FAMILY CHARACTERISTICS AND ECTC-SPECIFIC QUESTIONS

Family characteristics were reported in the first online survey, including parent and child age, sex, race, and ethnicity; parent education, marital status, and insurance status; and the number of children and adults in the home. Household monthly income was reported at each time point. ECTC-specific questions included which months families received ECTC payments, the amount of money received each month, the number of children who qualified for payments, whether payments were helpful, why payments were not helpful, and how the additional income was spent. A list of options for how the additional income was spent was developed by the authors and provided in a checklist format to select all that applied. A write-in “other” option was provided. If parents reported not receiving ECTC payments they were asked why not (for example, they opted out).

The Department of Agriculture’s eighteen-item U.S. Household Food Security Survey Module assessed household food security,²⁰ using a thirty-day reference period in accordance with the scoring guidelines. Affirmative responses were summed and categorized as “high” (0 items), “marginal” (1–2 items), “low” (3–7 items), or “very low” (8 or more items) food security at each time point.

The National Cancer Institute’s Dietary Screener Questionnaire assessed children’s dietary consumption at each time point.²¹ The Dietary Screener Questionnaire is a brief and valid measure, with estimates in close agreement to twenty-four-hour dietary recalls,^22,23 yet the questionnaire’s thirty-day reference period maybe more reflective of a sustained response to ECTC payments. Twenty-six items asked about the consumption of fruit and vegetables, dairy and calcium, added sugars, red meat, processed meat, and whole grains and fiber. Parents reported on the frequency with

The percentage of families with very low food insecurity dropped substantially after three months of ECTC payments.

which their child consumed these items in the past month. A publicly available SAS algorithm converted responses into intake estimates,²⁴ using age- and gender-specific portion sizes from data in the 2009–10 National Health and Nutrition Examination Survey. Two questions on red and processed meats were excluded, given that they are not part of the scoring algorithm.

The fifteen-item Beverage Intake Questionnaire in Children and Adolescents estimated children’s habitual beverage intake during the past month.²⁵ This reliable indicator has produced results similar to those of twenty-four-hour dietary recalls.²⁵ Parents reported on children’s consumption frequency and amount for six beverages (water, 100 percent fruit juice, sweetened juice, regular soda, sweetened tea, and sports drinks). Flavored milk was also added, given the frequency with which children consume this beverage, including at school.²⁶ Scoring guidelines determined children’s average daily fluid ounce intake for each beverage and daily calorie consumption for the volume of each beverage consumed. For flavored milk, data from the Department of Agriculture estimating 20.8 calories per fluid ounce of chocolate milk²⁷ were used to calculate average daily calorie intake.