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Influence of Food Security and Social SupportQuality of Life Among Rural and Urban Iowans With Multiple Sclerosis: A Mixed-Methods Pilot Study
Journal article   Open access   Peer reviewed

Influence of Food Security and Social SupportQuality of Life Among Rural and Urban Iowans With Multiple Sclerosis: A Mixed-Methods Pilot Study

Solange Saxby, Anna M. Klein, Farnoosh Shemirani, Ellen T. Meiser, Tyler J. Titcomb, Linda G. Snetselaar and Terry L. Wahls
International journal of MS care, Vol.28(2), pp.65-74
03/02/2026
DOI: 10.7224/1537-2073.2024-068
url
https://doi.org/10.7224/1537-2073.2024-068View
Published (Version of record) Open Access

Abstract

Background: Multiple sclerosis (MS) can influence food security status and social support, affecting an individual’s quality of life (QOL). Thus, this pilot study aimed to understand the relationship between food security, social support, and QOL for individuals with MS in rural counties compared with urban counties in Iowa. Methods: Using a mixed-methods design, validated self-reported questionnaires were provided: Multiple Sclerosis Quality of Life-54, Social Support and Eating Habits Survey, Social Support and Exercise Survey (SSES), and the United States Department of Agriculture’s Household Food Security Survey Module. Semistructured interviews further explored participants’ perceptions of QOL, with a focus on food security, social support, and QOL. Thematic analysis was applied to qualitative interviews. Results: Thirty-four Iowa residents with MS participated (11 rural; 23 urban). Although the impact of food security on QOL did not differ between rural and urban participants, food security was inversely associated with lower mental QOL (r = –0.63; P < .001). Greater social support from family (SSES family participation; r = 0.43; P = .02) and friends (SSES friend participation; r = 0.39; P = .04) was linked to improved mental QOL. Qualitative findings supported these results and highlighted contextual differences in social support and food access between rural and urban residents. Conclusions: In individuals with MS, food insecurity is associated with decreased mental QOL scores, regardless of geographic location. Strengthening family- and friend-based social support may be an effective strategy to enhance mental QOL. Further research is warranted with a larger sample size to explore the influence of food security and social support on improving mental QOL.

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