High Food Insecurity Research Articles

Coping or adapting? Experiences of food and nutrition insecurity in specialised fishing households in Komodo District, eastern Indonesia

BackgroundThere is growing recognition of the need for fish to be better integrated into nutrition-sensitive strategies for addressing malnutrition. Fish are overwhelmingly produced by the small-scale sector, which supports food and nutrition security directly through the provision of fish and indirectly through the generation of income which can be used to purchase other desired foods. However, there has been relatively little research on the extent of food and nutrition security in specialised fishing communities. This study assessed food and nutrition security among households in specialised fishing communities in Komodo District, eastern Indonesia.MethodsWe assessed the seasonal nutrition quality of household diets using the Food Consumption Score for nutritional analysis and food insecurity using the Household Food Insecurity Access Scale in 66 households across three communities, using a modified cluster sampling strategy. We calculated and generated descriptive statistics for these indicators with Microsoft Excel and ran a logistic generalized linear mixed model to determine factors associated with severe food insecurity using SPSS. We used semi-structured interviews and focus group discussions to understand perceptions of, change over time, and strategies for dealing with food shortfalls.ResultsWhile most households have acceptable access to nutritious foods, especially protein and heme iron-rich foods, nearly one half of households consumed vitamin A rich foods on less than 3 days of the 7-day recall period in either season. More than half of households reported experiencing a moderate or severe level of food insecurity, with higher food insecurity in the wet season. Low maternal education (OR: 3.8, 95%CI 1.5–9.9) and lower household wealth (OR: 0.5, 95%CI 0.3–0.9) were found to be associated with a severe level of food insecurity. Household’s consumptive and non-consumptive response strategies reflect adaptation to chronic food insecurity but are nutritionally and economically unsustainable.ConclusionHouseholds in specialised fishing communities in Komodo District consumed diets with low diversity and experienced high levels of food insecurity. There is a need for culturally-appropriate nutrition-sensitive strategies to enhance food and nutrition security in vulnerable fishing communities.

Maltreatment and depression among left-behind adolescents in rural China: The moderating roles of food security and depression literacy

BackgroundMaltreatment is a leading cause of adolescent depression. Economic empowerment and mental health services provision are major policy options to solve this problem in developing countries. However, little is known about how these policy options jointly influence the association between maltreatment and adolescent depression. ObjectiveTo examine how the configuration of food security and depression literacy influenced the association between maltreatment and depression of Chinese rural left-behind adolescents (LBAs). ParticipantsThe analysis was based on the responses of 1,469 LBAs (12–18 years old) from 21 rural schools in 2018. MethodsThe participants responded to items on the Birleson Depression Self-Rating Scale, the Childhood Trauma Questionnaire, the Food Insecurity Experience Scale, a clinical vignette on depression, and questions on their demographic information. The data was analyzed using a hierarchical moderated regression model. ResultsMaltreatment was significantly associated with depression of LBAs (p < .001). The independent moderating effect of food insecurity (p < .05) or of depression literacy (p < .05) was observed only after including the interaction of maltreatment, food insecurity, and depression literacy. The configuration of food insecurity and depression literacy significantly moderated the focal association (p < .05). Specifically, in the low food insecurity setting, low depression literacy significantly strengthened the focal association (p < .01), while in the high food insecurity setting, high depression literacy significantly strengthened the focal association (p < .01). ConclusionsDepression interventions for adolescents in under-resourced communities should consider both food security and psychoeducation, and the implementation of the latter should be based on the level of the former.

524 Living in a county with high food insecurity is associated with preterm birth (PTB)

Studies on food insecurity in pregnancy have found an association with gestational diabetes and HTN, but effects of food insecurity on PTB are understudied. We sought to evaluate whether living in a county with higher food insecurity during pregnancy is associated with an increased risk of PTB. Retrospective analysis of women carrying non-anomalous singleton or twin gestations identified from a university healthcare system, 2014-2020. Women at high-risk for spontaneous ± medically indicated PTB were included in a 1:2 ratio with randomly selected low-risk controls. Each woman’s county of residence during pregnancy was linked to Feeding America’s Map the Meal Gap data, which provides the % of people in each county who are food insecure (having limited or uncertain access to adequate food). The primary outcome was PTB < 37 wks. Secondary outcomes were PTB < 34 and < 28 wks and any major neonatal morbidity (IVH, PVL, BPD, NEC, death). Data were analyzed by t-test, chi square, and logistic regression. 53,187 women met inclusion criteria; 8.8% delivered < 37, 2.9% < 34, and 1.0% < 28 weeks, and 1.2% of neonates had major morbidity. Population characteristics are shown in Table 1. Food insecurity ranged from 9.5-20.9% in the counties of residence of studied women. The median % of people with food insecurity was higher in counties of women with PTB < 37 (12.6% vs. 11.9%), < 34 (12.6% vs. 11.9%), and <28 wks (12.6% vs. 11.9%), and those whose neonates had major morbidity (12.8% vs. 11.9%) compared to those without each outcome (all p < 0.001). In regression models, the aOR for each outcome increased as food insecurity in one's county increased; the associations with PTB were greatest at the earliest GAs (Table 2). Women living in counties with high rates of food insecurity have a higher aOR of PTB < 37, < 34, and < 28 wks and their neonates have an increased aOR of major neonatal morbidity. These data emphasize how local environment may influence pregnancy outcomes. Future work should evaluate if reducing food insecurity lowers PTB and improves neonatal outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Food Insecurity among Low-Income Food Handlers: A Nationwide Study in Brazilian Community Restaurants.

This study aims to evaluate food insecurity (FI) among Brazilian Community restaurant food handlers and its associated factors. This cross-sectional study was performed with a representative sample of 471 food handlers working in community restaurants (CR) from all Brazilian regions. Participants are mostly female (62.2%), ≤40 years old (67.7%), with a partner (52.0%), and with up to eight years of education (54.1%). Predictors of participants’ socioeconomic status and CR geographic location are associated with the household food insecurity categories (p < 0.05). The predictors of socioeconomic conditions are associated with mild and moderate/severe FI category. Workers with less education are twice as likely to belong to the category with the highest FI severity. Lower per capita household income increased the chances of belonging to the mild insecurity category by 86%. It more than doubled the chance to be in the category of moderate/severe insecurity. Predictors of health status, lifestyle, and work are not associated with any multinomial outcome categories. However, working in the South, Southeast, or Midwest regions of Brazilian decreased the chances of belonging to one of the FI categories, with significance only for the mild category. Variables that show an association for this population are per capita household income for the different levels of FI and the CR region for mild FI. A high prevalence of FI in this population points to the need for more studies with low-income workers to prevent FI and its health consequences.

Socioeconomic and Ecological Controls of Nature-Based Solutions Across Developing Economies

Nature-based solutions (NbS) are recognised avenues for implementing internationally agreed commitments on climate change mitigation. However, practical implementation of NbS strategies is impeded by, among other things, a lack of understanding of the underlying biophysical, social and political contexts of NbS. In this paper, we used data on potential carbon sink outcomes from implementing eight NbS across 126 developing countries to evaluate how socioeconomic and ecological factors may influence the uptake, allocation and effectiveness of NbS. Brazil (16.5%), China (14.3%), Indonesia (12.2%), India (6.3%) and Mexico (5.1%) hold approximately 54% of 10.25 PgCO2yr−1 potential carbon sink from NbS. NbS’ potential for climate change mitigation decreased with population growth. Moreover, we found a positive association between development aid and NbS potential, albeit attenuated for regions with poor governance structures and higher food insecurity. We highlight the need for careful assessment of complementary food security safeguards for surging populations, and sustainable restoration/afforestation as a socio-ecological implementation of nature-based solutions.

Enhancing capacity of Zimbabwe's health system to respond to climate change induced drought: a rapid nutritional assessment.

IntroductionZimbabwe experienced the negative effects of the devastating cyclone Idai which affected several districts in the country, and the drought due to low rainfall that has affected the whole country. As a result of these catastrophes, the food and nutrition security situation in the country has deteriorated. For this reason, we carried out a rapid assessment of the health facilities in 19 sampled high global acute malnutrition and high food insecurity districts from the ten provinces of Zimbabwe to ascertain the preparedness of the facilities to respond to drought effects.Methodswe conducted a rapid nutritional assessment in 19 purposely selected districts with highest rates of global acute malnutrition from the 10 provinces of Zimbabwe. From these districts, we selected a district hospital and a rural health facility with high number of acute malnutrition cases. We adapted and administered the WHO recommended checklist (Multi-Cluster/Sector Initial Rapid Assessment (MIRA) as the assessment tool. We used STATA to generate frequencies, and proportions.Resultsabout 94% (16/19) of the districts had less than 50% health workers trained to manage acute malnutrition. A total of 26% (5/19) of the district hospitals and 32% (6/19) of the primary health care facilities were not admitting according to integrated management of acute malnutrition (IMAM) protocol. Twelve districts (63%) had none of their staff trained in infant and young child feeding (IYCF), 58% (11/19) had no staff trained in growth monitoring and 63% (12/19) of the districts had no trained staff in baby friendly hospital initiative (BFHI). A total of 60% of the provinces did not have combined mineral vitamin mix stocks, 80% had no resomal stocks, 20% did not have micronutrient powder stocks and 30% had no ready to use supplementary food stocks in all their assessed facilities. Fifty percent (50%) of the health facilities were not adequately stocked with growth monitoring cards. Manicaland had the least (20%) number of health facility with a registration system to notify cases of malnutrition.Conclusionwe concluded that the Zimbabwe health delivery system is not adequately prepared to respond to the effects of the current drought as most health workers had inadequate capacity to manage acute malnutrition, the nutrition surveillance was weak and inadequate stocks of commodities and anthropometric equipment was noted. Following this, health workers from six of ten provinces were trained on management of acute malnutrition, procurement of some life -saving therapeutic and supplementary foods was done. We further recommend food fortification as a long-term plan, active screening for early identification of malnutrition cases and continuous training of health workers.

Prevalence of Parental refusal rate and its associated factors in routine immunization by using WHO Vaccine Hesitancy tool: A Cross sectional study at district Bannu, KP, Pakistan

ObjectiveTo determine the vaccination refusal rate, associated factors and perceptions of parents who refused routine immunization for their children using the World Health Organization (WHO) SAGE Working Group on Vaccine Hesitancy Survey Tool. Materials and methodsA cross-sectional survey was conducted using multi-stage cluster sampling in Bannu District, Khyber Pakhtunkhwa Province, Pakistan from March 2019 to July 2019. A WHO validated questionaire was used. The outcome variable was parental refusal of routine immunization of their children. Logistic regression was performed for associations, and multi-regression was applied to identify any confounders. ResultsOf 610 parents, 170 (27.9%) refused vaccination of their children. Of these, the majority of mothers had no education [n = 145 (85.3%); p = 0.03], and mothers were less likely to own a mobile phone than fathers [24 (14.1%) vs 152 (89.4%); p ≤ 0.001]. The vaccination refusal rate was higher in parents with food security [n = 88 (51.8%)] compared with parents with minimal food insecurity [n = 62 (36.5%)] and high food insecurity [20 (11.8%); p ≤ 0.05)]. On multi-variate logistic regression, fathers who were employed [adjusted odds ratio (OR) 0.59, 95% confidence interval (CI) 0.37–0.94; p = 0.02] and had a high level of education (adjusted OR 0.21, 95% CI 0.08–0.50; p ≤ 0.001) were less likely to refuse vaccination of their children. Parents with high food insecurity were more likely to refuse vaccination of their children (adjusted OR 2.2, 95% CI 1.0–0.50; p = 0.04) compared with parents with minimal food insecurity (adjusted OR 1.6, 95% CI 1.0–2.5; p = 0.02). ConclusionThe vaccination refusal rate was very high among parents, and this was associated with inability to read or write, no education, owning a mobile phone, unemployment and food security.

Choice Food Pantries in the Deep South: A Novel Approach to Addressing Food Insecurity in Older Adults

Older adults in the deep south are living with high food insecurity rates; this is exacerbated by challenges with rural-living, like transportation limitations and no grocery stores. To address this, we must increase emergency food assistance offerings and adopt best practices for food pantries including choice food pantry approaches, which empowers clients with some autonomy in choosing the foods they receive as part of their pantry distribution. Coalitions in eight income-limited, aging, rural Mississippi Delta counties received support from a Centers for Disease Control and Prevention Grant to enhance the food-related infrastructure in their communities through technical assistance and economic investments. A detailed process evaluation was conducted on this effort. Each coalition adopted food pantry-related policies like adding new food pantries and adapting their existing food pantries with the choice model. Both aging volunteers and clients indicated positive outcomes from the process of adding pantries and adapting existing ones.

Seasonality, Food Insecurity, and Clinical Depression in Post-Partum Women in a Rural Malawi Setting.

We evaluate the association between food insecurity (FI) and clinical depression, and the modifying effects of seasonality on this association. Food insecurity is assessed from 175 post-partum women in the rural Ntcheu District of central Malawi using the USAID's Household Food Insecurity Access Scale (HFIAS). Clinical depression is measured using a validated Chichewa version of the Self-Reporting Questionnaire (SRQ). Interviews were conducted from October 2016 to June 2017 and spanned 5 months of the dry season (April-November) and the 4 months of rainy season (December-March). After adjusting for age and parity, participants who reported high FI (HFIAS score ≥ 9) had 4.6 (95%CI 1.8-11.4) times the odds of meeting the cut-off for clinical depression (SRQ score ≥ 8). The effect was greater during the dry season (OR 9.9; 95%CI 2.0-48.6), than in the rainy season (OR 2.6; 95%CI 0.8-8.3) though the interaction term was not statistically significant (p = 0.18) CONCLUSIONS FOR PRACTICE: High FI is associated with diagnostic markers of clinical depression.

COVID-19, Food Insecurity, and Migration

ABSTRACTIn this policy piece, we investigate the coronavirus disease 2019 (COVID-19)–food-insecurity migration channel and develop a policy agenda. The interaction between COVID-19 and the drop in economic activity will lead to increased food insecurity within and across countries. Higher food insecurity may act as a multiplier for the epidemic due to its negative health effects and increased migration. Research has shown that food insecurity affects within-country and cross-border migration. Besides the mean prevalence rate, the distribution of food insecurity affects the migration decision. The impacts of COVID-19 are particularly strong for people in the lower tail of the food-insecurity distribution. In the current context, the effect of food insecurity therefore could be increased migration, including both rural–urban migration and international migration. Importantly, the crisis might lead to a structural break in migration patterns. People might avoid heavily affected COVID-19 destination countries (e.g., United States, Italy, or Spain) and move to other countries. Due to the persistent nature of migration flows, this could have long-lasting effects.

Determinants and Consequences of Food Insecurity in Artisanal Fishing Families From the Coastal Community of Sonora, Mexico.

Families living from artisanal fisheries are vulnerable to food insecurity. This research aimed to assess the determinants and consequences of food insecurity in artisanal fishing families from the coastal community of Sonora, Mexico, and to understand how these families face food insecurity. This was a cross-sectional study with 116 mothers. A socioeconomic, demographic, and nutritional knowledge survey was applied to assess determinants. A survey about food in the community and food security scale were collected to evaluate food insecurity and two 24-hour dietary recalls and anthropometric measures to assess consequences. Field notes about facing food insecurity were collected. Sixty-eight percent of families have food insecurity. Being above the poverty line, higher father education, knowing how many glasses of water should be drunk per day, and how many minutes of physical activity should be done per day were associated with lower food insecurity. Not having medical service and lower mother education were associated with higher food insecurity. Higher food insecurity was associated with buying in a convenience store; higher food insecurity and higher mother education were associated with lower dietary score; and higher father education was associated with higher dietary score. Being below the extreme poverty line by income and number of children were associated with lower waist circumference; lower father education was associated with higher waist circumference of mothers. Artisanal fishing families residing in the coastal community of Sonora, Mexico, experience high food insecurity associated with social and economic determinants and their dietary quality.

Pre-COVID-19 food insecurity prevalence and risk factors in caregivers of pediatric cancer patients at a children’s cancer hospital.

205 Background: Food insecurity (FI) affects 1 in 5 US households with children and is associated with malnutrition and poor diet quality in children. Malnutrition negatively impacts clinical trial outcomes, chemotherapy tolerance, and survival rate in cancer patients, who may be at higher FI risk given the financial toxicity of treatment. Thus, we aimed to assess FI prevalence and sociodemographics of pediatric patient caregivers at MD Anderson Cancer Center Children’s Cancer Hospital (MDACC-CCH) and to identify healthcare provider sociodemographics and FI practice considerations. Methods: We surveyed caregivers and providers at MDACC-CCH anonymously from December 2019 to January 2020. Caregiver surveys included sociodemographics and The Hunger Vital Sign FI screening tool. Oncologists and other providers were surveyed on FI-related practice considerations. Univariate relationships between known covariates and FI were explored using purposeful covariate selection and multivariable logistic regression to model variables associated with FI risk factors. Results: Baseline characteristics are listed in Table. Of 67 caregiver responses, 36% were positive for FI. Univariate analyses revealed that race, education level, spousal/child support, marital status, and household income were associated with FI status. Final logistic regression model indicated that race other than Non-Hispanic White and lower education level were positively associated with FI. Of 38 provider responses, 58% reported being knowledgeable about FI to some extent. No providers referred patients to community food access resources. Conclusions: In a small pilot study, FI is prevalent in families of pediatric cancer patients at MDACC-CCH and may be associated with race and education level. Further research is needed to assess the impact of the COVID-19 pandemic on FI in this population and to determine appropriate interventions and clinical pathways to improve FI status. [Table: see text]

Socioeconomic inequality in the risk of intentional injuries among adolescents: a cross-sectional analysis of 89 countries

IntroductionIn 2015, the elimination of hunger worldwide by 2030 was declared by the United Nations as a Sustainable Development Goal. However, food insecurity remains pervasive, contributing to socioeconomic health inequalities....

Predictors of social support, physical health and mental health among food insecure internally displaced persons in Turkana, Kenya

BackgroundFood insecurity and the mental and physical health of internally displaced persons (IDPs) is a public health concern. The aim of this study was to determine the predictors of social support, physical and mental health among food insecure IDPs in Nakwamekwei IDP camp in Turkana, Kenya.MethodsA cross sectional study was conducted among 159 household heads living in the camp. Analysis was conducted using statistical summaries, logistic regression and linear regression.ResultsNinety four percent (94%) of the households were severely food insecure and the rest of the households had moderate food insecurity. Majority of the household heads (77%) had symptoms of depression and those with five or more children were 3 times (95%CI, 1.31–9.24; p = 0.015) more likely to be have symptoms of depression, while those who were married were less likely to have the same (95%CI, 0.14–0.92; p = 0.038). Seventy six percent (76%) of the household heads had anxiety symptoms; none of the predictor variables were significantly associated with anxiety symptoms in the adjusted analysis. Those who had spent many years in the camp, were older, and had more children had significantly poorer physical health (p = 0.042, p = 0.001, and p = 0.047, respectively). Those who were married and those who had experienced violence in the current camp had significantly higher social support (p = 0.001 and p = 0.006, respectively).ConclusionsParticipants have been living in camp for the last 10 years hence the need to improve their living conditions, address their physical and mental health as well as food insecurity. This can be done by providing the participants with safe drinking water, constructing pit latrines to prevent communicable disease and adhere to the Sphere recommendations for sanitation and hygiene as well as training them in income generating activities to mitigate the high unemployment and food insecurity rates. The IDPs should be integrated into the local community to bring an end to their protracted displacement.

Dental Care Utilization of Hospitalized Persons Living with HIV and Substance Use.

People living with HIV (PLWH) who use drugs experience worse health outcomes than their non-using counterparts. Little is known about how often they seek dental care and the factors that influence their utilization. PLWH with substance use disorders who were inpatients at 11 urban hospitals (n = 801) participated in a National Institute on Drug Abuse Clinical Trials Network study to improve engagement in HIV outcomes. Dental care utilization at each time point during the study period (baseline, 6months and/or 12months) was assessed (n = 657). Univariate analysis and logistic regression were used to examine factors associated with dental care utilization. Over half (59.4%) reported not having received any dental care at any timepoint. Participants with less than high school education had lower odds of reporting dental care utilization than those with more than education (aOR = 0.60 [95% CI 0.37-0.99], p = 0.0382). Participants without health insurance also had lower odds of reporting dental care utilization than those with insurance (aOR = 0.50 [95% CI 0.331-0.76], p = 0.0012). Higher food insecurity was associated with having recent dental care utilization (OR = 1.03 [95% CI 1.00, 1.05], p = 0.0359). Additionally, those from Southern states were less likely to report dental care utilization (aOR = 0.55 [95% CI 0.38, 0.79], p = 0.0013). Having health insurance and education are key factors associated with use of dental care for PLWH with substance use disorders. The association between food insecurity and dental care utilization among this population suggests the need for further exploration.

Lessons learned from India’s Green Revolution

Partition of British India in 1947 triggered a huge refugee crisis in India. In addition, low agricultural yield and high population growth fueled food insecurity. The fear of the Bengal Famine of 1943 was still fresh and the Indian Government wanted to prevent further famines. The philanthropic organizations of the USA (Rockefeller and Ford Foundation) collaborated with Indian policymakers and scientists that helped in the groundwork of the Green Revolution. Jack Loveridge explains how technology and international cooperation contributed to India's Green Revolution and what lessons can be learned for the future. The challenges related population control, environment, social and economic inequality in the Green Revolution were highlighted. Interview by Somidh Saha (ITAS-KIT).

Low Food Security Present on College Campuses despite High Nutrition Literacy

ABSTRACT College students have higher food insecurity than non-student households. The relationship between college student food security and nutrition literacy has not been explored. Across three campuses (n = 672), the relationship was assessed between food security and nutrition literacy. Low and very low food security were highly prevalent (44%) with very low food security highest among Black (30%) and freshmen students (32.7%). Among students with adequate nutrition literacy, a greater proportion were food secure (58%) with only 18% having low food security; however, this relationship was weak (r = +0.143, p < 0.01). Targeted measures to address food security must consider race and student class disparities.

Blood mercury and plasma polychlorinated biphenyls concentrations in pregnant Inuit women from Nunavik: Temporal trends, 1992–2017

The Inuit of Nunavik (Northern Quebec, Canada) are exposed to polychlorinated biphenyls (PCBs) and mercury (Hg) through their consumption of marine country foods. A temporal trend study was initiated in 1992 to monitor circulating levels of PCBs and Hg in pregnant Inuit women, since the fetus is most at risk of adverse health effects. We set out (1) to describe temporal trends of PCBs and Hg levels in pregnant Nunavik women between 1992 and 2017; (2) to determine the prevalence of participants exceeding the guidance values in 2017; (3) to investigate relations between marine country food intake and contaminant levels over the study period. A total of 559 pregnant women provided a blood sample for contaminant analysis from 1992 to 2017. PCB congeners were quantified in plasma (serum) by gas chromatography (GC) coupled to electron capture detection or mass spectrometry (MS). We determined whole blood mercury concentration by cold vapor atomic absorption or inductively-coupled plasma MS. We performed multilevel modeling to assess temporal trends in contaminant levels and relations with marine country food consumption. Concentrations of total PCBs and Hg decreased by 84% and 65% between 1992 and 2017, respectively. Nevertheless, 10% and 22% of women in 2017 exceeded guidance values for PCBs and Hg, respectively. While the decline in marine country food intake is the only factor associated with decreasing Hg levels, other factors may explain the decline in PCB levels. Despite the significant decline in PCBs and Hg levels from 1992 to 2017, exposure to these contaminants is still quite prevalent among pregnant Nunavik women. Most of the decline in Hg exposure is likely due to a shift away from marine country foods to store-bought foods, which is a concern given the cultural and nutritional importance of country foods and the high food insecurity that prevails in Nunavik.

P61 SNAP-Ed Participants Improved and Maintained Healthy Eating and Shopping Behaviors Following the 4-Week 10 Tips Intervention

Objective To assess the impact of 10 Tips for Adults on healthy eating and shopping behaviors. Use of Theory or Research The Social Cognitive Theory states behavior change is predicted by knowledge of health risks and benefits and perceived self-efficacy. 10 Tips aims to increase the likelihood participants will make healthy choices on a budget. Target Audience Adults in Maine eligible for Supplemental Nutrition Assistance Program Education (SNAP-Ed). Program Description 10 Tips includes 2 independent nutrition education series (Series A: Choose MyPlate and Series B: Eating Better on a Budget), each consisting of four 30–60 minute lessons. Evaluation Methods Retrospective pre/post and follow-up surveys (6–8 weeks later) were completed by the intervention group. Baseline and follow-up surveys were completed online by a comparison group comprised of randomly selected SNAP recipients. Outcome variables, measured using a 5-point Likert scale, were treated as continuous for analysis. Longitudinal analysis was conducted comparing groups using linear mixed models controlling for food security and baseline value of the outcome. Results Intervention (n = 295) and comparison (n = 410) groups were demographically similar, but the comparison group had higher food insecurity and participation in assistance programs. Adjusted mean frequencies improved significantly among 10 Tips participants from baseline to follow-up for fruit consumption (P Conclusions Participants of 10 Tips, a 4-lesson series, reported significant improvements in healthy eating and shopping behaviors 6–8 weeks after the intervention, offering an attractive option to potential participants hesitant to commit to a longer program. Funding Supplemental Nutrition Assistance Program - Education.

P65 Navigating Food Insecurity at College: Examining Student Experiences and Perspectives on Solutions

<h3>Background</h3> There is growing awareness of food insecurity among college students, with several studies documenting its presence and recommendations for addressing it. The majority of studies are quantitative and fail to offer insight into how students view food insecurity and what they and their universities can do about it. This study provides that perspective. <h3>Objective</h3> To examine how students experiencing food insecurity make sense of, navigate, and recommend addressing it. <h3>Study Design, Setting, Participants</h3> An anonymous survey was administered at a Mid-Atlantic university using Qualtrics and elicited 1,283 responses (93.1% undergraduate; 6.9% graduate). Following the survey, three 90-minute focus groups were conducted with 13 students (84.6% undergraduate; 15.4% graduate) who self-identified as food insecure. <h3>Measurable Outcome/Analysis</h3> The 68-item survey included questions regarding students' background, finances, and food security status (using the 6-item USDA-FSS Short Form survey). The 19-item focus group guide included questions concerning food behaviors/practices, experiences with food insecurity, and solutions. Survey data were analyzed using SPSS. Focus groups were transcribed verbatim, and thematic analysis was conducted in NVivo using an inductive approach. <h3>Results</h3> Of survey respondents, 38.9% indicated moderate to high food insecurity, with highest rates among Pell Grant recipients (55.4%), students with college debt (50.6%), and first-generation students (47.9%). Focus group themes included hesitancy to self-identify as food insecure; encounters with stigma; lack of awareness and understanding by the university; negative impact on social life; and self-reliance, particularly coping independently by donating plasma, eating cheap food, not eating, sneaking food, and using credit cards. Participants offered traditional solutions (eg, pantry, no-frills dining) and upstream solutions such as addressing stigma and developing new programming (eg, peer mentoring programs). <h3>Conclusions</h3> Quantitative findings are similar to those of previous studies, particularly relating to vulnerable groups; however, qualitative findings offer a unique perspective regarding students' perceptions of food insecurity, identities as food-insecure college students, and perspectives on addressing it.