Comparisons of Cooking, Dietary, and Food Safety Characteristics of Food Secure and Food Insecure Sophomores at a University in Appalachia.

Introduction: Food insecurity means lacking access to adequate, nutritious, and safe food. Collegiate food insecurity rates at ten Appalachian campuses range from 22.4% to 51.8% and have been associated with unfavorable health and academic outcomes. Purpose: This study compared cooking, dietary, and food safety characteristics of food secure (FS) and food insecure (FI) sophomores at a university in Appalachia in the context of the USDA definition of food security. Methods: Data were collected using an online questionnaire. Descriptive and inferential procedures compared FS and FI sophomores (p < 0.05). Results: Participants (n = 226) were 65.0% females, 76.1% whites, and 46% FI. About 40% of on-campus and 50% of off-campus residents were FI, and 70% of FI students reported needing help accessing food. Cooking was undertaken "less often" by 61.5% of FS and 55.8% of FI sophomores. Mean cooking self-efficacy scores for FS and FI students were 44.9, vs 43.4, (p > 0.05) out of 52 points. Grains were consumed most often by 40% of FS and FI students and vegetables were consumed least often by 70% of both groups. Mean food safety test scores for FS and FI students were 6.2 1.60 vs 6.6 1.52 (p > 0.05) out of 11 points. Requested educational activities included making a budget and planning balanced meals. Implications: The high rate of food insecurity reflects an ongoing need among sophomores for campus and community food assistance and for educational activities that teach purchasing and preparation of affordable, healthy and safe foods.

Use and Perceptions of a Campus Food Pantry Among Food Insecure College Students An Exploratory Study from Appalachia.

Introduction: Food insecurity has emerged as a public health problem among college students in Appalachia, jeopardizing their physical, mental, and emotional health and academic success. Campus food pantries have been established in this region, but no data are available concerning student use or perception of services. Purpose: This study measured use and perceptions of a campus food pantry by students at a mid-sized university in rural North Carolina. Methods: An online questionnaire collected behavioral and perceptual data, and follow-up interviews explored these variables. Descriptive statistics with significance at p<0.05 and thematic analytical procedures were used. Results: Questionnaires were submitted by 896 of 6000 recruited students (14.9%), and four students granted interviews. Food insecurity affected 437 (48.8%) of participants, of whom 76 (17.4%) were pantry shoppers. Shoppers (n = 94) were 27.7% males, 65.1% females, and 7.2% non-cisgender, 63.8% non-Hispanic white, 84.5% undergraduate, and 14.3% graduate students. Reasons for non-pantry use by food insecure students included: others need it more (30.1%) and feel embarrassed (20.7%). Benefits of pantry use were: spent more on necessities (56.4%) and job performance improved (18.1%). Shoppers perceived the pantry's physical environment most favorably and food offerings less favorably. Implications: The low use of the campus food pantry by food insecure students suggests that these students may be jeopardizing their physical and mental health and academic success. Greater efforts by faculty, academic advisers, and student leaders are needed to promote pantry use and decrease the associated stigma.

Food Insecurity Among College Students with and without Medical Disorders at a University in Appalachia.

Objective: This study compared severity of food insecurity, characteristics, and behaviors of college students with and without diagnosed medical disorders. Design: Data were collected using a cross-sectional online questionnaire. Variables measured were food security status, disorders, coping strategies, and perceived barriers to food access. Descriptive and inferential statistics examined associations and compared groups. Statistical significance was p≤0.05. Setting: Data were collected at Appalachian State University in North Carolina. Participants: The sample was 247 food insecure students, of whom 60% were females, 50% 3rd- and 4th-year students, and 75% whites. Results: Medical disorders were reported by 67.2% of food insecure students, and a greater proportion of students with than without disorders experienced very low food security (63.3% vs. 43.2%, p=0.003). The most common disorder categories were psychiatric (40.5%) and gastrointestinal (31.6%). Characteristics of food insecure students with disorders included female gender, suboptimal academic performance, employed, off-campus residence. Coping strategies used by students with and without disorders, respectively, to improve food access, included brought food back to school after visiting family, friends, significant others (90.9% vs. 63.0%) and ate less healthy food so you could eat more (77.7% vs. 49.4%). Perceived barriers among students with disorders included feel overwhelmed making food choices (12.7%) and meal plan runs out (10.2%). Food insecure students with disorders made greater use of coping strategies and identified more perceived barriers. Conclusions: Food insecure students with disorders experienced more severe food deprivation and require multidimensional food assistance programs beyond those generally available on college campuses.

Expenditure, Coping, and Academic Behaviors among Food-Insecure College Students at 10 Higher Education Institutes in the Appalachian and Southeastern Regions.

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.

Freshmen at a University in Appalachia Experience a Higher Rate of Campus than Family Food Insecurity.

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.

Health Belief Model Offers Opportunities for Designing Weight Management Interventions for College Students.

OBJECTIVE: Identify weight-related beliefs of college students and test the predictive power of the Health Belief Model for body mass index (BMI). DESIGN: Cross-sectional online survey with beliefs measured on 5-point scales. SETTING: University in North Carolina. PARTICIPANTS: Undergraduates (n = 516; 91.9%), females (n = 399; 71.3%), white non-Hispanic students (n = 507; 86.2%), and 20.3% of overweight or obese status. VARIABLES MEASURED: Perceived severity, susceptibility, barriers, benefits, and internal and external cues to action. ANALYSIS: One-way ANOVA and regression. Significance was P < .05. RESULTS: Strongest beliefs concerned benefits of healthy eating and physical activity (mean, 4.1 ± 0.7); weakest beliefs concerned barriers to adopting such behaviors (mean, 2.6 ± 0.9). The regression model was statistically significant (P < .001) and explained 17% of variance in BMI (multivariate coefficient = 0.177). Perceived severity, susceptibility, external cues, barriers, and benefits predicted BMI. CONCLUSIONS AND IMPLICATIONS: Several beliefs were identified that could serve as the basis for weight-related interventions addressing specific concerns, needs, and goals of college students.

Knowledge of healthy foods does not translate to healthy snack consumption among exercise science undergraduates.

This cross-sectional survey study compared the on- and off-campus snack choices and related correlates of convenience samples of exercise science (ES) ( n = 165, M = 45%, F = 55%) and non-exercise science (NES) ( n =160, M = 43%, F = 57%) undergraduates. The hypothesis posed was that knowledge of healthy foods will not translate to healthier snack consumption by the ES students, and that the snack choices and related correlates of ES and NES students will be similar. Data were collected using self-administered questionnaires completed in classrooms (ES sample) and at high-traffic locations on-campus (NES sample). Chi-square and t-test analyses compared ES and NES students on snack correlates. Snacks consumed most often by the ES and NES students on-campus were health bars/squares ( n = 56 vs. n = 48) and savory snacks ( n = 55 vs. n = 71), and off-campus were savory snacks ( n = 60 vs. n = 71) and fruits ( n = 41 vs. n = 34). Over half of both samples believed their snack choices were a mix of unhealthy and healthy. Fruits were considered healthier snacks and chips less healthy by both samples, and fruits were the most often recommended snack. About 20% believed these choices would impact their health unfavorably, and about two thirds self-classified in the action stages for healthy snacking. Since knowledge about healthy food choices did not translate to healthy snack selection, these students would benefit from interventions that teach selection and preparation of healthy snacks on a restricted budget.

Snacking Patterns and Snack Correlates in Third- and Fourth-Year Nursing and Dietetics Students: An Exploratory Study from the Midwestern United States.

AIMS: To compare snacking behaviors and psychosocial correlates of third- and fourth-year nursing (n=52) and dietetics (n=48) students. METHODS: Questionnaires assessed snack choices, awareness of healthy snacks, snack recommendations and beliefs, stage of change and perceived benefits/barriers for healthy snacking, and situational snacking. RESULTS: The snacks purchased most often on and off campus by the nursing students were soft drinks/caffeinated beverages (58%) and chips (42%), and for the dietetics students were chips (35%) and fresh fruit (33%). One-third of the nursing and 8% of the dietetics students believed their snack choices would have an unfavorable effect on their long-term health. Two-thirds of the nursing and 75% of the dietetics students self-classified in the action stages for healthy snacking. Snacks considered healthy and recommended by both samples were fresh fruits/vegetables and granola bars. More than 90% of both samples believed their job responsibilities would include modeling and teaching healthy snacking to patients. The barriers to healthy snacking identified most often by both samples were limited budget and not readily available. CONCLUSIONS: On-campus vendors should be approached with suggestions about featuring nutrient-dense snacks at discounted prices and offering smaller snack packs of popular products.

Rural Latino parents offer preschool children few nutrient-dense snacks: a community-based study in Western Illinois.

The aims of this descriptive study were to identify the snacks offered to preschool children by Latino parents living in a rural community, assess the overall healthfulness of those snacks, and measure related psychosocial correlates. Data were collected using Spanish-language questionnaires and interviews completed by 96 parents. Thirty-two percent of snack offerings were nutrient dense. The energy-dense snacks offered most often by the greatest proportion of parents were regular yogurt (17%), whole milk (16%), and fruit drinks (16%); the nutrient-dense snacks offered most often were fresh fruit (43%), low-fat milk (37%), and fruit juice (34%). Two-thirds of parents felt confident about offering healthy snacks, and 67% self-classified in the action stages. The primary barrier to offering healthy snacks was children's refusal to eat these products. These parents would benefit from interventions that teach how to overcome perceived barriers and how to purchase and prepare healthy snacks appealing to preschoolers.

Is field of study or location associated with college students' snacking patterns?

Objective. To compare on- and off-campus snacking patterns among college students pursuing degrees in health-related fields (HRFs) and nonhealth-related fields (NHRFs). Materials and Methods. Snack frequency questionnaire, scales measuring barriers, self-efficacy, and stage of change for healthy snacking, and a snack knowledge test (SKT). Participants. 513 students, 46% HRFs, and 54% NHRFs. The students' mean ± SD BMI was 24.1 ± 4.3 kg/m(2) (range 14.6 to 43.8), and 32.2% were overweight/obese. Results. Softdrinks (on-campus), lowfat milk (off-campus), and sports drinks were popular among HRFs and NHRFs. Cost and availability were barriers to healthy snacking, students felt least confident to choose healthy snacks when emotionally upset, and 75% (65%) of HRFs (NHRFs) self-classified in the action stage of change for healthy snacking. The HRFs scored higher on the SKT. Conclusions. Neither location nor field of study strongly influenced snacking patterns, which featured few high-fiber foods.

A quantitative assessment of the cultural knowledge, attitudes, and experiences of junior and senior dietetics students.

OBJECTIVE: To assess the cultural competence of dietetics majors. DESIGN: Self-administered questionnaire. SETTING: Classrooms at 7 universities. PARTICIPANTS: Two hundred eighty-three students-98 juniors (34.6%) and 185 seniors (65.4%)-recruited during class time. MAIN OUTCOME MEASURES: Knowledge was measured using a multiple-choice test, attitudes were assessed using scales, and experiences were measured using a list of activities. ANALYSIS: Descriptive statistics were obtained on all variables. Correlation analyses identified associations between competencies. Statistical significance was P < .05. RESULTS: Knowledge scores were highest on questions concerning food habits and lowest on questions concerning health beliefs. Approximately 45% of the students preferred to counsel clients from their own culture. A majority (89.2%) favored allocation of nutrition resources to assist culturally diverse clients in managing chronic diseases, and 65.7% favored the inclusion of more cultural information in their dietetics curriculum. The intercultural activities engaged in most often were eating ethnic food and watching films about other cultures, whereas those undertaken least often were completing a study abroad program or an internship abroad. CONCLUSIONS AND IMPLICATIONS: These students would benefit from more interactive intercultural learning opportunities to enhance their knowledge base and communication skills.

An Exploratory study of compliance with dietary recommendations among college students majoring in health-related disciplines: application of the transtheoretical model.

Compliance with food group and nutrient recommendations, and self-efficacy, stage of change, perceived barriers and benefits for healthy eating were assessed among a convenience sample of college students majoring in health-related disciplines. Dietary and psychosocial data were collected using three-day food records and scales, respectively. Means (SD), frequencies, and percents were calculated on all data, and logistic regressions were used to determine whether any of the psychosocial correlates predicted the stage of change for healthy eating. Noncompliance with food group recommendations ranged from 53% for the meat/meat alternates group to 93% for the vegetables/juice group, whereas noncompliance with nutrient recommendations ranged from 26% for cholesterol to 99% for potassium. A majority of students (57%) self-classified in the preaction and 40% in the action stages of change for eating healthy. The students' self-efficacy to eat healthy was highest in positive/social situations and lowest when experiencing emotional upset. The most important perceived barrier to healthy eating was that friends/roommates do not like to eat healthy foods, and the most important perceived benefit was that eating healthy foods provides the body with adequate nutrients. The difficult/inconvenient self-efficacy subscale predicted the stage of change for healthy eating. These students would benefit from interactive learning opportunities that teach how to purchase and prepare more whole grain foods, fruits, and vegetables, enhance their self-efficacy for making healthy food choices when experiencing negative emotions, and overcome perceived barriers to healthy eating.

Correlates for healthful snacking among middle-income midwestern women.

OBJECTIVE: To assess snacking patterns, self-efficacy, barriers, stage of change, and awareness of healthful snacks among middle-income midwestern women. DESIGN: Self-administered questionnaire. SETTING: An urban church. PARTICIPANTS: Convenience sample of 56 women, mean age 43.9 years and mean body mass index (BMI) 25.9 kg/m(2). MAIN OUTCOME MEASURES: A snack quality index (SQI) assessed healthfulness of snack choices; subscales identified self-efficacy and barriers; and a test measured knowledge of healthful snacks. ANALYSIS: SQI scores were based on energy density and frequency of consumption. Correlations identified associations between SQI scores and self-efficacy and barriers. Analysis of variance identified significant differences between subscale scores for self-efficacy and barriers. Statistical significance was P < .05. RESULTS: The mean SQI score was 64.9%. Participants felt least confident to choose healthful snacks when experiencing negative emotions, and the most important barrier to healthful snacking was an unfavorable taste perception. The majority of the women (86%) were in the pre-action and 14% in the action stages of change for healthful snacking. The mean score on the snack knowledge test was 84.2%. CONCLUSIONS AND IMPLICATIONS: These women need information concerning snacks high in fiber and low in trans fat, and interventions for enhancing self-confidence for healthful snack selection under challenging circumstances and for overcoming barriers.

Race and sex differences in college student physical activity correlates.

OBJECTIVES: To assess sex/race differences on psychosocial correlates of physical activity among college students. METHODS: Survey research protocol. RESULTS: Students (n=636) exercised an average of 3.5 days per week, with black females being the least active. Across subgroups, health/fitness was rated as the most important motive for exercise, followed by appearance and mental health. Of the correlates, enjoyment and the use of self-management strategies were most strongly associated with activity level. Only 40% were aware that adults should accumulate 30 minutes of moderate-intensity physical activity on most days (ie, 5) of the week for health benefits. CONCLUSIONS: Findings highlight the importance of teaching self-management skills and fostering exercise enjoyment in health promotion programs for college students.

Development and application of rapid assessment diet and physical activity indexes, which suggest high consumption of energy-dense foods and inadequate exercise among adolescents from 6 Latin American cities: a pilot study.

This study describes the development and application of a rapid assessment diet quality index (RADQI) and a rapid assessment physical activity index (RAPAI) to characterize the energy intake and expenditure patterns of 1279 Latin American adolescents. Secondary aims were to describe the strength of the relationships of energy intakes and expenditures with sex, socioeconomic status, body mass index, and city of residence and to identify the students' reasons for undertaking physical activity and the types of activities they most enjoyed. Participants were eighth and ninth grade students from Buenos Aires, Argentina; Guatemala City, Guatemala; Havana, Cuba; Lima, Peru; Panama City, Panama; and Santiago, Chile. The RADQI and RAPAI scores were rescaled to T scores with a mean of 50 points (+/-10) for comparison. The RADQI scores ranged from 53.0 points (+/-10.5) in Panama City to 44.7 points (+/-8.3) in Santiago, and RAPAI scores ranged from 54.8 points (+/-9.2) in Panama City to 46.2 points (+/-8.6) in Santiago. The correlation between RADQI and RAPAI scores for the combined data set was weak but positive. The 2 reasons most often given for undertaking physical activity were to improve their physical health and to improve their psychological well-being, whereas the types of physical activities most enjoyed involved competitive sports. Results suggest frequent intakes of energy-dense diets and inadequate physical activity participation, prompting a need for learning opportunities targeted at adolescents and their families that teach healthy food choices and encourage greater physical activity participation.

An exploration of the attitudinal and perceptual dimensions of body image among male and female adolescents from six Latin American cities.

Using survey methodology, this exploratory study examined the attitudinal and perceptual dimensions of body image among 1,272 eighth- and ninth-grade males and females from higher and lower socioeconomic backgrounds in Buenos Aires, Argentina (n = 195), Guatemala City, Guatemala (n = 212), Havana, Cuba (n = 213), Lima, Peru (n = 218), Panama City, Panama (n = 195), and Santiago, Chile (n = 239). The two dimensions of body image were assessed by showing the participants nine male and nine female silhouettes depicting body sizes ranging from extremely thin (#1) to extremely obese (#9). Approximately 50% of the male and female adolescents chose silhouette #3 as best depicting the attractive male body. Silhouette #2 was chosen by 45% of the females as best depicting feminine attractiveness, while 45% of the males chose silhouette #3. When identifying the silhouette that best depicted the healthy male body, 26% of the participants chose silhouette #2, 41% chose #3, and 19% chose #4. Silhouette #2 was selected by 33% of the adolescents as best depicting the healthy female body, 38% chose #3, and 14% chose #4. In all cities, the effect of body mass index (BMI) on body satisfaction was highly significant (p < 0.001). Almost 40% of the middle weight adolescents indicated a preference to be thinner, even though 72% of the males and 84% of the females in this subgroup already perceived themselves as thin. Similarly, 89% of the heavier weight participants indicated a preference to be thinner, even though only 10% of the males and 2% of the females in this subgroup perceived themselves as heavy. In five of the six cities, a significantly higher (p < 0.05) percentage of females than males desired to be thinner, the exception being Havana, where the distribution of desired change in body size was almost identical for males and females. Findings suggest a need for culturally sensitive, age- and gender-specific preventive interventions focusing on the importance of achieving a healthy weight during adolescence to promote body size acceptance among adolescents who are at a healthy weight.

Are household factors putting immigrant Hispanic children at risk of becoming overweight: a community-based study in eastern North Carolina.

North Carolina has one of the fastest growing populations of Hispanic immigrants in the U.S. The prevalence of overweight among Hispanic children in the state has increased to 17%. Therefore, the objectives of this descriptive, exploratory study were to identify potential risk factors for childhood overweight at the household level among 128 immigrant Hispanic families with school-aged children living in Eastern North Carolina. Data concerning parental beliefs about overweight children, family participation in physical activity, and household availability of higher-calorie foods were collected using a structured, close-ended interview form. Forty-seven percent of parents believed that overweight children are unhealthy, 11% that if a child is overweight, it is God's will, and over 90% believed that overweight children should be taken to a nutritionist or physician for help with weight reduction. The activities undertaken by families four to seven times per week were watching television (70%), listening to music (69%), and reading (61%). Cookies, cold cereals, crackers, whole milk, ice cream, cheese, hotdogs, peanut butter, soft drinks, fruit drinks, chips, and pudding were regularly available in a majority of households. Regression analysis indicated that household income, parental education, and rural versus urban residence had no significant impact on frequency of family participation in physical activity or household availability of higher-calorie foods. Findings suggest a need for bilingual community health professionals to develop culturally sensitive wellness programs targeted at immigrant Hispanic families that promote greater engagement in moderate-intensity physical activity and more frequent consumption of lower-calorie foods.