Objective: To describe current food insecurity (FI)-related training among nutrition/dietetics, public health, and social work students. Methods: A cross-sectional online survey was used among students (n = 306) enrolled in health-related programs at 12 US universities. Participants reported FI-related course-based and extracurricular experiences and rated confidence to address FI on a scale of 1-3. Open-ended questions investigated perceived definitions of FI and impactful course activities. Descriptive statistics and thematic analysis were used for data analysis. Results: Participants' FI definitions were multifaceted. Most (80.6%) reported FI being covered in at least 1 course. The overall mean confidence to address FI was 2.2 0.48. Participants suggested increasing application-based opportunities and skills training. Conclusions and Implications: Most students have a basic understanding of FI and report high confidence to address it in the future. Impactful FI-related experiences and participants' suggestions guide developing an FI training resource to enhance student FI competency and sensitivity.

There is consensus regarding the socio-political roots of the concept of race (and ethnicity) in the United States (US). However arbitrary, the US societal constructions of race have meant racial/ethnic minorities experience disproportionate health burdens. The present study examined the so-called “white health advantage” effect in a large sample of US respondents, comparing Latinos (non-White and White) with non-Latino Whites. This cross-sectional study used deidentified data from the Dynata Global COVID Symptoms map project, collected between July 7–14, 2020 (n = 135,075). A dichotomous health status variable was created with respondents answering yes/no to any COVID-19 symptoms (difficulty breathing, coughing, fatigue, fever, and loss of taste or smell). We included relevant predisposing (age, gender, number of children, race, ethnicity, marital status, and education) and enabling factors (housing conditions, income, employment status, business ownership, and number of cars owned – a proxy measure for wealth). Multivariate logistic regression models showed significant differences in health status (as measured by COVID-19 symptoms) when comparing Latinos (non-White, White) and non-Latino Whites. For instance, higher socioeconomic status had a protective effect only among non-Latino Whites. In turn, being married/living with a partner was only associated with COVID-19 symptoms among White Latinos, indicating that the apparent benefits of this “improving” socio-political location are somewhat limited. Our study found significant differences in COVID-19 symptoms when comparing Latinos (non-White, White) and non-Latino Whites. Our findings underscore the importance of further examining health outcomes by racial identities of US Latinos, which can help inform future health equity efforts.

Background Oregon State University Extension Service implements the Federally funded SNAP-Ed and EFNEP programs throughout Oregon. For nearly 20 years these programs have been operationalized as, “Las Comidas Latinas” to provided cultural nutrition education for Latinx communities. Although food insecurity continues to be a systemic challenge for these families, our work centers the strengths of the Latinx families to maintain cultural food practices. Objective The present mixed methods study examined the types of foods that Latina mothers kept in their homes to promote healthy eating and their preference around growing food. Study Design, Settings, Participants Participants were mothers aged 18 years and older, identified as Latina, and lived in two counties in Oregon. A total of 101 mothers participated in structured surveys, and 31 participated in follow-up interviews qualitative interviews to explore their food preferences and experiences with personal food production. Results Results indicate that when asked about they types of foods they kept in their homes, 84% of mothers indicated having fruits always or the majority of the time, 85% indicated having vegetables always or the majority, and only 25% indicated having unhealthy foods (eg, chips) always or the majority of the time in their home. Additionally, 41% of mothers indicated growing their own food. For those who indicated not growing their own food, the 59% indicated no access to land as the reason, followed by not enough knowledge (33%), and lack of resources (26%). Similarly, qualitative findings indicate strong preference for fresh and home-grown food. The practice of growing their own food was common in their home countries, but as mothers immigrated to the U.S, they were unable to do grow their own food, because of space, time, or were not allowed to grow their own foods in their current residence. Conclusions Maintaining cultural food practices such as grown food at home can help support Latina mothers’ efforts to promote health eating and reduce food insecurity. Funding Supplemental Nutrition Assistance Program – Education, Linn-Benton-Lincoln Health Equity Alliance

This study explored the barriers and facilitators to the successful implementation and sustainment of food insecurity initiatives on college campuses. Respondents (n = 65) included faculty, staff, administrators, and student leaders at higher education institutions in 28 states. Through an online survey, respondents reported experiencing multiple barriers (mean 3.7, SD 1.7) when implementing food insecurity initiatives. The three most commonly reported barriers were funding (79.4%), marketing/student awareness (74.6%), and stigma (60.3%). Public institutions were found to more commonly face accessibility (p = 0.005), volunteer (p = 0.008), and stigma (p = 0.042) barriers compared to private institutions. Themes regarding Campus Culture, Resources and Operations, and Data Collection were considered facilitators to sustaining campus-based initiatives. Food insecurity is a barrier to academic performance, perseverance, and success yet initiatives to aid food insecure students are hindered by lack of institutional support and integration into campus culture. Higher education administrators should look to the barriers and facilitators identified in this study to ensure the initiatives on campus have the supports needed to succeed. Further study implications and a root cause analysis are discussed.

Background Recently, a call to action was made for schools that educate health professionals to provide training on social and economic determinants of health. Training future professionals in health-related fields (eg, nutrition, public health, and social work) to understand and identify the context-specific social determinants of health, including food insecurity, should be prioritized when designing curricula for clinical and public settings. Objective This study explored how students conceptualize food insecurity and their understanding of the complex conditions that lead to experiences of insufficient food resources. Use of Theory or Research Students’ responses regarding the factors that influence or cause food insecurity were classified under the five levels of the social-ecological model (individual, interpersonal, organizational, community, or policy). Target Audience A convenience sample of 306 undergraduate and graduate students enrolled in academic health-related programs (47.4% nutrition and dietetics, 21.6% public health, 19.0% social work) at 12 US universities participated in a cross-sectional online survey. Evaluation Methods Responses to an open-ended question soliciting the students' definitions of food insecurity were analyzed for themes. A team of four researchers developed a codebook using an inductive approach. Two researchers then independently coded the responses, reconciled differences within the coding process, and identified emerging themes. Results Students’ understanding of food insecurity was diverse—definitions representing a continuum of responses ranging from physiological experiences of hunger to worrying about food access. Themes associated with individual, interpersonal, and community-level factors influencing food insecurity were identified. Students highlighted food quality, access, and consistency as essential features of being food secure. Conclusion Understanding the multi-dimensional factors contributing to food insecurity and the contexts in which food insecurity occurs is essential for future nutrition, dietetics, and public health professionals. Nutrition professionals teaching in higher education settings have an opportunity to support students’ understanding of food insecurity and its multiple factors. Funding None Recently, a call to action was made for schools that educate health professionals to provide training on social and economic determinants of health. Training future professionals in health-related fields (eg, nutrition, public health, and social work) to understand and identify the context-specific social determinants of health, including food insecurity, should be prioritized when designing curricula for clinical and public settings. This study explored how students conceptualize food insecurity and their understanding of the complex conditions that lead to experiences of insufficient food resources. Students’ responses regarding the factors that influence or cause food insecurity were classified under the five levels of the social-ecological model (individual, interpersonal, organizational, community, or policy). A convenience sample of 306 undergraduate and graduate students enrolled in academic health-related programs (47.4% nutrition and dietetics, 21.6% public health, 19.0% social work) at 12 US universities participated in a cross-sectional online survey. Responses to an open-ended question soliciting the students' definitions of food insecurity were analyzed for themes. A team of four researchers developed a codebook using an inductive approach. Two researchers then independently coded the responses, reconciled differences within the coding process, and identified emerging themes. Students’ understanding of food insecurity was diverse—definitions representing a continuum of responses ranging from physiological experiences of hunger to worrying about food access. Themes associated with individual, interpersonal, and community-level factors influencing food insecurity were identified. Students highlighted food quality, access, and consistency as essential features of being food secure. Understanding the multi-dimensional factors contributing to food insecurity and the contexts in which food insecurity occurs is essential for future nutrition, dietetics, and public health professionals. Nutrition professionals teaching in higher education settings have an opportunity to support students’ understanding of food insecurity and its multiple factors.

Understanding impacts of the COVID-19 pan­demic among households with children is neces­sary to design appropriate public health responses that protect food and nutrition security. The objec­tive of this research was to understand predictors of food insecurity during the COVID-19 pandemic among households with at least one child (<18 years), including whether foods reported as out-of-stock were associated with the likelihood of food insecurity. An online survey using validated measures and open-ended questions was distrib­uted to a convenience sample in five states—Louisiana, Montana, North Carolina, Oregon, and West Virginia—during the early months of the COVID-19 pandemic (April through September of 2020). Predictors of food insecurity (race/ethnicity, age, marital status, education, federal nutrition assistance program participation, number of adults and children in the household, rurality, and missing foods when shopping) among households with children during the COVID-19 pandemic were modeled using logistic regression (p < 0.05, a priori). To further illuminate household experiences during this time, two researchers independently coded open-ended survey question data using inductive and deductive approaches to construct themes. Households with children had increased odds of experiencing food insecurity during the COVID-19 pandemic if they had the following characteristics: Hispanic ethnicity; age between 25 and 44 years; additional adult household members; economic hardship; SNAP/WIC participation; being widowed, divorced, or separated; and report­ing foods not available when shopping. Partici­pants described mainly negative changes to dietary patterns and practices as a result of the COVID-19 pandemic. They also described food security chal­lenges and ideas for improving food security. Con­sistent with other data collected and analyzed dur­ing the height of the COVID-19 pandemic, this study contributes findings that emphasize the need for enhanced public health responses and emer­gency preparedness measures that protect food and nutrition security. Because of the increased short- and long-term consequences including exposure to adverse circumstances, impaired learning, risks to mental health, and poor health outcomes, ensuring an adequate food supply is especially important for households with children.

College food insecurity is a known detriment to student success, but little is known about the implementation of campus-based programmes to help address this issue on campus in the United States. The objective of this research study was to determine the types of food insecurity initiatives implemented and assess how such programmes are managed, funded, and evaluated. A cross-sectional, 23-item online survey was administered among individuals involved with campus food insecurity initiatives identified through professional networks. Food pantries were the most common (97.1%) and mobile food sharing applications were the least common (14.7%) food security initiatives. A majority of respondents (69.7%) stated that at least one programme on their campus was evaluated, although the methods varied and uncertainty about the methods used was common. An allocated budget was provided at some institutions (38.9%), but funding mechanisms varied. Student Life Offices were most commonly reported as being responsible for programme management. Most respondents (75.3%) reported there had been programme changes due to COVID-19. This research confirmed that food insecurity programmes are widely available, although the type, funding, and leadership of these programmes vary. A coordinated approach on campus to align programming efforts is needed.

Addressing health disparities associated with inadequate food and nutrition access and limited education is the center of our work as nutrition educators. However, understanding how to begin work in this area and the role of policy, system, and environmental (PSE) strategies may be challenging for professionals who have traditionally focused on direct education. Communities in Action: Pathways to Health Equity is an essential resource for all food and nutrition professionals and students. It is a primer on health equity, social determinants of health, and the role of communities in the implementation of PSE to address health disparities.

Food insecurity on college campuses is a major public health problem and has been documented for the last decade. Sufficient food access is a crucial social determinant of health, thus campuses across the country have implemented various programmes, systems and policies to enhance access to food which have included food pantries, campus gardens, farmers' markets, meal share or voucher programmes, mobile food applications, campus food gleaning, food recovery efforts, meal deliveries and task force/working groups. However, little is understood about how to best address food insecurity and support students who are struggling with basic needs. The impact of food insecurity on students' academic and social success, in addition to their overall well-being, should be investigated and prioritised at each higher education institution. This is especially true for marginalised students, such as minority or first-generation students, who are at heightened risk for food insecurity. In order to create a culture of health equity, in which most at-risk students are provided resources and opportunities to achieve optimal well-being, higher education institutions must prioritise mitigating food insecurity on the college campus. Higher education institutions could benefit from adopting comprehensive and individualised approaches to promoting food security for marginalised students in order to facilitate equal opportunity for optimal scholastic achievement among students of all socio-demographic backgrounds.

Little is known about the differences in dietary practices among food secure and food insecure populations during the early COVID-19 pandemic restrictions. The purpose of this study was to examine differences in dietary practices the early COVID-19 pandemic restrictions between adults reporting food security versus food insecurity. An online cross-sectional survey using validated measures was administered between April and September 2020 to explore both dietary patterns and practices and food security status among persons residing in five U.S. states from different regions of the country during the COVID-19 pandemic. Between-group differences (food secure versus food insecure) were examined for dietary practice outcomes using Pearson’s Chi-Square test statistic, with Fisher’s Exact test for cell counts less than five. There were 3,213 adult respondents. Food insecurity increased among the survey sample from 15.9% before the COVID-19 pandemic to 23.1% during the onset of the COVID-19 pandemic (p < 0.01). Compared to food secure respondents, those experiencing food insecurity reported more group gatherings for meals during the pandemic, decreased fruit and vegetable intake, and a need for more nutrition support resources than food secure respondents (p < 0.05). Food secure individuals reported increasing alcohol consumption, more frequent take-out or delivery ordering from fast food or restaurants, and more interest in supporting the local food system (p < 0.05). Results indicate a clear risk of disparities in dietary practices based on food security status during the early COVID-19 pandemic restrictions. Public health research, practice, and policy efforts should tailor specific efforts towards both food secure and food insecure groups.

Households with a low-income in rural places experience disproportionate levels of food insecurity. Further research is needed about the nuances in strategies that households with a low-income in rural areas apply to support food security nationally. This study aimed to understand the barriers and strategies that households with a low-income in rural areas experience to obtain a meal and support food security in the United States. We conducted a qualitative study with semi-structured interviews among 153 primary grocery shoppers with a low-income residing in rural counties. A majority of family’s ideal meals included animal-based protein, grains, and vegetables. Main themes included struggles to secure food and coping mechanisms. Ten categories included affordability, adequacy, accommodation, appetite, time, food source coordinating, food resource management, reduced quality, rationing for food, and exceptional desperation. These results can inform public health professionals’ efforts when partnering to alleviate food insecurity in rural areas.

Helping patients lose weight can mitigate their risk of chronic disease and improve their quality of life. Over-the-counter dietary supplements for weight loss, however, are not reviewed or approved for safety or efficacy, nor does evidence support their clinical use. This commentary on a case suggests 3 reasons why clinicians cannot ethically recommend these supplements to patients: these products' safety and efficacy are unknown, ingredient lists might not be complete, and advertising could be misleading. This article reviews facts clinicians should know regarding over-the-counter weight loss products and explains how they can support, educate, and promote culturally and individually sensitive weight-management strategies.

The objectives of this paper are to investigate: 1) how the COVID-19 pandemic influenced both physical activity practices and mental health status, and 2) to assess the relationship between the two. Our mixed-methods study draws on 4,026 online survey responses collected between April - September 2020 across five states (Louisiana, Montana, North Carolina, Oregon and West Virginia). Logistic regression models were run for two outcome variables (physical activity and mental health status (measured using the Kessler Psychological Distress scale)). Researchers controlled for race/ethnicity, household income/size, gender, urbanicity, education, employment, use of government assistance and presence of chronic health conditions. Qualitative analysis was applied to open-ended survey responses to contextualize quantitative findings. Household income was significant in predicting difficulty maintaining pre-pandemic physical activity levels; pre-pandemic physical activity levels were associated with increased psychological distress levels during COVID-19; and race/ethnicity, income status and urbanicity were significantly associated with deteriorating mental health status and physical activity levels during COVID-19. Data suggests that a bi-directional, cyclical relationship between physical activity and mental health exists. Policy implications should include physical activity promotion as a protective factor against declining mental health.

The Supplemental Nutrition Assistance Program (SNAP) is a critical program that helps reduce the risk of food insecurity, yet little is known about how SNAP addresses the needs of rural, food-insecure residents in the United States (U.S.). This study examines how rural, food-insecure residents perceive SNAP. Semi-structured interviews were conducted with 153 individuals living in six diverse rural regions of Arkansas, Montana, North Carolina, Oregon, Texas, and West Virginia. SNAP was described as a crucial stop-gap program, keeping families from experiencing persistent food insecurity, making food dollars stretch when the family budget is tight, and helping them purchase healthier foods. For many rural residents interviewed, SNAP was viewed in a largely positive light. In efforts to continue improving SNAP, particularly in light of its relevance during and post-coronavirus (COVID-19) pandemic, policymakers must be aware of rural families' perceptions of SNAP. Specific improvements may include increased transparency regarding funding formulas, budgeting and nutrition education for recipients, effective training to improve customer service, connections among social service agencies within a community, and increased availability of automation to streamline application processes.

Weight-related behaviors and perception during adolescence can influence life-long weight management habits. Among the general population, difference in behaviors and beliefs have been observed by race/ethnicity and sex, but research is limited in athletes. PURPOSE: Determine if weight-related behaviors and perceptions differ by sex, race/ethnicity, and socioeconomic status (SES) in adolescent soccer players. METHODS: Adolescent soccer players (n=493, 56% Female, 45% Latino) completed a health history survey that included questions related to weight-related behaviors and perception. Body Mass Index (BMI, kg/m2) was determined from measured height and weight. RESULTS: Self-reported behaviors (trying to gain/lose weight or not change weight) differed by sex and by race/ethnicity (p<0.05). Males were 10.2 times more likely to desire weight gain than females. Latinos were more likely to desire to lose weight vs. Whites. Weight-status perception varied by sex (p=0.03); more males self-reporting being "underweight" than other categories. No race/ethnicity differences were observed (p>0.05). Weight loss strategies differed by race/ethnicity (p<0.0001) with Latinos reporting using exercise and drinking more water for weight loss. Adolescents desiring weight loss (38.7%) were 2.4 times more likely to skip breakfast or lunch. CONCLUSIONS: Future research should focus on understanding factors related to race/ethnicity and sex that influence weight-related attitudes/behaviors.

Background: Frequent intake of sugar-sweetened beverages (SSB) decreases diet quality and is associated with adverse health outcomes.Objective: We examined associations between status of actively trying to eat a healthy diet and SSB intake among a convenience sample of Hispanic adults.Study Design, Settings, Participants: This cross-sectional study used 2015 Estilos data including a convenience sample of 1,000 Hispanic adults (≥ 18 years) from an online panel survey (conducted in Spanish and English).Measurable Outcome/Analysis: The outcome variable was SSB intake (regular soda, sweetened coffee/tea drink, sports/energy drink, and fruit drink).The exposure variable was agreement on actively trying to eat a healthy diet (disagree, neither, or agree).Covariates included sociodemographic and acculturation variables, and weight status.We used chi-square tests and logistic regression analyses to examine the associations between actively trying to eat a healthy diet and SSB intake.Results: Overall, 71.3% of Hispanics agreed that they were actively trying to eat a healthy diet and 17.4% neither disagreed nor agreed.The prevalence of SSB intake ≥ one time/day was the highest among those who neither disagreed nor agreed (94.3%), followed by agreed (89.9%) and disagreed (89.4%).In the crude models, the odds of consuming sweetened coffee/tea drink ≥ one time/day was greater among those who agreed (OR = 1.65) than those who disagreed, and the odds of consuming sports/ energy drink ≥ one time/day was lower among who neither disagreed nor agreed (OR = 0.51) than those who disagreed.However, after controlling for covariates, these associations were no longer significant.Conclusion: Daily SSB intake among a convenience sample of Hispanics was high regardless whether or not they are actively trying to eat a healthy diet.Intention alone may not be adequate for Hispanic adults to change their behaviors.Beverage may be a topic for additional consideration when seeking to promote healthful dietary behaviors among Hispanics.

The purpose of this study was to compare changes in diet and daily physical activity (PA) in high school (HS) soccer players who participated in either a two-year obesity prevention intervention or comparison group, while controlling for sex, race/ethnicity, and socioeconomic status. Participants (n = 388; females = 58%; Latino = 38%; 15.3 ± 1.1 years, 38% National School Breakfast/Lunch Program) were assigned to either an intervention (n = 278; 9 schools) or comparison group (n = 110; 4 schools) based on geographical location. Pre/post intervention assessment of diet was done using Block Fat/Sugar/Fruit/Vegetable Screener, and daily steps was done using the Fitbit-Zip. Groups were compared over-time for mean changes (post-pre) in fruit/vegetables (FV), saturated fat (SF), added sugar, and PA (daily steps, moderate-to-vigorous PA) using analysis of covariance. The two-year intervention decreased mean added sugar intake (−12.1 g/day, CI (7.4, 16.8), p = 0.02); there were no differences in groups for FV or SF intake (p = 0.89). For both groups, PA was significantly higher in-soccer (9937 steps/day) vs. out-of-soccer season (8117 steps/day), emphasizing the contribution of organized sports to youth daily PA. At baseline, Latino youth had significantly higher added sugar intake (+14 g/day, p < 0.01) than non-Latinos. Targeting active youth in a diet/PA intervention improves diet, but out of soccer season youth need engagement to maintain PA (200).