Copyright 2019, Rafael Antonio Quijada Landaverde

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

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.


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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.


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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


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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


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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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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:


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:


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


17

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


19

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).


21

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.


22

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


23

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).


24

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


25

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).


26

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


27

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


28

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


29

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


30

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


31

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).


32

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


33

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.


34

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


35

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


36

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 &


37

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.


38

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.


39

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


40

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).


41

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


42

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


43

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


44

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


45

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).


46

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).


47

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.


48

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),


49

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.


79

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


80

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


81

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


82

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


83

[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.


84

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)


85

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


86

Figure 15. Front page of informative manual.

Figure 16. Certificate of participation.


87

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


88

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


89

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.


90

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



91

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.


92

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.


93

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



94

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



95

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


96

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.


97

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


98

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


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


99

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.


100

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


101

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


102

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


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


103

Figure 24. Differences between pretest and posttest scores in control group

Research Objective Six

For pre-test and post-test:


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


104

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.


105

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


Pretest Knowledge Scores for Experimental and Control Group

Low

Defficient

Good

Very good

Excelent

0

10

20

30

40

50

60


Posttest Knowledge Score for Experimental and Control Group

Low

Defficient

Good

Very good

Excelent


106

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



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).


107

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



108

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.


109

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*


.02 .01 .09 .03 .19 94.77 .725

Note. *p < .05


110

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



111

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


118

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.


119

Research Objective Two

Describe farmers from the rural community in El Salvador.


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).


120

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.


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



food security and nutrition of small farmers between pre-test and post-test.


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


121

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



perceptions toward food security and nutrition in the small farmers between pre-test and

post-test.


122


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


123

not register any change in their attitudes and perceptions because they did not receive the

educational intervention.

Research Objective Six



food security and nutrition of small farmers between experimental and control group.


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).


124

Research Objective Seven



perceptions toward food security and nutrition of small farmers between experimental

and control group.


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.


125

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.


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.


126

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.


127

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.


128

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).


129

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.


130

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


131

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______

Copyright 2019, Rafael Antonio Quijada Landaverde

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