An adapted Household Food Insecurity Access Scale is a valid tool as a proxy measure of food access for use in urban Iran

We carried out this study to assess the validity and application of the Household Food Insecurity Access Scale (HFIAS) in measuring household food insecurity in the urban area of Varamin City, Iran, in 2009. In this cross-sectional descriptive study, 400 households from different parts of the urban areas of Varamin were selected by a multistage sampling scheme. Household food security was measured by the HFIAS 9-item questionnaire that asks whether a specific condition associated with the experience of food insecurity ever occurred during the previous 30 days. Based on their HFIAS questionnaire scores, households were classified into four groups: food secure, mildly, moderately and severely food insecure. In the second stage of the study, 30 households from each food security group were randomly selected to assess the validity and reliability of the HFIAS questionnaire. Food security was observed in 21 % of households. Mildly, moderately and severely food insecure households were 46.5, 25.0 and 7.5 %, respectively. In more than half the households (54.3 %) the ratio of calorie consumption to RDA was below 70 %. Poor food quality and insufficient food intake were the two factors that explained 77.5 % of the total variance. The HFIAS had good internal consistency (Cronbach's alpha = 0.95).