Mapping outcomes reported in primary studies of interventions addressing access to food in LMICs to inform a core outcome set
1
Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
2
Centre for Evidence-based Health Care, Stellenbosch University, Cape Town, South Africa
3
Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
4
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
5
Southern Africa Food Lab, Stellenbosch University, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3697
ABSTRACT
INTRODUCTION:
Trials assessing the same condition and intervention report outcomes inconsistently, which undermines the utility of intervention research 1,2. Multiple outcome reporting has been demonstrated in food security intervention evaluations 3. Developing a core outcome set (COS) to measure in related studies may help address this issue and strengthen the evaluation of interventions addressing food access in LMICs. The first step of the project was to develop a preliminary list of candidate outcomes for the COS.
METHODS:
We conducted a cross-sectional analysis of 90 studies included in a published systematic review on this topic4.Two researchers independently extracted data on the study characteristics and outcomes reported in studies. We mapped outcomes onto pre-specified categories to build an outcome taxonomy for interventions to promote access to food. The research team then refined the list of outcomes for consultation.
RESULTS:
We included 90 studies published from 1989 to 2023. Most are cluster RCTs (54%) in rural settings (68%) in Africa (51%) or Asia (33%), assessing interventions to increase buying power (86%). Eight studies assessed food vouchers and subsidies and one the social environment. The 90 studies reported 1296 outcome instances, and 150 unique outcomes. The categories with most unique outcomes reported were psychosocial (n=23), food intake (n=21), economic (n=18) and anthropometry (n=17). None reported on satisfaction outcomes. Fifty unique outcomes were selected for stakeholder consultation on the COS, mostly from the food intake, anthropometry, and economic outcome categories. Of those excluded, 85 were reported in less than 5% of included studies and 15 were outside the COS scope. Conclusion. A taxonomy of 150 unique outcomes was developed for interventions promoting food access in LMICs. Of these, 50 outcomes will inform a Delphi survey with stakeholders in 2026, who will rate their importance and agree on the final COS.
Trials assessing the same condition and intervention report outcomes inconsistently, which undermines the utility of intervention research 1,2. Multiple outcome reporting has been demonstrated in food security intervention evaluations 3. Developing a core outcome set (COS) to measure in related studies may help address this issue and strengthen the evaluation of interventions addressing food access in LMICs. The first step of the project was to develop a preliminary list of candidate outcomes for the COS.
METHODS:
We conducted a cross-sectional analysis of 90 studies included in a published systematic review on this topic4.Two researchers independently extracted data on the study characteristics and outcomes reported in studies. We mapped outcomes onto pre-specified categories to build an outcome taxonomy for interventions to promote access to food. The research team then refined the list of outcomes for consultation.
RESULTS:
We included 90 studies published from 1989 to 2023. Most are cluster RCTs (54%) in rural settings (68%) in Africa (51%) or Asia (33%), assessing interventions to increase buying power (86%). Eight studies assessed food vouchers and subsidies and one the social environment. The 90 studies reported 1296 outcome instances, and 150 unique outcomes. The categories with most unique outcomes reported were psychosocial (n=23), food intake (n=21), economic (n=18) and anthropometry (n=17). None reported on satisfaction outcomes. Fifty unique outcomes were selected for stakeholder consultation on the COS, mostly from the food intake, anthropometry, and economic outcome categories. Of those excluded, 85 were reported in less than 5% of included studies and 15 were outside the COS scope. Conclusion. A taxonomy of 150 unique outcomes was developed for interventions promoting food access in LMICs. Of these, 50 outcomes will inform a Delphi survey with stakeholders in 2026, who will rate their importance and agree on the final COS.
| eISSN: | 2654-1459 |
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