1. 29 may 2014 Dr Federico Roncarolo

2. FAO, IFAD and WFP: The State of Food Insecurity in the World 2013.The multiple dimensions of food security. Rome, 2013

3. PROOF Research to identify policy options to reduce food insecurity

5. CHAIRE CACIS - Chaire Approches Communautaires et Inégalités de Santé

6. Intervention strategyCharacteristicsType of relation Traditional (food banks, soup kitchens, food boxes) Interventions based on food gathering and redistribution, they try to answer to an immediate and daily need of food Food assistance Food aid Alternative (collective kitchens, community gardens, buying groups) Interventions developing networks of mutual aid and social participation through skills developments Mutual aid integration Social integration Social transformation (Community-supported agriculture, food-related community economic development) Interventions aimed at the participation in collective actions, with the objective of increasing citizens’ empowerment on individual and collective food security E mpowerment of people and collectivity

7. To assess the effects of interventions conducted by community organizations in the Montreal Metropolitan Region to address the food security and health of their users, and to generate evidence-based data on the effects of two different strategies to fight food insecurity

8. Longitudinal study of newly recruited participants in traditional and alternative food security interventions. Participants selected in a two stage cluster sampling frame.

9. Sample units: community organizations working on food security in the Montreal Metropolitan Region Analysis units: participants in food security interventions individuals between 18 and 65 years of age registered for the first time, and for less than 6 months in selected MMR food security community organizations

10. Organizations: 50 new participants for traditional interventions 30 new participants for alternative interventions Participants: between 18 and 65 years of age registered for the first time, and for less than 6 months

11. 30-45 minutes questionnaires administered face to face in French or in English, according to the preference of participants. Follow-up nine months after the first interview

12. T1T2 Traditional interventions 711372 (52.3%) Alternative interventions 11378 (69%) Total824450 (54.6%) 16 organizations implementing traditional interventions 6 organizations implementing alternative interventions

13. Traditional intervention Alternative intervention Total The organization quit the study 25 (7.4%)--25 (6.7%) Not found228 (67.3%)14 (40%)242 (64.7%) Not available/rejected86 (25.4%)18 (51.4%)104 (27.8%) Not concordant data--3 (8.6%)3 (0.8%) Total339 (100%)35 (100%)374 (100%)

14. Traditional interventions n. (%) Alternative interventions n. (%) Total n. (%) Gender * Male Female 332 (46.7) 365 (51.3) 22 (19.5) 87 (77.0) 354 (43.0) 452 (54.9) Age <30 years 30-49 years 50-65 years 117 (16.5) 370 (52.0) 222 (31.2) 24 (21.2) 58 (51.3) 29 (25.7) 141 (17.1) 428 (51.9) 251 (30.5) Country of birth * Canada Others 466 (65.5) 241 (33.9) 47 (41.6) 65 (57.5) 513 (62.3) 306 (37.1) Marital status * Married/ common law spouse Single Other (separated, divorced, widowed) 214 (30.1) 340 (47.8) 139 (19.5) 45 (39.8) 34 (30.1) 29(25.7) 259 (31.4) 374 (45.4) 168 (20.4) Education * Less than a high school diploma Secondary (high) school diploma or equivalent Less than a bachelor degree Bachelor’s degree or above 197 (27.7) 186 (26.2) 196 (27.6) 107 (15.1) 25 (22.1) 26 (23.0) 34 (30.1) 222 (26.9) 211 (25.6) 222 (26.9) 141 (45.2) Number of other people in household beside the respondent, mean (sd)* 1.61 (1.50)2.20 (1.55)1.70 (1.52) *p<0.05

15. Traditional Alternative I n t e r v e n t i o n 46.2% 69.9%

16. V. Van Gogh, 1885: The potatoes eaters

17. Definition of security10-items adults food security scale 8-items adults food security scale Household food security Security (no or 1 indication of difficulties with income- related food access) 0 or 1 positive answers Adult + child in insecurity Moderate insecurity (indication of compromise in quality and/or quantity of food consumed ) 2 to 5 positive answers 2 to 4 positive answers Adult OR child in moderate food insecurity Severe insecurity (indication of reduced food intake and disrupted eating patterns) ≥ 6 positive answers ≥5 positive answers Adult OR child in severe food insecurity Canadian Community Health Survey, Cycle 2.2, Nutrition (2004)— Income-Related Household Food Security in Canada

18. OR: 0.47 (i.c.95%: 0.19-1.15) OR: 0.35 (i.c.95%: 0.23-0.53) p=0.902 I n t e r v e n t i o n s

19. OR: 0.42 (i.c.95%: 0.08-2.15) OR: 0.36 (i.c.95%: 0.18-0.69) p=0.698 TraditionalAlternative I n t e r v e n t i o n s

20. OR: 0.46 (i.c.95%: 0.20-2.02) OR: 0.38 (i.c.95%: 0.27-0.55) p=0.738 Traditional I n t e r v e n t i o n s

21. Matisse, 1909: The dance

22. Beta coeff : Trad: 2.33 (i.c.95%: -0.25;4.91) Altern: -2.20 (i.c.95% : -7.87;3.47) Interaction time-group: p=0.222 Beta coeff : Trad: 6.01 (i.c.95%: 3.90-8.11) Altern: 4.09 (i.c.95% : -0.85;9.03) Interaction time-group: p=0.573 Percentile scale

23. Participants in traditional and alternative interventions present significant differences before starting the interventions Does food insecurity interventions increase inequalities among the most vulnerable who attend traditional interventions and participants in alternatives? If we just consider T1 and T2 results, it seems that the effects of traditional interventions are effective in reducing food insecurity and improving mental health Alternative interventions seem to have some positive effects concerning food insecurity and mental health although they never reach a statistical significant level

24. Giuseppe Arcimboldo, 1573: Summer Thank you!