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Plencner LM, Nalubega Ross J, Hall M, Hurley EA, Raphael JL, De Miranda ED, Colvin JD. Piloting Home Produce Delivery to Improve Food Security, Budget, and Diet in Families with Children: A Mixed-Methods Study. Acad Pediatr 2024:S1876-2859(24)00287-0. [PMID: 39098600 DOI: 10.1016/j.acap.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 07/23/2024] [Accepted: 07/25/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND Few children in food insecure (FI) households meet dietary recommendations for fruit and vegetables ("produce"). Barriers include affordability, accessibility, and desirability. Home produce delivery may reduce FI, increase produce consumption, and decrease budget tradeoffs. OBJECTIVE Evaluate the acceptability and potential impact of delivering produce through home visiting programs on FI, diet, and budget tradeoffs. METHODS In this prospective pre/post mixed methods study, 51 parents engaged in home visiting programs were enrolled. Participants completed pre- and post-program surveys on FI (18-item Food Security Scale), produce consumption, and budget tradeoffs. Pre- and post-surveys were compared using McNemar's test and weighted kappas. Interview guides were based on Social Cognitive Theory and a previously published framework. Interviews were conducted in English or Spanish; thematic analysis was completed. RESULTS Twenty-nine (56.9%) participants completed both surveys. Most were female (96.3%) and Hispanic (79.3%) (Table 1). Food security improved in the post-period, with more participants reporting high food security (pre: 6.9%, post: 31.0%) and fewer reporting very low food security (pre: 20.7%, post: 6.9%, p<0.01) (Table 2). Budgetary tradeoffs decreased in the post-program period (pre: 71.4%, post: 48.1%, p=0.03). Fifteen participants were interviewed. Themes included 1) saved money, 2) increased fruit and vegetable consumption, and 3) interest in future participation. CONCLUSION This pilot study found that an intervention for delivery of produce through home visiting programs was acceptable to participants and resulted in potential improvements in FI and household budgets. This supports future studies to further explore the impact of this novel intervention. WHAT'S NEW In this prospective mixed-methods pilot, home delivered produce was acceptable and feasible with potentially improved food security and household budgets; evidence of potential change in produce consumption was mixed. Changes in budget tradeoffs is a novel outcome in food programs.
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Affiliation(s)
- Laura M Plencner
- Children's Mercy Hospitals and Clinics, 2401 Gillham Rd, Kansas City, Missouri 64108 USA; University of Missouri-Kansas City School of Medicine, 2401 Gillham Rd, Kansas City, Missouri 64108 USA.
| | - J Nalubega Ross
- Children's Mercy Hospitals and Clinics, 2401 Gillham Rd, Kansas City, Missouri 64108 USA.
| | - Matthew Hall
- Children's Hospital Association, 16011 College Blvd #250, Lenexa, KS, 66219, USA.
| | - Emily A Hurley
- Children's Mercy Hospitals and Clinics, 2401 Gillham Rd, Kansas City, Missouri 64108 USA; University of Missouri-Kansas City School of Medicine, 2401 Gillham Rd, Kansas City, Missouri 64108 USA.
| | - Jean L Raphael
- Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA.
| | | | - Jeffrey D Colvin
- Children's Mercy Hospitals and Clinics, 2401 Gillham Rd, Kansas City, Missouri 64108 USA; University of Missouri-Kansas City School of Medicine, 2401 Gillham Rd, Kansas City, Missouri 64108 USA.
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Liebe RA, Holmes C, Misyak SA. Differing Within-Household Food Security Statuses Are Associated with Varied Maternal Mental Health Outcomes. Nutrients 2024; 16:1522. [PMID: 38794760 PMCID: PMC11123853 DOI: 10.3390/nu16101522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Household food insecurity is not necessarily equally experienced by all household members, with mothers often changing their intake first when food resources are limited. The purpose of this study was to understand the association between maternal mental health and intrahousehold differences in food security statuses. A cross-sectional survey was administered to Virginia mothers with low income (August-October 2021), assessing validated measures of food security, mental and physical health and related factors. Participants (n = 570) were grouped according to the food security status of adults and children within the household. Linear regression was used to assess the outcomes of interest by group and controlled for key demographic variables. Mothers in households with any food insecurity reported worse overall mental health and used 3-4 more food coping strategies than households experiencing food security (p < 0.05). Only mothers in households where adults experienced food insecurity reported significantly greater anxiety and depressive symptoms (61.5 and 58.1, respectively) compared to households experiencing food security (55.7 and 52.4, p < 0.001). While any experience of household food insecurity is associated with worse maternal mental health, there were differences by the within-household food security status. Future research should explore screening measures that capture specific household members' food security to connect households with available resources.
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Affiliation(s)
- Rachel A. Liebe
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74075, USA
| | - Chanit’a Holmes
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA 24061, USA;
| | - Sarah A. Misyak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA;
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Liebe RA, Porter KJ, Adams LM, Hedrick VE, Serrano EL, Cook N, Misyak SA. "I'm Doing the Best that I Can": Mothers Lived Experience with Food Insecurity, Coping Strategies, and Mental Health Implications. Curr Dev Nutr 2024; 8:102136. [PMID: 38645883 PMCID: PMC11031732 DOI: 10.1016/j.cdnut.2024.102136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/23/2024] Open
Abstract
Background Food insecurity can have lasting physical and mental health consequences. The experience of food insecurity within a household may disproportionately impact mothers because they tend to manage the household food environment. Objective This study sought to understand the stresses faced by United States mothers experiencing food insecurity, related coping mechanisms, and the impacts of these stressors on their mental health. Methods Semistructured interviews were conducted in May and June 2022 with a purposive sample of Virginia mothers who reported experiences of food insecurity. Participants were recruited from a related survey and university and community LISTSERVs. Interviews were transcribed and analyzed by trained coders. A thematic analysis was conducted to describe themes that emerged from the data. Virtual interviews were 20-60 min in duration. Mothers with children living in their household, having experienced food insecurity, and living in Virginia were eligible. Results The following 3 themes emerged from the interviews with the mothers (n = 15): 1) food insecurity added stress to mothers' lives in multiple ways (e.g. worry about obtaining the "right" foods and internalized or experienced stigma), 2) mothers used positive and negative coping strategies to address the impacts of these stressors (e.g. use of community resources and reduced personal food intake), and 3) the stressors and coping strategies had varying impacts on mothers' mental health (e.g. added to existing mental health challenges or reduced their mental capacity to make changes). Conclusions Study findings suggest that a multilevel and tailored approach to address diverse stressors is warranted. Future research should explore emotional coping strategies that comprehensively empower mothers to manage stressors, leverage resources, and reduce social stigma associated with food insecurity and accessing nutrition and mental health assistance. This may improve their household food security and mitigate the burden of stressors on their mental health because system-level solutions to food insecurity are pursued.
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Affiliation(s)
- Rachel A Liebe
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, United States
| | - Kathleen J Porter
- Department of Public Health Sciences, University of Virginia, Christiansburg, VA, United States
| | - Leah M Adams
- Department of Psychology, George Mason University, Fairfax, VA, United States
| | - Valisa E Hedrick
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Elena L Serrano
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States
- The Virginia Cooperative Extension Family Nutrition Program, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Natalie Cook
- Department of Population Health Science, Virginia Tech, Blacksburg, VA, United States
| | - Sarah A Misyak
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States
- The Virginia Cooperative Extension Family Nutrition Program, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, United States
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Pérez EJ, Carabali M, Mercille G, Sylvestre MP, Roncarolo F, Potvin L. Characterizing Trends in the Use of Food Donations and Other Food-Related Community-Based Social Assistance Programs in a Cohort of New Food Bank Users in Quebec, Canada. Int J Public Health 2024; 69:1605833. [PMID: 38404502 PMCID: PMC10884234 DOI: 10.3389/ijph.2024.1605833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
Objective: To characterize 12-month trends in the use of food donations and other food-related community-based social assistance programs (CB-SAPs) during the first year following the enrollment of new food bank (FB) users in Quebec, Canada. Methods: A cohort of 1,001 newly registered FB-users in Quebec from the Pathways Study were followed-up during 12-month following baseline assessment. Outcomes were monthly use of food donations and other food-related CB-SAPs. Main predictors were alternative food source utilization (AFSU) profiles: 1) exclusive-FB-users; 2) FB+fruit/vegetable-market-users; and 3) Multiple/diverse-AFS-users. Covariates included sociodemographic characteristics, health status, and major life events. We fit Bayesian hierarchical mixed-effect models, accounting for spatial clustering, temporal correlation, and censoring. Results: We observed an overall downward trend of food donation use among study completers (n = 745). Each AFSU profile had a distinctive monthly trend of food donation use, but probabilities of use across the three profiles overlapped, between 44% and 55%. The use of other food-related CB-SAPs was low and not correlated with AFSU profiles. Conclusion: De novo FB-users use food donations in different ways over time according to specific contextual AFSU profiles.
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Affiliation(s)
- Elsury Johanna Pérez
- School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal & CIUSSS du Centre-Sud-de-l’île-de-Montréal, Montréal, QC, Canada
- Chaire de Recherche du Canada sur les Approches Communautaires et Inégalités de Santé (CACIS), Université de Montréal, Montréal, QC, Canada
| | - Mabel Carabali
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal & CIUSSS du Centre-Sud-de-l’île-de-Montréal, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Geneviève Mercille
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal & CIUSSS du Centre-Sud-de-l’île-de-Montréal, Montréal, QC, Canada
- Chaire de Recherche du Canada sur les Approches Communautaires et Inégalités de Santé (CACIS), Université de Montréal, Montréal, QC, Canada
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Sylvestre
- School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal & CIUSSS du Centre-Sud-de-l’île-de-Montréal, Montréal, QC, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Federico Roncarolo
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal & CIUSSS du Centre-Sud-de-l’île-de-Montréal, Montréal, QC, Canada
- Chaire de Recherche du Canada sur les Approches Communautaires et Inégalités de Santé (CACIS), Université de Montréal, Montréal, QC, Canada
| | - Louise Potvin
- School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal & CIUSSS du Centre-Sud-de-l’île-de-Montréal, Montréal, QC, Canada
- Chaire de Recherche du Canada sur les Approches Communautaires et Inégalités de Santé (CACIS), Université de Montréal, Montréal, QC, Canada
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Thomas MK, Amstutz C, Orr-Roderick D, Horter J, Holben DH. Medical Mistrust Among Food Insecure Individuals in Appalachia. FAMILY & COMMUNITY HEALTH 2023; 46:192-202. [PMID: 37079541 PMCID: PMC10179979 DOI: 10.1097/fch.0000000000000362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study focused on the relationship between food insecurity and medical mistrust within Appalachia. Food insecurity has negative consequences on health, while medical mistrust can lead to a decrease in health care use, creating additive consequences to already vulnerable populations. Medical mistrust has been defined in various ways, with measures addressing health care organizations and individual health care providers. To determine whether food insecurity has an additive impact on medical mistrust, a cross-sectional survey was completed by 248 residents in Appalachia Ohio while attending community or mobile clinics, food banks, or the county health department. More than one-quarter of the respondents had high levels of mistrust toward health care organizations. Those with high food insecurity levels were more likely to have higher levels of medical mistrust than those with lower levels of food insecurity. Individuals with higher self-identified health issues and older participants had higher medical mistrust scores. Screening for food insecurity in primary care can reduce the impact of mistrust on patient adherence and health care access by increasing patient-centered communication. These findings present a unique perspective on how to identify and mitigate medical mistrust within Appalachia and call attention to the need for further research on the root causes among food insecure residents.
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Affiliation(s)
- Melissa K. Thomas
- Department of Primary Care (Dr Thomas), Ohio University Heritage College of Osteopathic Medicine (Ms Amstutz), Athens, Ohio; Learning Resource Center, Ohio University Heritage College of Osteopathic Medicine/Medical Education, Athens, Ohio (Ms Orr-Roderick); Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio (Ms Horter); and Department of Nutrition and Hospitality Management, Office of Food and Nutrition Security, The University of Mississippi, University, Mississippi (Dr Holben)
| | - Ciara Amstutz
- Department of Primary Care (Dr Thomas), Ohio University Heritage College of Osteopathic Medicine (Ms Amstutz), Athens, Ohio; Learning Resource Center, Ohio University Heritage College of Osteopathic Medicine/Medical Education, Athens, Ohio (Ms Orr-Roderick); Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio (Ms Horter); and Department of Nutrition and Hospitality Management, Office of Food and Nutrition Security, The University of Mississippi, University, Mississippi (Dr Holben)
| | - Debra Orr-Roderick
- Department of Primary Care (Dr Thomas), Ohio University Heritage College of Osteopathic Medicine (Ms Amstutz), Athens, Ohio; Learning Resource Center, Ohio University Heritage College of Osteopathic Medicine/Medical Education, Athens, Ohio (Ms Orr-Roderick); Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio (Ms Horter); and Department of Nutrition and Hospitality Management, Office of Food and Nutrition Security, The University of Mississippi, University, Mississippi (Dr Holben)
| | - Julia Horter
- Department of Primary Care (Dr Thomas), Ohio University Heritage College of Osteopathic Medicine (Ms Amstutz), Athens, Ohio; Learning Resource Center, Ohio University Heritage College of Osteopathic Medicine/Medical Education, Athens, Ohio (Ms Orr-Roderick); Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio (Ms Horter); and Department of Nutrition and Hospitality Management, Office of Food and Nutrition Security, The University of Mississippi, University, Mississippi (Dr Holben)
| | - David H. Holben
- Department of Primary Care (Dr Thomas), Ohio University Heritage College of Osteopathic Medicine (Ms Amstutz), Athens, Ohio; Learning Resource Center, Ohio University Heritage College of Osteopathic Medicine/Medical Education, Athens, Ohio (Ms Orr-Roderick); Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio (Ms Horter); and Department of Nutrition and Hospitality Management, Office of Food and Nutrition Security, The University of Mississippi, University, Mississippi (Dr Holben)
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Liebe RA, Adams LM, Hedrick VE, Serrano EL, Porter KJ, Cook NE, Misyak SA. Developing a conceptual framework for the relationship between food security status and mental health among low-income mothers. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2022.1078811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IntroductionBuilding household resiliency is one strategy that may help insulate households from the effects of food system volatility that contributes to in food insecurity. A stronger understanding of the relationship between food security and mental health is needed to identify potential factors for intervention to improve household resiliency to food system stressors. Because mothers often make household food decisions, they are an important population for building household resiliency. The purpose of this study was to develop and test a conceptual framework for the relationship between food security and mental health for low-income mothers and to identify potential targets for intervention.MethodsA conceptual framework was developed based on the existing literature on mental health and food security, as well as factors that impact both constructs. This framework was tested by a path analysis using data from a 2021 cross-sectional survey of low-income Virginia mothers that used validated scales to assess food security status, indicators of mental and physical health, food coping strategies, and social support.Results and discussionThe initial model was systematically adapted to develop the final retained model. The retained model did not include a direct effect of food security on mental health, but highlighted two significant mediators of the relationship, food coping strategies and social support. While the effect of social support was not practically significant, the effects of food coping strategies as a mediator from food security to perceived stress and life satisfaction were small (β = 0.21, 0.14, respectively; p < 0.001). The retained model provides a framework for understanding the relationship between food security and mental health and highlights potential targets for intervention. Notably, reducing the need for mothers to utilize food coping strategies should be targeted on multiple levels to reduce the impact on mental health and ultimately improve resiliency to future food system shocks.
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Hazzard VM, Loth KA, Crosby RD, Wonderlich SA, Engel SG, Larson N, Neumark-Sztainer D. Relative food abundance predicts greater binge-eating symptoms in subsequent hours among young adults experiencing food insecurity: Support for the "feast-or-famine" cycle hypothesis from an ecological momentary assessment study. Appetite 2023; 180:106316. [PMID: 36167172 PMCID: PMC9808920 DOI: 10.1016/j.appet.2022.106316] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/14/2022] [Accepted: 09/20/2022] [Indexed: 01/05/2023]
Abstract
Food insecurity (FI) may increase risk for binge eating through a "feast-or-famine" cycle, where fluctuations in food availability correspond to alternating periods of food restriction and opportunities for binge eating, but research on this topic is limited. To clarify the relationship between food availability and binge eating in the context of FI, this study examined the association between momentary food security level and subsequent binge-eating symptoms among individuals in food-insecure households and investigated how this association differs by factors that may modify the extent to which food availability fluctuates. Ecological momentary assessment data were collected in 2020-2021 from 75 young adults (Mage = 25.3 ± 1.8 years; 72% female; 72% Black, Indigenous, or a Person of Color) in the United States who had experienced past-month household FI. For 14 days, participants reported four times per day on food security and eating episodes, and binge-eating symptoms were assessed for each reported eating episode. About 35% of the variance in momentary food security ratings was accounted for by within-person variability over time. A significant within-person association was observed in multilevel analyses, indicating that instances of greater food security relative to one's average level predicted greater subsequent binge-eating symptoms. Moderation analyses revealed that this association was significant only among individuals reporting use of food assistance programs, high engagement in resource trade-off coping strategies (e.g., skipping bill payments to buy food), or low food security-related self-efficacy. Overall, findings offer support for the "feast-or-famine" cycle hypothesis as an explanation for the link between FI and binge eating, emphasize the importance of identifying approaches to promote more stable access to adequate food, and suggest potential intervention targets to reduce risk for binge eating in populations experiencing FI.
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Affiliation(s)
- Vivienne M Hazzard
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA; Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA; Sanford Center for Biobehavioral Research, Fargo, ND, USA.
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, ND, USA; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Stephen A Wonderlich
- Sanford Center for Biobehavioral Research, Fargo, ND, USA; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Scott G Engel
- Sanford Center for Biobehavioral Research, Fargo, ND, USA
| | - Nicole Larson
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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Mitchell A, Ellison B, Bruening M. Persistent and Episodic Food Insecurity and Associated Coping Strategies Among College Students. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:972-981. [PMID: 36184354 DOI: 10.1016/j.jneb.2022.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To determine the rates of episodic and persistent food insecurity among college students and whether coping strategies employed differs on the basis of food security status. DESIGN Online cross-sectional survey administered in March 2021. SETTING A large Midwestern university. PARTICIPANTS A random sample of students (n = 5,000) were invited to participate via email with a response rate of 20% (n = 888). MAIN OUTCOME MEASURES Food insecurity was assessed using the 10-item US Department of Agriculture Adult Food Security Survey Module. Food acquisition and management coping strategies were measured using modified questionnaires. ANALYSIS Pearson's chi-squared tests, 1-way ANOVAs, and post hoc analyses were conducted to examine associations of sociodemographic factors and coping strategies with food security status. Linear regression models were used to estimate the association between the coping strategies scale and subscales with food insecurity status. RESULTS The food insecurity rate was 22%, with 11% and 10% of students experiencing episodic and persistent food insecurity, respectively. Coping strategies varied significantly by food security status (P < 0.001), with students facing persistent food insecurity employing coping strategies most frequently. CONCLUSIONS AND IMPLICATIONS Future research is needed to better understand the persistent nature of food insecurity and coping strategies to develop tailored policies and programs for the college student population.
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Affiliation(s)
- Ana Mitchell
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL.
| | - Brenna Ellison
- Agricultural Economics, Purdue University, West Lafayette, IN
| | - Meg Bruening
- College of Health Solutions, Arizona State University, Phoenix, AZ
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Understanding the Relationship between Food Security and Mental Health for Food-Insecure Mothers in Virginia. Nutrients 2022; 14:nu14071491. [PMID: 35406104 PMCID: PMC9003049 DOI: 10.3390/nu14071491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 12/04/2022] Open
Abstract
Food insecurity, which disproportionately impacts mothers, can have chronic consequences on physical and mental health. There is a relationship between food insecurity and mental health, but the relationship’s mechanisms are unclear. This study aimed to understand how mental health outcomes differ by food insecurity severity and race among Virginia mothers. A cross-sectional survey employed previously validated food security status measures, physical and mental health, social support, and food coping strategies. Results were analyzed using descriptive statistics, Spearman’s rank-order correlations, linear regression, and chi-squared with effect sizes. Overall, respondents (n = 1029) reported worse mental health than the U.S. average (44.3 ± 10.1 and 50, respectively). There was a large effect of food security on mental health (d = 0.6), with worse mental health outcomes for mothers experiencing very low food security (VLFS) than low food security (LFS; p < 0.001). There was a small effect of race on mental health (φc = 0.02), with Black mothers having better mental health than White mothers (p < 0.001). Compared to mothers experiencing LFS, mothers experiencing VLFS had less social support (d = 0.5) and used more food coping strategies, especially financial strategies (d = −1.5; p < 0.001). This study suggests that food-insecure mothers experience stressors and lack adequate social support, which is even more distinct for mothers experiencing VLFS.
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Nielsen DE, Labonté K, Karamanoglu I, Han HY, Tavanaei M, Duhamel PG, Agellon LB, Paquet C, Dube L. Longitudinal Patterns of Food Procurement Over the Course of the COVID-19 Pandemic: Findings From a Canadian Online Household Survey. Front Public Health 2022; 9:752204. [PMID: 35127611 PMCID: PMC8810501 DOI: 10.3389/fpubh.2021.752204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Consumer food procurement during the COVID-19 pandemic has been understudied. This investigation aimed to longitudinally evaluate food procurement patterns, concern of virus exposure in grocery retailers, and food access challenges over the pandemic among a sample of households in Quebec, Canada. Methods Online surveys were collected at three time points of the pandemic: first wave in spring 2020 (lockdown period), summer 2020 (deconfinement period), and second wave in winter 2021 (curfew period). Respondents were the household's primary grocery shopper (n = 491). Non-parametric tests and multivariable logistic regression were conducted to compare responses over time and to evaluate characteristics of respondents who regularly used no-contact grocery methods (store pick-up or home delivery). Results Frequency of in-store grocery shopping was lowest during the lockdown (once per week or less), and significantly increased over time to resemble pre-pandemic frequency. Concern of virus exposure in grocery retailers and disinfection/discarding of food packaging was highest during the lockdown, but significantly decreased over time. At all time points, use of public transit, walking or cycling for grocery shopping was associated with regular use of no-contact grocery methods (curfew odds ratio (OR): 3.13 (95% confidence interval 1.60, 6.14). Age (60 years+) was associated with regular use during the lockdown [OR: 2.27 (1.13, 4.59)]. Conclusion Among our sample, frequency of in-store grocery shopping was lowest and concern of virus exposure in stores was highest during the lockdown period. No-contact grocery use was associated with transportation mode and potentially with personal risk perception (age).
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Affiliation(s)
- Daiva E. Nielsen
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | | | - Irem Karamanoglu
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Hannah Yang Han
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Mandana Tavanaei
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Paul-Guy Duhamel
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Luis B. Agellon
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Catherine Paquet
- Faculté des Sciences de l'administration, Laval University, Quebec, QC, Canada
| | - Laurette Dube
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
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Parks CA, Nugent NB, Fleischhacker SE, Yaroch AL. Food System Workers are the Unexpected but Under Protected COVID Heroes. J Nutr 2020; 150:2006-2008. [PMID: 32584977 PMCID: PMC7337867 DOI: 10.1093/jn/nxaa173] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 11/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) poses an occupational health risk to food system workers including farmers/producers, grocery store workers, emergency food system staff and volunteers (e.g., food pantry workers), and others. These food system workers have been pushed to the front-line of this pandemic, providing essential services that support food consumption for all Americans. Food system workers are some of the most economically vulnerable populations and are at risk of further financial disparities and contraction of COVID-19 during this pandemic. As we continue to grapple with the best strategies to support the food system and mitigate concerns around the spread of COVID-19, appropriate measures must be considered to better protect and support front-line food system workers that safeguard food access for all Americans.
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Affiliation(s)
- Courtney A Parks
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA,Address correspondence to CAP (E-mail: )
| | | | | | - Amy L Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, NE, USA
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12
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Crosby RA, Kubicek K, Kipke MD. Is the experience of hunger associated with risk of engaging in condomless anal sex among minority young men who have sex with men? Int J STD AIDS 2020; 31:447-453. [PMID: 32208817 PMCID: PMC8437430 DOI: 10.1177/0956462420911562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although emerging evidence suggests that hunger may be a risk factor for engaging in risk behaviors that lead to HIV acquisition, this has rarely been explored for young minority men who have sex with men (YMSM). This study explored a range of sexual risk behaviors for associations with a measure of hunger, assessed among 448 YMSM residing in Los Angeles, CA. Forty-five percent experienced hunger (past 12 months). Hunger was significantly associated with engaging in any condomless anal receptive sex (CARS) (adjusted odds ratio 1.74; 95% confidence interval 1.01–3.01; P .049). Further, hunger was also significantly associated with a greater percentage of CARS (Beta .12; t 2.18; P .03). Parallel effects were not observed relative to condomless anal insertive sex. Findings suggest that the experience of hunger among young minority MSM is generally not associated with a milieu of sexual risk. One important exception is that hunger may lead to having CARS. This suggests a potential ‘trade off’ for receptive partners experiencing hunger and partially supports the idea that at hunger may predispose minority YMSM to partner demands not to use condoms.
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Affiliation(s)
- Richard A Crosby
- Kinsey Institute for Research on Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA
- College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Katrina Kubicek
- Community, Health Outcomes and Intervention Research Program, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Michele D Kipke
- Community, Health Outcomes and Intervention Research Program, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Brown AGM, Esposito LE, Fisher RA, Nicastro HL, Tabor DC, Walker JR. Food insecurity and obesity: research gaps, opportunities, and challenges. Transl Behav Med 2020; 9:980-987. [PMID: 31570918 DOI: 10.1093/tbm/ibz117] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Food insecurity, defined as a lack of consistent access to enough food for an active, healthy life, is a major public health concern with 11.8% of U.S. households (15.0 million) estimated to be affected at some point in 2017 according to the United States Department of Agriculture Economic Research Service. While the link between food insecurity, diet quality, and obesity is well documented in the literature, additional research and policy considerations are needed to better understand underlying mechanisms, associated risks, and effective strategies to mitigate the adverse impact of obesity related food insecurity on health. With its Strategic Plan for NIH Obesity Research, the NIH has invested in a broad spectrum of obesity research over the past 10 years to understand the multifaceted factors that contribute to the disease. The issue of food insecurity, obesity and nutrition is cross-cutting and relates to many activities and research priorities of the institutes and centers within the NIH. Several research gaps exist, including the mechanisms and pathways that underscore the complex relationship between food insecurity, diet, and weight outcomes, the impacts on pregnant and lactating women, children, and other vulnerable populations, its cumulative impact over the life course, and the development of effective multi-level intervention strategies to address this critical social determinant of health. Challenges and barriers such as the episodic nature of food insecurity and the inconsistencies of how food insecurity is measured in different studies also remain. Overall, food insecurity research aligns with the upcoming release of the Strategic Plan for NIH Nutrition Research and will continue to be prioritized in order to enhance health, lengthen life, reduce illness and disability and health disparities.
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Affiliation(s)
| | - Layla E Esposito
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Rachel A Fisher
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | | | - Derrick C Tabor
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
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McArthur LH, Fasczewski KS, Wartinger E, Miller J. Freshmen at a University in Appalachia Experience a Higher Rate of Campus than Family Food Insecurity. J Community Health 2019; 43:969-976. [PMID: 29633107 DOI: 10.1007/s10900-018-0513-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Food insecurity means having limited or uncertain access, in socially acceptable ways, to an adequate and safe food supply. Ample evidence has identified college students as vulnerable to this problem, but little research has focused on freshmen. This cross-sectional study examined family and campus food insecurity among freshmen at a university in Appalachia. An online questionnaire contained sociodemographic items and scales that measured food security status, academic progress, coping strategies for accessing food, and social support. T-tests and Chi square analyses compared food insecure and food secure students. Statistical significance was p < .05. Participants were 456 freshmen, 118 males (26%) and 331 females (73%). Family and campus food insecurity were experienced by 32 (7.1%) and 98 (21.5%) of the freshmen, respectively, and 42.5% of those who experienced campus food insecurity believed their food access had worsened since starting college. Family and campus coping strategies, respectively, included stretching food (72.9 vs. 18.4%) and purchasing cheap, processed food (68.8 vs. 16.3%). Food secure students scored significantly higher on self-rated measures of academic progress (p < .01), and greater proportions of food secure students (60.7 vs. 43.9%, p < .01) perceived their eating habits since starting college as "healthy/very healthy," and perceived their health status as "good/excellent" (86.0 vs. 71.4%, p < .01). Students requested assistance with job opportunities (19.4%), affordable meal plans (18.4%), money management (13.3%), and eating healthy (11.2%). Findings suggest that college student food insecurity begins during the freshmen year, and that there is a need for campus and community-based interventions to increase food access among these freshmen and their families.
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Affiliation(s)
- Laura H McArthur
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC, 28608, USA
| | - Kimberly S Fasczewski
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, 28608, USA.
| | - Elaine Wartinger
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC, 28608, USA
| | - Jordan Miller
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC, 28608, USA
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Hagedorn RL, McArthur LH, Hood LB, Berner M, Anderson Steeves ET, Connell CL, Wall-Bassett E, Spence M, Babatunde OT, Kelly EB, Waity JF, Lillis JP, Olfert MD. Expenditure, Coping, and Academic Behaviors among Food-Insecure College Students at 10 Higher Education Institutes in the Appalachian and Southeastern Regions. Curr Dev Nutr 2019; 3:nzz058. [PMID: 31149651 PMCID: PMC6536735 DOI: 10.1093/cdn/nzz058] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/16/2019] [Accepted: 04/23/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A number of studies have measured college student food insecurity prevalence higher than the national average; however, no multicampus regional study among students at 4-y institutions has been undertaken in the Appalachian and Southeast regions of the United States. OBJECTIVES The aims of this study were to determine the prevalence of food insecurity among college students in the Appalachian and Southeastern regions of the United States, and to determine the association between food-insecurity status and money expenditures, coping strategies, and academic performance among a regional sample of college students. METHODS This regional, cross-sectional, online survey study included 13,642 college students at 10 public universities. Food-insecurity status was measured through the use of the USDA Adult Food Security Survey. The outcomes were associations between food insecurity and behaviors determined with the use of the money expenditure scale (MES), the coping strategy scale (CSS), and the academic progress scale (APS). A forward-selection logistic regression model was used with all variables significant from individual Pearson chi-square and Wilcoxon analyses. The significance criterion α for all tests was 0.05. RESULTS The prevalence of food insecurity at the universities ranged from 22.4% to 51.8% with an average prevalence of 30.5% for the full sample. From the forward-selection logistic regression model, MES (OR: 1.47; 95% CI: 1.40, 1.55), CSS (OR: 1.19; 95% CI: 1.18, 1.21), and APS (OR: 0.95; 95% CI: 0.91, 0.99) scores remained significant predictors of food insecurity. Grade point average, academic year, health, race/ethnicity, financial aid, cooking frequency, and health insurance also remained significant predictors of food security status. CONCLUSIONS Food insecurity prevalence was higher than the national average. Food-insecure college students were more likely to display high money expenditures and exhibit coping behaviors, and to have poor academic performance.
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Affiliation(s)
- Rebecca L Hagedorn
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources, and Design, West Virginia University, Morgantown, WV 26506, USA
| | - Laura H McArthur
- Department of Nutrition and Health Care Management, Appalachian State University, Leon Levine School of Health Sciences, Boone, NC 28607, USA
| | - Lanae B Hood
- Department of Nutrition, Health, and Human Performance, Meredith College, Raleigh, NC 27607, USA
| | - Maureen Berner
- University of North Carolina at Chapel Hill School of Government, USA
| | | | - Carol L Connell
- College of Education and Human Sciences, The University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Elizabeth Wall-Bassett
- School of Health Sciences, Nutrition and Dietetics Program, Western Carolina University, Cullowhee, NC 28723, USA
| | - Marsha Spence
- Department of Nutrition, University of Tennessee, Knoxville, TN 37996, USA
| | | | - E Brooke Kelly
- Department of Sociology and Criminal Justice, University of North Carolina at Pembroke, Pembroke, NC 28372, USA
| | - Julia F Waity
- Department of Sociology and Criminology, University of North Carolina Wilmington, Wilmington, NC 28403, USA
| | - J Porter Lillis
- Department of Sociology and Criminal Justice, University of North Carolina at Pembroke, Pembroke, NC 28372, USA
| | - Melissa D Olfert
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources, and Design, West Virginia University, Morgantown, WV 26506, USA
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Parks C, Calloway E, Chiappone A, Fricke H, Stern K, Yaroch AL. Perceptions of SNAP Policies Among Food Pantry Clients in the Midwest: A Comparison between SNAP and Non-SNAP Participants. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018. [DOI: 10.1080/19320248.2018.1549519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Courtney Parks
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
| | - Eric Calloway
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
| | | | | | - Katie Stern
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
| | - Amy L. Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
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McArthur LH, Ball L, Danek AC, Holbert D. A High Prevalence of Food Insecurity Among University Students in Appalachia Reflects a Need for Educational Interventions and Policy Advocacy. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:564-572. [PMID: 29242138 DOI: 10.1016/j.jneb.2017.10.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 05/21/2023]
Abstract
OBJECTIVES To measure prevalence and correlates of food insecurity among college students in Appalachia, compare food-insecure and food-secure students on correlates, and identify predictor variables. DESIGN Cross-sectional, online questionnaire. SETTING University in Appalachia. PARTICIPANTS Nonprobability, random sample of 1,093 students (317 male [30.1%]; 723 females [68.4%]). MAIN OUTCOME MEASURES Food insecurity, coping strategies, money expenditure, academic progress, and demographics. ANALYSIS Correlational, chi-square, and regression. RESULTS A total of 239 students experienced low food security (21.9%) whereas 266 had experienced very low food security (24.3%) in the past 12 months. Predictor variables were higher money expenditure and coping strategy scale scores, lower grade point averages, male gender, receiving financial aid, fair or poor self-rated health status, and never cooking for self or others. These variables accounted for 48.1% of variance in food security scores. Most frequently used coping strategies included purchasing cheap, processed food (n = 282; 57.4%), stretching food (n = 199; 40.5%), and eating less healthy meals to eat more (n = 174; 35.4%). CONCLUSIONS AND IMPLICATIONS Food-insecure students need interventions that teach budgeting skills and how to purchase and prepare healthy foods, as well as policies that increase access to food resource assistance.
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Affiliation(s)
- Laura Helena McArthur
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC.
| | - Lanae Ball
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC
| | - Ariel C Danek
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC
| | - Donald Holbert
- Department of Biostatistics, East Carolina University, Greenville, NC
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Hagedorn RL, Olfert MD. Food Insecurity and Behavioral Characteristics for Academic Success in Young Adults Attending an Appalachian University. Nutrients 2018; 10:nu10030361. [PMID: 29547533 PMCID: PMC5872779 DOI: 10.3390/nu10030361] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/07/2018] [Accepted: 03/14/2018] [Indexed: 12/05/2022] Open
Abstract
In order to investigate the impact of food insecurity on college students in a highly health disparate region we (1) assessed the prevalence of food insecurity among young adults at a large, rural university in Appalachia, and (2) investigated the relationship between food insecurity and behavioral characteristics including academic performance, coping strategies, and money expenditure. A cross-sectional design was used to capture a representative sample of young adults attending a large, central Appalachian university in Fall 2016. The United States Department of Agriculture (USDA) Adult Food Security Survey was used to measure food insecurity. Independent variables include money expenditure (MES), coping strategies (CSS), academic performance (APS), and demographic, health, economic and culinary variables. Participant responses (n = 692) showed one third (36.6%) of respondents were food-insecure. Students with higher scores for MES and CSS had significantly higher odds of being food-insecure (odds ratio (OR) = 2.07; 95% confidence interval (CI) 1.81 to 2.38 and OR = 1.20; 95% CI 1.16 to 1.23, respectively). The odds of high APS scores (OR = 0.79; 95% CI 0.73 to 0.86) were inversely related to food insecurity. Results of the logistic regression showed MES, CSS, health, and school year remained a significant predictor of food insecurity in college students. These findings suggest behavioral differences in terms of coping strategies, money expenditure, and academic progress among food-insecure students and can be used to identify and target at-risk students to promote student food security and well-being.
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Affiliation(s)
- Rebecca L Hagedorn
- Davis College of Agriculture, Natural Resources, and Design, Division of Animal and Nutritional Sciences, Department of Human Nutrition and Foods, West Virginia University, 333 Agricultural Sciences Building, Laboratory G25, P.O. Box 6108, Morgantown, WV 26506-6108, USA.
| | - Melissa D Olfert
- Davis College of Agriculture, Natural Resources, and Design, Division of Animal and Nutritional Sciences, Department of Human Nutrition and Foods, West Virginia University, 333 Agricultural Sciences Building, Laboratory G25, P.O. Box 6108, Morgantown, WV 26506-6108, USA.
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