SNAP Student Rules Are Not So Snappy: Lessons Learned From a Qualitative Study of California County Agency Workers.

OBJECTIVE: To examine the college student Supplemental Nutrition Assistance Program (SNAP) application process from the perspective of county agency workers. DESIGN: A qualitative study that included semistructured individual and group interviews (n = 14) between February and December, 2021. SETTING: Nine California counties with a University of California campus. PARTICIPANTS: A total of 24 county agency workers who regularly process or advise on college student SNAP applications. PHENOMENON OF INTEREST: Facilitators and barriers to processing student SNAP applications. ANALYSIS: Interviews were recorded, transcribed, and coded using thematic analysis. RESULTS: Five themes were identified regarding student applications: (1) a need for more consistency in policy dissemination and program administration, (2) student exemptions and the application process are perceived as challenging for students, (3) facilitators of successfully processing student applications, (4) tracking policy changes is burdensome, and (5) eliminate the student rules. CONCLUSION AND IMPLICATIONS: County agency workers perceived that students experience unnecessary barriers to accessing SNAP benefits and that implementing the student rules was taxing. Expanding SNAP access to low-income college students could be an equitable solution to mitigate the risk of student hunger while they pursue their degrees.

Associations between Changes in Food Acquisition Behaviors, Dietary Intake, and Bodyweight during the COVID-19 Pandemic among Low-Income Parents in California.

COVID-19 disrupted food access, potentially increasing nutritional risk and health inequities. This study aimed to describe and assess associations between changes in food/meal acquisition behaviors and relative changes in dietary intake and bodyweight from before to during the pandemic. Low-income parents (n = 1090) reported these changes by online survey in April-August 2021. Associations were assessed by multinomial logistic regression. Compared to those with no change, those who decreased supermarket shopping had greater odds of decreased fruit and vegetable (FV; OR[95%CI] = 2.4[1.4-4.1]) and increased salty snack intakes (OR[95%CI] = 1.7[1.0-2.8]). Those who decreased farmer's market shopping had greater odds of decreased FV intake (OR[95%CI] = 1.8[1.0-3.1]), increased bodyweight (OR[95%CI] = 1.7[1.1-2.6]), and increased SSB (OR[95%CI] = 1.9[1.1-3.2]) and sweets intakes (OR[95%CI] = 1.8[1.1-2.9]). Those who increased online food ordering had greater odds of increased sweets (OR[95%CI] = 1.7[1.1-2.8]), salty snacks (OR[95%CI] = 1.9[1.2-3.2]), and fast food (OR[95%CI] = 2.0[1.2-3.5]) intakes and bodyweight (OR[95%CI] = 1.8[1.1-2.9]). Those who increased healthy meal preparation had greater odds of increased FV intake (OR[95%CI] = 4.0[2.5-6.5]), decreased SSB (OR[95%CI] = 3.7[2.3-6.0]), sweets (OR[95%CI] = 2.7[1.6-4.4]), salty snacks (OR[95%CI] = 3.0[1.8-5]) and fast food intakes (OR[95%CI] = 2.8[1.7-4.6]) and bodyweight (OR[95%CI] = 2.2[1.2-4.0]). Interventions to address the potentially negative impacts of online food/meal shopping and support healthy home cooking may be needed to improve nutrition-related outcomes and reduce health disparities in the aftermath of the current pandemic and during future emergencies requiring similar restrictions.

COVID-19-related stressors exacerbate food insecurity and depressive symptoms among graduate students receiving campus basic needs services: Cross-sectional findings from seven California public universities.

Prior to the COVID-19 pandemic, food insecurity and depression were growing public health concerns among graduate students. Yet, little is known about how COVID-19-related stressors exacerbated these health outcomes among graduate students. To address this research gap, this study examined two types of COVID-19-related stressors, anticipated concerns about remote learning and challenges interfering with academic and research responsibilities, in relation to food insecurity and depressive symptoms among public university graduate students. Between August and October 2020, 631 graduate students who utilised basic needs services from seven University of California campuses completed an online survey assessing the effects of COVID-19 on their academic experiences, mental health, and basic needs security. Regression analyses examined associations of COVID-19-related concerns and COVID-19-related challenges with food insecurity as well as COVID-19-related concerns and COVID-19-related challenges in relation to depressive symptoms. All four models were adjusted for age, sex, race and ethnicity, campus affiliation, and living with a partner. Models examining food security status as the dependent variable were adjusted for depressive symptoms and vice versa. Graduate students concerned about delayed graduation, post-graduate employment, isolation from faculty and not having access to healthcare reported higher counts of depressive symptoms. Challenges associated with higher counts of depressive symptoms included caring for family more than usual, spending more time on errands and not paying for utilities in full. Students concerned about accessing healthcare had higher odds of experiencing food insecurity. Challenges associated with food insecurity included spending more time on errands, being unable to afford housing and sending money to family members during the pandemic. Our findings illuminate the pandemic's deleterious consequences on graduate students' mental health and food security, underscoring the need for strong academic and basic needs programs and policies.

Parent perceptions of changes in eating behavior during COVID-19 of school-aged children from Supplemental Assistance Program Education (SNAP-Ed) eligible households in California.

This cross-sectional study examined the associations between parent-reported, perceptions of changes in school-aged children's (ages 5-18) school meal participation, household cooking, fast food consumption, dietary intake, and weight during the COVID-19 pandemic. Respondents with low-income and school-aged children (n = 1040) were enrolled using quota sampling to approximate the distribution of low-income households and race/ethnicity among California residents who completed an on-line questionnaire developed by the authors. Adjusted multinomial models examined associations between parent-reported changes in school meal participation and time spent cooking, with parent-reported changes in child diet and body weight during COVID-19 (from before March 2020 to January-March 2021). During the pandemic, decreased school meal participation was associated with decreased child's fast food intake (OR[95 %CI] = 1.47[1.04-2.07]); conversely, increased school meal participation was associated with increased child's fast food intake (OR[95 %CI] = 1.71[1.09-2.68]). Decreased cooking at home was associated with decreased fruit and vegetable intake (OR[95 %CI] = 2.71[1.62-4.53]), increased sugar-sweetened beverage intake (OR[95 %CI] = 3.83[2.16-6.81]), and increased fast food intake (OR[95 %CI] = 4.09[2.45-6.84]); while increased cooking at home was associated with increased fruit and vegetable (OR[95 %CI] = 2.26[1.59-3.20]), sugar-sweetened beverage (OR[95 %CI] = 1.88[1.20-2.94]), sweets (OR[95 %CI] = 1.46[1.02-2.10]), and salty snack food intake (OR[95 %CI] = 1.87[1.29-2.71]). These parent-reported perceived changes in meal sources during the pandemic for children from low-income California households, and the mixed results in their associations with changes in parent-reported child dietary intake, suggest the need for strengthening policies and programs to support both access to, and healthfulness of, meals from school and home during prolonged school closures.

Supplemental Nutrition Assistance Program Education reductions during COVID-19 may have exacerbated health inequities.

Objective: Describe, and assess disparities in, the changes in Supplemental Nutrition Assistance Program Education (SNAP-Ed) that occurred the year before vs. the year when COVID-19 restrictions were implemented. Design: Observational study comparing reach, intensity, and dose of California Local Health Department (LHD) SNAP-Ed interventions in Federal Fiscal years 2019 and 2020 (FFY19, FFY20). Analysis: Student t-tests determined significance of differences in the number of Direct Education (DE) programs, Policy, Systems and Environmental change (PSE) sites, people reached, and intervention intensity and dose between FFY19 and FFY20 using data reported online by LHDs. Linear regression assessed associations between census tract-level characteristics (urbanicity; percentages of population with income <185% of federal poverty level, under 18 years of age, and belonging to various racial/ethnic groups; and California Healthy Places Index) and changes in number of DE programs, PSE sites, people reached, and intervention dose between FFY19 and FFY20. Results: From FFY19 to FFY20, the number of DE programs, PSE sites, people reached, and census tract-level intervention intensity and dose decreased. Higher census tract poverty, higher proportions of Black and Latino residents, and less healthy neighborhood conditions were associated with greater decreases in some intervention characteristics including PSE sites, PSE reach, DE programs, and DE dose. Conclusions and implications: These reductions in LHD SNAP-Ed interventions indicate reduced access to education and environments that support healthy eating and obesity prevention during a time when this support was especially needed to reduce risk of COVID-19 infection and complications. Disproportionately reduced access, may have worsened health disparities in already-disadvantaged communities. Assuring maintenance of SNAP-Ed interventions, especially in disadvantaged communities, should be a priority during public health emergencies.

Helping College Students Get Supplemental Nutrition Assistance Program: Facilitators of and Barriers to Students Accessing the Federal Nutrition Assistance Program.

OBJECTIVE: To identify effective practices for assisting college students with Supplemental Nutrition Assistance Program (SNAP) applications and explore challenges in student SNAP enrollment. DESIGN: In-depth interviews with key informants on experiences assisting college students with SNAP applications. SETTING: University of California campuses. PARTICIPANTS: Twenty-one key informants, including staff from the University of California on-campus Basic Needs Centers, campus financial aid offices, county agencies, and food banks. PHENOMENON OF INTEREST: Facilitators and barriers of college student SNAP enrollment. ANALYSIS: Transcripts were coded to identify emerging themes. RESULTS: Two of the most frequently mentioned facilitators were county staff presence on campus for application assistance and a strong relationship between campus staff and the county SNAP agency. A common barrier was inconsistent student SNAP eligibility information and procedures across county offices. CONCLUSION AND IMPLICATIONS: Federal coordination with state agencies on student SNAP policy is much needed. This approach could help to eliminate heterogeneous interpretations of student exemptions across counties and between county staff. Future research is warranted to identify policy leverage points at the county, state, and federal levels, such as eliminating the student rule, to ensure equitable access to SNAP among college students.

Campus Food Pantry Use Is Linked to Better Health Among Public University Students.

OBJECTIVE: To examine retrospectively whether access to a campus food pantry (CFP) is related to improvements in sleep, mental health, and physical health among college students in a public university system. DESIGN: Retrospective, cross-sectional study of student CFP users who completed an online survey in the summer of 2019. SETTING: Ten-campus University of California system. PARTICIPANTS: A total of 1,855 students completed the survey. MAIN VARIABLES MEASURED: Students reported the number of CFP visits in a usual week or month. Students retrospectively rated their perceived health, depressive symptoms, and sleep sufficiency before and after having food pantry access. The difference between pre- and post-food pantry access responses was calculated. ANALYSIS: Path analysis was used to examine direct and indirect paths of the relationship between CFP visits with self-reported changes in depressive symptoms and perceived health through positive changes in self-reported sleep sufficiency, controlling for sociodemographic factors. RESULTS: More monthly CFP visits were directly related to decreased depressive symptoms and improved perceived health (ßdepressive = 0.10, P < 0.001; ßhealth = 0.12, P < 0.001). In addition, more CFP visits were related to improved sleep sufficiency (ß = 0.09, P = 0.001), which in turn was related to a decrease in depressive symptoms (ß = 0.24, P = 0.001; indirect effect: 0.02, P < 0.01) and improved perceived health (ß = 0.23, P < 0.001; indirect effect: 0.02, P < 0.01). CONCLUSIONS AND IMPLICATIONS: Findings suggest that college campus emergency food access is associated with self-reported improvements in student health outcomes associated with food security. Until more long-term solutions that improve college student nutrition are developed, food pantries may be filling a gap.

Crop diversity is associated with higher child diet diversity in Ethiopia, particularly among low-income households, but not in Vietnam.

OBJECTIVES: To examine associations of household crop diversity with school-aged child dietary diversity in Vietnam and Ethiopia and mechanisms underlying these associations. DESIGN: We created a child diet diversity score (DDS) using data on seven food groups consumed in the last 24 h. Generalised estimating equations were used to model associations of household-level crop diversity, measured as a count of crop species richness (CSR) and of plant crop nutritional functional richness (CNFR), with DDS. We examined effect modification by household wealth and subsistence orientation, and mediation by the farm's market orientation. SETTING: Two survey years of longitudinal data from the Young Lives cohort. PARTICIPANTS: Children (aged 5 years in 2006 and 8 years in 2009) from rural farming households in Ethiopia (n 1012) and Vietnam (n 1083). RESULTS: There was a small, positive association between household CNFR and DDS in Ethiopia (CNFR-DDS, ß = 0·13; (95 % CI 0·07, 0·19)), but not in Vietnam. Associations of crop diversity and child diet diversity were strongest among poor households in Ethiopia and among subsistence-oriented households in Vietnam. Agricultural earnings positively mediated the crop diversity-diet diversity association in Ethiopia. DISCUSSION: Children from households that are poorer and those that rely more on their own agricultural production for food may benefit most from increased crop diversity.

Campus Food Pantry Use Addresses a Gap Among California Public University Students.

OBJECTIVE: To identify factors associated with campus food pantry (CFP) visits and evaluate outreach strategies. DESIGN: Cross-sectional. SETTING: Ten University of California campuses. PARTICIPANTS: University of California CFP student users (n = 1,513) completed a survey in 2019. VARIABLES MEASURED: Students reported reasons for CFP visits, how they heard about the CFP, monthly CFP visits, and food security status. Sociodemographic information was obtained through institutional records. ANALYSIS: Poisson regression for associations of monthly CFP visits (dependent) with sociodemographic variables (Model 1), reasons for CFP visits (Model 2), and outreach strategies (Model 3). Logistic regression for associations between reasons for CFP visits and food security status (dependent; Model 4). RESULTS: On average, students made 3.66 (SD, 4.75) CFP visits in the past month. Factors associated with more CFP visits included being first-generation to attend college, Filipino/Pacific Islanders, homeless, older, and male (Model 1). Not wanting to run out of food and hearing about the CFP through basic needs staff were associated with more CFP visits (Models 2 and 3). Students who visited the CFP because of financial insecurity had higher odds of food insecurity (Model 4). CONCLUSIONS AND IMPLICATIONS: Findings suggest that CFPs provide critical emergency food assistance for students at risk of food insecurity.

Redefining Basic Needs for Higher Education: It's More Than Minimal Food and Housing According to California University Students.

PURPOSE: A student-specific definition of basic needs for higher education is warranted to inform programs and policies for underserved students. The purpose of this study was to: 1) explore how students define basic needs, 2) understand experiences of housing insecurity, and 3) understand experiences of food insecurity within the context of housing insecurity. DESIGN: Qualitative research elicited student perceptions of basic needs and experiences of housing and food insecurity. SETTING: Focus group discussions were conducted at 5 University of California campuses between February and March 2019. PARTICIPANTS: Undergraduate (n = 37) and graduate (n = 21) students were recruited from campus basic needs centers. METHODS: Each student completed a brief survey. Researchers conducted 11 focus groups using a semi-structured interview guide. Transcripts were coded to identify themes. RESULTS: Students were female (76%), age 23.6 (SD = 5.8) years; 46% were Pell grant recipients; and 52% were first-generation college students. Most had experienced food insecurity (98%) and 26% had experienced homelessness. Eight themes were identified: 1) students define basic needs as more than minimal food and shelter and as the responsibility of students and the university, 2) students encounter multifaceted housing insecurity issues, 3) affording rent is a priority that most often leads to experiencing food insecurity, 4) transportation barriers interfere with meeting students' basic needs to succeed as students, 5) students with nontraditional characteristics, graduate students, and out-of-state students face unique challenges in meeting basic needs, 6) limited financial aid and lack of financial aid guidance are barriers to meeting basic needs, 7) fees contribute additional challenges to students meeting basic needs, and 8) additional university basic needs services are essential. CONCLUSION: A student-informed definition of basic needs included food, housing, mental health, sleep, hygiene, and transportation. This understanding of basic needs can inform future research, programs, and policy to address housing insecurity in higher education.