
elementary education. However, a considerable portion of the farmers was illiterate. The
socio-economic context influences the educational level achieved by the individual
(Merriam et.al, 2007). Although primary and secondary education is completely free in
El Salvador, there remains high levels of illiteracy and early attrition. In the study area,
there is a primary education center. Accessing a higher level of education represents an
additional cost that often cannot be supported by rural families. In addition, poor
transportation systems limit access to higher education centers.
The farmers' age ranged from 19 to 81 years of age. The average age of the
participants was 46.1 years. A low percentage (13.5%) of farmers were young (19-31
years). The participation rate of young people in agriculture has decreased steadily in
recent years. Young people do not want to work in agriculture based on negative
perceptions about agriculture, lack of credit, and poverty (FAO; Center for Agricultural
and Rural Cooperation [CTA]; IFAD, 2014).
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The houses of the participants were structured in a similar way. Most households
have a male head of household and are composed of five members of the family. The
majority of farmers in the research area own a house (70%) and a smaller proportion,
agricultural land (35%).
Research Objective Three
Illustrate the current food security and nutrition situation.
Conclusions and Implications.
In general, the severity of the food and nutritional insecurity of the farmers was
moderate to severe. The overall score on the Food Insecurity Experience Scale was 4.5.
Food security analysts use this score to effectively design and implement appropriate
assistance for food insecurity and nutrition problems (FAO, 2008).
Research Objective Four
For experimental and control group:
Determine whether there is a statistically significant difference in knowledge on
food security and nutrition of small farmers between pre-test and post-test.
Conclusions and Implications.
In the experimental group, knowledge test scores increased from pretest (M =
7.93, SD = 2.31) to posttest (M = 20.78, SD = 2.3). There was a statistically significant
difference t (106) = -28.97, p < .001. The knowledge test scores for the control group
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follow the same tendency; increased from pretest (M = 8.19, SD = 2.50) to posttest (M =
8.40, SD = 2.89). There was no statistically significant difference t (94) = -.208, p = .706.
In the experimental group, results reflect the positive impact of the intervention on
farmers’ knowledge scores between pretest and posttest. The farmers’ knowledge score in
the control group was not significantly varied and when compared to the experimental
group, it shows the effectiveness of the educational intervention on improving farmers'
knowledge about food security and nutrition. The knowledge test included 25 questions
based on the three learning modules and focused on basic concepts of food and nutrition
security. The farmers’ score was the sum of the correct answers.
Results show that farmers increased their knowledge of food security and
nutrition after receiving the educational intervention. According to Feder, Murgai,
Quizon (2004), farmers that participate in educational opportunities have knowledge
advantages compared with other farmers and are more willing to make changes in
agricultural practices (Kilpatrick & Rosenblatt, 2000).
Research Objective Five
For experimental and control group:
Determine whether there is a statistically significant difference in attitudes and
perceptions toward food security and nutrition in the small farmers between pre-test and
post-test.
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Conclusions and Implications.
The attitudinal instrument included the following research constructs: (1)
Community, (2) Food choices, (3) Education, (4) Food safety, (5) Water treatments, (6)
Agricultural production, and (7) Intentions of adoption, which is exclusive for the posttest
and is approached separately in research objective eight. The agricultural production
construct is the only one with no statistically significant difference from pretest to
posttest scores in experimental group was. The attitudes were higher for posttest (M =
3.16, SD = .36) than pretest (M = 3.14, SD = .41), t (106) = .215, p = .83. The educational
intervention did not have a statistically significant impact on farmers’ attitudes and
perceptions assessed on the agricultural production construct. The cultural roots of
agricultural production in rural communities limit the adoption of new technologies and
knowledge (Ejembi & Obekpa, 2017).
In the experimental group, no significant differences were found in the
agricultural production construct. A statistically significant difference was found for the
other five research constructs. The tendency was for farmers to increase their scores from
pretest to posttest.
In the control group, there was no statistically significant difference in research
constructs between pretest and posttest. The community, food safety, water treatments,
and agricultural production research constructs’ scores decreased from pretest to
posttest. The tendency was the opposite for food choices and education research
constructs; the scores increased from pretest to posttest. Farmers in the control group did
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not register any change in their attitudes and perceptions because they did not receive the
educational intervention.
Research Objective Six
For pre-test and post-test:
Determine whether there is a statistically significant difference in knowledge on
food security and nutrition of small farmers between experimental and control group.
Conclusions and Implications.
The comparison of the knowledge scores between the farmers in the experimental
group and the control group was made using the difference between the pretest and the
posttest for each group. This comparison shows the change in farmers' knowledge
derived from the participation in the educational intervention. The score for the
experimental group was 12.64 units higher than for the control group. The importance of
farmers' knowledge is in the relationship between the level of knowledge and
improvement in the quality of life. Farmers with more knowledge are more likely to
obtain better results, adapt to new scenarios, and solve problems (Jasinskas &
Simanavičienė, 2008).
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Research Objective Seven
For pre-test and post-test:
Determine whether there is a statistically significant difference in attitudes and
perceptions toward food security and nutrition of small farmers between experimental
and control group.
Conclusions and Implications.
In order to understand the differences in farmers’ attitudes and perceptions
between the experimental and control group, pretest scores were subtracted from posttest
scores; the difference was used to measure the participants’ change.
The agricultural production construct score was the only one higher for the
experimental group than the control group. Farmers in the experimental group, who
participated in the four hours educational intervention, scored higher in the community,
education, food choices, food safety and water treatments constructs. The constructs
that scored higher for the experimental group also had a statistically significant difference
between the experimental and control group. These results provide an accurate
representation of the potential intervention effects on the farmers’ attitudes and
perceptions towards food security and nutrition.
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Research Objective Eight
For the experimental group:
Determine whether there is a statistically significant difference in intentions of
adoption toward food security and nutrition in the small farmers between the
experimental group and control group.
Conclusions and Implications.
The intentions of adoption construct was only measured after the educational
intervention and scores were higher for the experimental group than control group. When
comparing the groups’ differences, a statically significant difference was found. The
difference between experimental and control group in the intentions of adoption of the
concepts and technologies could be associated with the farmers’ participation in the
educational intervention. Kenny (1975), stated that to compare the pretest and posttest
the test should be similar and under the same conditions and learning environment. In the
study, the experimental and control group were treated in similar ways and received the
same instrument and amount of time to complete it.
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Discussion
Farmers’ state of food security and nutrition in rural El Salvador is affected by
many social, economic, and environmental factors. In the rural areas of El Salvador, the
dimensions of food security are not guaranteed, and are weakened by widespread
exclusion of these communities from the resources and opportunities for better living
(European Commission [UC], 2008). In El Salvador, the highest levels of poverty affect
mainly rural populations (Figure 29). The lack of income limits many basic needs of
farmers, including food, education, and water and sanitation (Technical Secretariat of the
Presidency of the Republic of El Salvador [TSPRSV], 2017). Fifty seven percent of the
Salvadoran rural population is considered poor or extremely poor (Habitat for Humanity,
2017; WB, 2015). In 2017, of the total population living in poverty or extreme poverty,
83.7% of households did not have adequate sanitation conditions and 49% did not have
access to potable water (TSPRSV, 2017).
Figure 29. Map of poverty distribution by department in El Salvador; Fuente: TSPRSV, 2017.
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Food security is a multidimensional concept usually related to social
development, poverty, and health (Wineman, 2014). Worldwide, education is
implemented as an important means to enhance food and nutrition security (De Muro &
Burchi, 2007). Farrell (2013) stated that in developing economies, interventions that seek
to improve food security through addressing either current problems or seeking to prevent
problems are likely to improve the life conditions of the population over the long-term.
The results of this research study indicate a change in farmers’ knowledge on food
security and nutrition after the educational intervention. Despite the change in
knowledge, the results do not guarantee a change in the behaviors related to food security
and nutrition. Nevertheless, Ajzen, et al. (2011) said that the adequate level of
information influences people’s behavior, which could generate the expected results in
the individual. According with Brenes (2017), referring to the Theory of Planned
Behavior, knowledge is an important component of the behavior change process.
Farmers’ attitudes and perception scores increase after the educational
intervention and are evidence of the contribution of the training to the possible change on
farmers’ food security and nutrition. After the educational intervention, farmers
expressed their intentions to adopt the concepts on family nutrition, home water
treatments, and agricultural production practices. However, these results should be
interpreted cautiously because the agricultural production attitudes and perceptions did
not change significantly after the training.
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Recommendations for Practitioners
For future interventions that seek sustainable community development, or more
specifically an improvement in the food and nutritional security of a community, it is
recommended to include an education and training component for the participants. The
results of this study demonstrated the changes in farmers’ knowledge, attitudes, and
perceptions, possibly generated by participation in the educational intervention (Berckler
& Wiggins, 1989).
Educational interventions in rural communities should be designed, implemented,
and evaluated, promoting the active participation of women and youth. Improving food
and nutrition security is a task in which all family members should participate. The
qualitative analysis in this study showed that although women work in agricultural
activities, they do not have a decisive role. However, women decide the family diet and
have the leading role in the food decisions at home. On the other hand, young people and
children work in family agricultural production in the geographical area of this study. In
addition, food choices and preferences during childhood not only influence development
and growth, but also affect the adoption of bad eating habits during adulthood (Taylor,
Evers, & McKenna, 2005).
The impacts of the educational intervention are extremely important for
policymakers seeking to address the food problems of developing economies. Usually,
policymakers are interested in the participation and motivation of adults in community-
based educational programs (Merriam, et al., 2007).
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For future educational programs for farmers, it is recommended to identify the
motivations of farmers to participate in this type of programs. The reasons for the
participation of adults in the multiple educational modalities are diverse and influence the
kind of results the program can achieve (Merriam, et al., 2007).
In the design process of educational interventions, local and indigenous
knowledge must be effectively incorporated (Merriam, et al., 2007). Many communities
have developed unique and effective adaptation mechanisms that could be replicated and
disseminated as measures to mitigate or alleviate food security problems.
In adult education, there is a connection between the learning process and
practical experience (Merriam, et al., 2007). For this reason, educational interventions
should offer practical activities that represent meaningful learning experiences for
participants (Truluck & Courtenay, 2010). Adults incorporate their knowledge and
previous experiences into new ones and generate new knowledge. It is important that
educational interventions for adults promote an active participation and a leadership role
among the participants (Merriam, et al., 2007).
Several local development projects, including those exclusively educational in
nature, fail due to lack of leadership (Heeks, 202). Educational interventions should
identify community leaders to serve as channels of dissemination and promotion of
knowledge (Merriam, et al., 2007). In addition, the generation of new community leaders
should be promoted through education and training among the participants.
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Recommendations for Future Research
It is recommended to explore other qualitative data collection techniques
including focus groups and ethnographic methods. Focus groups potentially create a
space where participants feel safe sharing information and interacting with each other and
with the moderator (Acocela, 2012). Ethnographic research, in which the researcher
would live among the community for an extended period, would facilitate a more detailed
identification of behaviors related to food and nutrition security. Identifying and
understanding the behaviors would allow the development of appropriate educational
interventions to work on the adoption of new knowledge and techniques and potentially
generate a behavior change.
The impacts of educational interventions on small rural farmers should be
evaluated in the short, medium, and long term ((David & Asamoah, 2011). Assessing the
level of knowledge retention and techniques that have been implemented over time would
assist in designing interventions that are more effective with similar communities. This
would provide valuable feedback for researchers in the design and execution of
educational interventions.
Another recommendation is the development of a series of educational
interventions that would allow participants continuous training that would build upon
earlier interventions. Based on the intervention designed in this study, it is recommended
to provide ample time for the execution of the intervention in order to fully address all
aspects of the intervention topic. In this study, not all the topics identified in the
qualitative stage were addressed in the educational intervention. It is recommended to
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evaluate the changes in knowledge, attitudes, and perceptions in the subjects not studied,
including access to markets, latrines construction and use, and climate change.
Educational interventions should be sensitive to the social, cultural, and economic
aspects of the population of interest. In food and nutrition security, many aspects of daily
life are influenced by tradition and are strongly rooted in cultural identity (Counihan &
Van Esterik, 2012). The participation and possible adoption of knowledge by farmers
must be motivated by offering accessible and relevant knowledge and technologies
(Adesina & Zinnah, 1993).
For a more comprehensive analysis of food security and nutritional status of the
population, a more in-depth study should be carried out. The research should include
information such as: (1) caloric intake, (2) current physical condition, (3) volatility of
food prices, and, (4) an analysis of potential risks to farmers, among others that should be
identified as appropriate for the population.
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APPENDICES
APPENDIX A- IRB APPROVAL LETTER
Original signature available upon request
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APPENDIX B-INTERVIEW QUESTIONS (ENGLISH VERSION)
1. Tell me a little about yourself and your family?
2. How many members of your family live in your home?
3. Does your house have all the basic services?
4. What are the main sources of food in your home?
5. Tell me about the agricultural products you plant and harvest?
6. Do you implement crop rotation?
7. Do you know the term, or could you explain what Food Safety is?
8. What do you think is your family's barrier to accessing enough food? And for the
community?
9. On what basis does the decision to buy or not buy a food?
10. In recent years, what has affected your agricultural production? What do you do
when this happens?
11. What do you do if you need food at home?
12. What is your main source of drinking water?
13. Do you consume the water directly from the source of supply?
14. Do you have difficulties finding some food in your community? Which? What do
you do to get them?
15. Who decides at home the food that is consumed?
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From the following list of images:
16. Choose 5 foods that are always present in your home
17. Choose 5 foods you never eat in your home
18. What do you think are the five most nutritious foods?
19. If only I could choose which one, I would choose.
20. What are the most expensive foods?
21. Which are the most abundant?
I will read a series of statements and please indicate if you feel identified:
22. In my community, there is little access to diverse and nutritious foods.
23. My income limits me to buy more food.
24. I do not have the cleaning conditions to properly prepare the food.
25. I do not feel prepared to face the climate changes in my agricultural production.
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APPENDIX C-INTERVIEW QUESTIONS (SPANISH VERSION)
1. ¿Cuénteme un poco de usted y de su familia?
2. ¿Cuantos miembros de su familia viven en su casa?
3. ¿Su casa tiene todos los servicios básicos?
4. ¿Cuáles son las principales fuentes de alimentos en su hogar?
5. ¿Cuénteme un poco de los productos agrícolas que siembra y cosecha?
6. ¿Usted tiene una rotación de cultivos?
7. ¿Conoce usted el termino o podría explicarme que es Seguridad Alimentaria?
8. ¿Cuál cree usted que es la barrera que tiene su familia para el acceso a suficiente
comida? ¿Y la comunidad?
9. ¿En que basa la decisión de comprar o no un alimento?
10. ¿En los últimos años que ha afectado su producción Agrícola? ¿Qué hace usted
cuando esto sucede?
11. ¿Qué hace si en su casa hace falta alimentos?
12. ¿Cuál es su fuente principal de agua para consumo?
13. ¿Consume el agua directamente de la fuente?
14. ¿Tienes dificultades para encontrar algunos alimentos en su comunidad ¿Cuáles?
¿Qué hacen para conseguirlos?
15. ¿Quién decide en su casa los alimentos que se consumen?
De la siguiente lista de imágenes:
16. Escoja 5 alimentos que siempre están presente en su hogar
17. Escoja 5 alimentos que nunca consume en su hogar
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18. ¿Cuáles piensa que son los 5 alimentos más nutritivos?
19. ¿Si solo podría escoger 5 cuales escogería?
20. ¿Cuáles son los alimentos más caros?
21. ¿Cuáles son los más abundantes?
Voy a leer una serie de enunciados y por favor indique si usted se siente identificado.
22. En mi comunidad hay poco acceso a alimentos diversos y nutritivos.
23. Mis ingresos me limitan para comprar más alimentos.
24. No tengo las condiciones de limpieza para preparar adecuadamente los alimentos.
25. No me siento preparado para afrontar los cambios de clima en mi producción
agrícola.
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APPENDIX D- WATER ANALYSES REPORT
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APPENDIX E- RESEARCH INSTRUMENT (SPANISH VERSION)
Datos demográficos Escriba o seleccione la respuesta para cada una de las siguientes preguntas sobre usted y su familia.
1. ¿Cuál es su género? Masculino ______ Femenino______ 2. ¿Cuál es su fecha de nacimiento? _______________________-
______(Día/Mes/Año) 3. ¿Cuál es su estado civil actual?
A. Soltero/a /No me casé B. Casado/a C. Vivo con mi pareja D. Separado/a de mi pareja E. Divorciado/a F. Viudo/a
4. Pensando en su hogar, ¿Cuál es, en promedio, el ingreso económico mensual? A. Menos de $50 B. Entre $51 y $100 C. Entre$101 y $200 D. Entre $201 y $300 E. Entre $301 y $400 F. Entre $401 y $500 G. Más de $501
5. ¿La cabeza de su hogar es de género masculino o femenino? Masculino ______ Femenino______
6. ¿Cuál es la fecha de nacimiento de la cabeza de hogar? ____________(Día/Mes/Año)
7. ¿La cabeza de tu hogar sabe leer y escribir? Sí ______ No______ 8. ¿Cuál es el nivel educativo de la cabeza de su hogar?
A. Nunca fui a la escuela B. 1er grado C. 2do grado D. 3er grado E. 4to grado F. 5to grado G. 6to grado H. 7mo grado I. 8vo grado J. 9no grado
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K. Bachillerato L. Educación técnica vocacional M. Educación universitaria. N. Otro (Por favor, especifique):
_______________________________________
9. (Si no es usted la cabeza del hogar) ¿Cuál es su nivel educativo? A. Nunca fui a la escuela B. 1er grado C. 2do grado D. 3er grado E. 4to grado F. 5to grado G. 6to grado H. 7mo grado I. 8vo grado J. 9no grado K. Bachillerato L. Educación técnica vocacional M. Educación universitaria N. Otro (Por favor, especifique):
_______________________________________
Taller de Seguridad Alimentaria y nutricional. Por favor seleccione la respuesta o respuestas correctas para las siguientes preguntas.
Pregunta: Falso Verdadero
1.Una dieta variada en la casa, debería tener alimentos de origen animal y vegetal
2.Una dieta debe tener alimentos suficientes para las necesidades de cada miembro de la familia.
3. Los alimentos no se deben preparar en condiciones de limpieza.
4.Una dieta balanceada ayuda a prevenir enfermedades y reducir los gastos médicos en el hogar.
5.Limpiar el piso es el primer paso que se debe seguir para preparar alimentos limpios.
6.Cuando preparamos los alimentos en casa debemos limpiar los instrumentos que utilizamos.
7.Los huevos y las carnes requieren un cuidado especial durante la cocción.
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10. El agua tratada debe ser utilizada para: A. Agua para tomar B. Trapear el piso C. Lavar la ropa D. Bañarse
11. El método de tratamiento de agua que usa una tela para eliminar basura del agua se llama: A. Colación B. Filtración C. Cloración D. Ebullición
12. La filtración con la tela es suficiente para tratar el agua para consumo humano. A. Sí, es suficiente B. No, no es suficiente C. Depende de la tela que se utilice D. Depende del agua que se está filtrando
13. ¿Cuánto tiempo debe hervir el agua de consumo humano para matar las bacterias del agua? A. 1 minuto B. 3 minutos C. 5 minutos D. 10 minutos
14. ¿Cómo se puede eliminar el sabor residual del agua después de la ebullición? A. Dejar enfriar el agua B. Almacenar el agua en la refrigeradora C. Agitar el agua y agregarle sal D. Agitar el agua y agregar azúcar
15. Una ventaja de la filtración es: A. Sencillo de aplicar B. Limpia todo tipo de agua C. El agua dura mucho tiempo después de filtrarla D. El alto costo económico
16. ¿Cuánto tiempo se debe esperar después de agregar la lejía al agua? A. 10 minutos B. 15 minutos C. 20 minutos
8.Es importante almacenar los alimentos en condiciones adecuadas para asegurar su calidad.
9.Se deben separar los alimentos crudos de los cocidos para asegurar la limpieza.
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D. 25 minutos
17. ¿Cuántas gotas de lejía se deben colocan por cada litro de agua? A. 5 gotas B. 6 gotas C. 7 gotas D. 8 gotas
18. Después de la filtración debo: A. Aplicar otro tratamiento como la ebullición o la cloración B. No debo hacer nada, el agua está lista para consumirla C. Repetir la filtración para asegurar la calidad del agua D. Almacenar el agua para consumirla más tarde
19. Un huerto casero permite a la familia: A. Comprar más alimentos en el mercado B. Disponibilidad de alimentos durante todo el año C. Tener más dinero para la familia D. Tener mejores condiciones de limpieza para preparar alimentos
20. ¿Cuál es la altura ideal de las camas biointensivas? A. 50 cm B. 60 cm C. 70 cm D. 80 cm
21. ¿A qué altura se debe hacer la doble excavación en las camas biointensivas? A. 30 cm B. 40 cm C. 50 cm D. 60 cm
22. ¿Cómo se deben dividir los cultivos en la cama biointensiva? A. 50-30-20 B. 50-10-40 C. 20-20-60 D. 50-50
23. ¿Cuál de las siguientes es una ventaja de las camas biointensivas? A. Las plantas se desarrollan mejor B. Las plantas consumen más agua C. Los vegetales se producen más rápido D. Las verduras son más pequeñas
24. ¿Cuál es una ventaja de la siembra cercana? A. Mayor producción en menor espacio. B. Las plantas viven por más tiempo C. Se requiere más trabajo para sembrar D. No hay que tener herramientas de trabajo
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25. Seleccione la estructura en la que se debe hacer una doble excavación: A. Contenedor hidropónico B. Paredes vivas C. Cajoneras D. Camas biointensivas
En una escala de 1 a 5, donde 1 significa muy en desacuerdo y 5 significa muy de acuerdo, por favor indique su nivel de acuerdo con las siguientes afirmaciones.
1 2 3 4 5 1. No hay grandes problemas de salud por
comer alimentos contaminados.
2. La peor cosa que puede pasar cuando comes un alimento contaminado es enfermarse.
3. En realidad, no me importa la limpieza de los alimentos.
4. La limpieza de los alimentos no es importante para la salud de mi familia.
5. Estoy dispuesto a cambiar mis prácticas de limpieza de alimentos, por otros métodos nuevos que pueda aprender.
6. La temperatura de almacenamiento de alimentos no es importante en mi casa.
7. La limpieza del agua no es importante en mi casa.
8. No me interesa tratar el agua que consumimos en mi casa.
9. Los tratamientos de agua de consumo son muy complicados.
10. El agua contaminada no es un riesgo para mi familia.
11. No se debe tratar las aguas para consumo que vienen de fuentes naturales.
12. Yo entiendo las diferencias que hay entre los diferentes métodos de tratamientos de agua.
13. No entiendo bien que alimentos son saludables.
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14. No tiene sentido seguir pasos específicos para la limpieza de los alimentos.
15. Yo no creo en los procesos de limpieza de alimentos.
16. Necesito aprender más sobre la alimentación de mi familia.
17. Yo sé cuándo una dieta es balanceada. 18. Los talleres sobre preparación limpia de
alimentos no son importantes para mí.
19. La producción de alimentos en huertos caseros es muy difícil.
20. No estoy capacitado para producir alimentos en un huerto casero.
21. En realidad, no me preocupan los beneficios nutricionales de una dieta balanceada.
22. Puedo diferenciar los beneficios de los alimentos en los diferentes grupos alimenticios.
23. Sé cuándo debo lavarme las manos para evitar contaminar los alimentos.
24. No me interesa la alimentación de mi comunidad.
25. Estoy dispuesto a intercambiar productos alimenticios con otros miembros de mi comunidad.
26. No me interesa pasar tiempo con mi familia. 27. Producir alimentos en mi casa es una
manera de pasar tiempo con mi familia.
28. La alimentación de mi familia no es una prioridad para mí.
29. Mi alimentación es saludable. 30. Me siento mejor cuando como sano y
limpio.
31. No me interesa producir alimentos en mi casa.
32. Los alimentos que se producen en huertos caseros no son de buena calidad.
33. Mi familia no necesita producir alimentos un huerto casero.
34. En casa no me como un alimento que no sé de donde viene.
35. Un alimento que se cae al suelo, no debe ser lavado para consumirlo.
36. Los animales de mi casa pueden entrar a mi casa sin problemas.
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37. No me preocupa cómo se cocinan los alimentos que consumo
38. Tengo los recursos adecuados para poder producir alimentos en casa.
39. Para tener una alimentación saludable he de consumir alimentos variados (Cereales, verduras, carne, lácteos…).
40. La bebida que más me gusta tomar es agua. 41. El sabor de los alimentos es más importante
que los beneficios nutricionales.
42. Yo voy a implementar los procesos aprendidos sobre limpieza de alimentos.
43. Yo pretendo seguir aprendiendo sobre la preparación limpia de alimentos.
44. Yo planeo usar los tratamientos de purificación de agua en mi casa.
45. Estableceré un jardín familiar. 46. Toda la familia trabajará en el huerto
familiar.
47. Voy a buscar nuevas opciones de alimentos para mejorar la dieta de mi familia.
Basado en la experiencia de su familia, responda SI o No a las siguientes preguntas
1. Usted se haya preocupado por no tener suficientes alimentos para comer por falta de dinero u otros recursos
SI ______ NO______
2. Usted no haya podido comer alimentos saludables y nutritivos por falta de dinero u otros recursos.
SI ______ NO______
3. Usted haya comido poca variedad de alimentos por falta de dinero u otros recursos.
SI ______ NO______
4. Usted haya tenido que dejar de desayunar, almorzar o cenar porque no había suficiente dinero u otros recursos para obtener alimentos.
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SI ______ NO______
5. Usted haya comido menos de lo que pensaba que debía comer por falta de dinero u otros recursos.
SI ______ NO______
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APPENDIX F-RESEARCH INSTRUMENT (ENGLISH VERSION)
Demographics Write or select the answer for each of the following questions about you and your family.
10. Gender Male ______ Female______ 11. What is your birth date? _____________________________(Day/Month/Year) 12. What is your current marital status?
A. Single /I did not get married B. Married C. I live with my partner D. Separated of my partner E. Divorced F. Widower
13. Thinking about your home, what is, on average, the monthly economy income? A. Less than $50 B. Between $51 y $100 C. Between $101 y $200 D. Between $201 y $300 E. Between $301 y $400 F. Between $401 y $500 G. More of $501
14. The head of your household is: Male ______ Female______
15. What is the date of birth of the head of household? ____________(Day/Month/Year)
16. The head of your home can read and write? Sí ______ No______
17. What is the educational level of the head of your home?
A. Never went to school B. 1st grade C. 2nd grade D. 3rd grade E. 4th grade F. 5th grade
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G. 6th grade H. 7th grade I. 8th grade J. 9th grade K. High school L. Vocational technical education M. University education N. Other (Please, specify): _______________________________________
18. (If you are not the head of the household) ¿What is your educational level? A. Never went to school B. 1st grade C. 2nd grade D. 3rd grade E. 4th grade F. 5th grade G. 6th grade H. 7th grade I. 8th grade J. 9th grade K. High school L. Vocational technical education M. Universitary education N. Other (Please, specify): _______________________________________
19. How many people live in your house? Number of people that live in the house under 18 years old: _______________ Number of people that live in the house of 18 years old and older: ___________
20. The house where you live belongs to your family. Yes ______ No______
21. Do you own land? Yes ______ No______ How many hectares do you have? ______________hectares
22. Your family owns land. Yes ______ No______ ¿How many hectares they have? ______________hectares
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Workshop on Food and Nutrition Security. Please select the correct answer or answers for the following questions.
10. The treated water must be used to: A. Drinking water-Water for consume B. Mop the floor C. Laundry D. Bath
11. The method of water treatment that uses a cloth to remove garbage from water is called:
A. Collation B. Filtration C. Chlorination D. Boiling
12. The filtration with the cloth is sufficient to treat water for human consumption.
Questions: False True
1. A varied diet in the house should have foods of animal origin and vegetables.
2. A diet must have enough food for the needs of each member of the family.
3.Foods should not be prepared under clean conditions.
4. A balanced diet helps prevent diseases and reduce medical expenses in the home.
5. Cleaning the floor is the first step that must be followed to prepare clean food.
6. When preparing food at home we must clean the instruments we use.
7. Eggs and meats require special care during cooking.
8. It is important to store food in adequate conditions to ensure its quality.
9. Raw and cooked foods must be separated to ensure cleanliness.
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A. Yes, is enough B. No, is not enough C. Depends on the cloth that is used. D. Depends on the water that is being filtered.
13. How long should water for human consumption boil/have to boil to kill bacteria in the water?
A. 1 minute B. 3 minutes C. 5 minutes D. 10 minutes
14. How can the residual taste of water be removed after boiling?
A. Let the water cool B. Store the water in the refrigerator C. Shake water and add salt D. Shake water and add sugar
15. One advantage of the filtering is:
A. Simple to apply B. Cleans all types of water C. The water lasts a long time after filtering it D. Its high economic cost
16. How long should you wait after adding the bleach to the water?
A. 10 minutes B. 15 minutes C. 20 minutes D. 25 minutes
17. How many drops of bleach should be placed per liter of water?
A. 5 drops B. 6 drops C. 7 drops D. 8 drops
18. After the filtration I should:
A. Apply another treatment such as boiling or chlorination B. I must not do anything, the water is ready to consume it C. Repeat filtration to ensure water quality D. Store the water to consume it later
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19. A home garden allows the family to:
A. Buy more food in the market B. Have availability of food throughout the year C. Having more money for the family D. Have better cleaning conditions to prepare food
20. What is the ideal height of biontensive beds?
A. 50 cm B. 60 cm C. 70 cm D. 80 cm
21. At what height should double excavation be done in biointensive beds?
A. 30 cm B. 40 cm C. 50 cm D. 60 cm
22. How should crops be divided in the biointensive beds?
A. 50-30-20 B. 50-10-40 C. 20-20-60 D. 50-50
23. Which of the following is an advantage of biointensive beds?
A. Plants develop better B. Plants consume more water C. Vegetables are produced faster D. Vegetables are smaller
24. What is an advantage of nearby planting?
A. Greater production in smaller space B. Plants live longer C. More work is required to plant D. You do not need to have work tools
25. Select the structure in which a double excavation should be done:
A. Hydroponic container B. Living walls C. Chest of drawers D. Biointensive beds
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On a scale of 1 to 5, where 1 means strongly disagree and 5 means strongly agree, please indicate your level of agreement with the following statements
1 2 3 4 5 26. There are no major health problems from
eating contaminated food.
27. The worst thing that can happen when you eat a contaminated food is to get sick.
28. Actually, I do not care about the cleaning of the food.
29. The cleaning of food is not important for the health of my family.
30. I am willing to change my food cleansing practices, by other new methods I can learn.
31. The storage temperature of food is not important in my house.
32. Water cleaning is not important in my house.
33. I am not interested in treating the water we consume in my house.
34. The water treatments are very complicated.
35. Contaminated water is not a risk to my family.
36. Water for consumption that comes from natural sources should not be treated.
37. I understand the differences between the different methods of water treatment.
38. I do not understand what foods are healthy.
39. It does not make sense to follow specific steps for cleaning food.
40. I do not believe in the processes of cleaning food.
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41. I need to learn more about my family's diet.
42. I know when a diet is balanced. 43. The workshops on clean food preparation
are not important to me.
44. The production of food in home gardens is very difficult.
45. I am not trained to produce food in a home garden.
46. Actually, I am not worried about the nutritional benefits of a balanced diet.
47. I can differentiate the benefits of food in different food groups.
48. I know when I should wash my hands to avoid contaminating food.
49. I am not interested in feeding my community.
50. I am willing to exchange food products with other members of my community.
51. I am not interested in spending time with my family.
52. Producing food in my house is a way to spend time with my family.
53. Feeding my family is not a priority for me. 54. My food is healthy. 55. I feel better when I eat healthy and clean. 56. I am not interested in producing food in
my house.
57. The foods produced in home gardens are not good quality.
58. My family does not need to produce food in a home garden.
59. At home, I do not eat a food that I do not know where it comes from.
60. A food that falls to the ground should not be washed to consume it.
61. The animals of my house can enter my house without problems.
62. The animals of my house can enter my house without problems.
63. I have the right resources to produce food at home.
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64. To have a healthy diet I have to eat a variety of foods (cereals, vegetables, meat, dairy products ...).
65. The drink that I like to drink the most is water.
66. The taste of food is more important than the nutritional benefits.
67. I am going to implement the processes learned about cleaning food.
68. I intend to continue learning about clean food preparation.
69. I plan to use water purification treatments at home.
70. I will establish a family garden. 71. The whole family will work in the family
garden.
72. I will look for new food options to improve my family's diet.
Based on your family experience, please answer YES or NO to the following questions:
1. During the last 12 MONTHS, was there a time when you were worried you would not have enough food to eat because of a lack of money or other resources? Yes ______ No______
2. Still thinking about the last 12 MONTHS, was there a time when you were unable to eat healthy and nutritious food because of a lack of money or other resources? Yes ______ No______
3. Was there a time when you ate only a few kinds of foods because of a lack of money or other resources? Yes ______ No______
4. Was there a time when you had to skip a meal because there was not enough money or other resources to get food?
Yes ______ No______
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5. Still thinking about the last 12 MONTHS, was there a time when you ate less than you thought you should because of a lack of money or other resources? Yes ______ No______
6. Was there a time when your household ran out of food because of a lack of money or other resources? Yes ______ No______
7. Was there a time when you were hungry but did not eat because there was not enough money or other resources for food? Yes ______ No______
8. During the last 12 MONTHS, was there a time when you went without eating for a whole day because of a lack of money or other resources? Yes ______ No______