Lessons learned from implementing a diversity, equity, and inclusion curriculum for health research professionals at a large academic research institution.

Objective: Despite advances in incorporating diversity and structural competency into medical education curriculum, there is limited curriculum for public health research professionals. We developed and implemented a four-part diversity, equity, and inclusion (DEI) training series tailored for academic health research professionals to increase foundational knowledge of core diversity concepts and improve skills. Methods: We analyzed close- and open-ended attendee survey data to evaluate within- and between-session changes in DEI knowledge and perceived skills. Results: Over the four sessions, workshop attendance ranged from 45 to 82 attendees from our 250-person academic department and represented a mix of staff (64%), faculty (25%), and trainees (11%). Most identified as female (74%), 28% as a member of an underrepresented racial and ethnic minority (URM) group, and 17% as LGBTQI. During all four sessions, attendees increased their level of DEI knowledge, and within sessions two through four, attendees' perception of DEI skills increased. We observed increased situational DEI awareness as higher proportions of attendees noted disparities in mentoring and opportunities for advancement/promotion. An increase in a perceived lack of DEI in the workplace as a problem was observed; but only statistically significant among URM attendees. Discussion: Developing applied curricula yielded measurable improvements in knowledge and skills for a diverse health research department of faculty, staff, and students. Nesting this training within a more extensive program of departmental activities to improve climate and address systematic exclusion likely contributed to the series' success. Additional research is underway to understand the series' longer-term impact on applying skills for behavior change.

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.

Assessing sleep behaviors in Latino children and adolescents: what is known, what are we missing, and how do we move forward?

PURPOSE OF REVIEW: Sleep health is a commonly overlooked component of pediatric cardiometabolic risk. Disparities in sleep duration and meeting of pediatric sleep guidelines have been well documented among at-risk populations in the United States, including Latinos. However, sleep research often fails to describe or account for contextual and cultural factors impacting the ability for Latino families to meet guidelines. The current review focuses on recent findings related to measurement of sleep duration, understanding of contextual factors that impact sleep hygiene, and interventions designed to increase sleep duration and quality among U.S. Latino families with infants, young children, and adolescents. RECENT FINDINGS: Ten studies focusing on sleep health in U.S. Latino children, using different study designs were identified. Overall, cross-sectional studies confirmed inadequate sleep among Latino children, intervention studies demonstrated promise of culturally-sensitive health behavior education for improving sleep in early childhood, and qualitative studies highlighted neighborhood and cultural factors that impact sleep quality. IMPLICATIONS FOR CLINICAL PRACTICE AND RESEARCH: Rather than new prevalence studies on adherence to sleep recommendations among Latino families, research focusing on adapting clinical guidelines to accommodate the realities of many Latino families (e.g., co-sleeping and bedsharing) will advance our knowledge. A shift towards objective measurement of the 24-h period as well as evaluating specific contextual barriers that make It challenging to meet sleep guidelines for Latino children is needed.

Campus Food Pantry Use May Improve Daily Frequency of Fruit and Vegetable Intake Among California University Students Experiencing Food Insecurity.

BACKGROUND: University students are at increased risk for both food insecurity and suboptimal fruit and vegetable (F/V) intake. Campus food pantries (CFP) have been a common intervention in response to student food insecurity, but there have been few evaluations of the effectiveness of this strategy on improving students' dietary intake. OBJECTIVE: To examine differences in the frequency of F/V intake by food security status, and whether the number of monthly CFP visits was associated with frequency of F/V intake among university students who were CFP clients. DESIGN: Cross-sectional PARTICIPANTS: The study population included 1,188 university students across the 10-campus University of California system who had accessed their CFP or Basic Needs Center. MAIN MEASURES: United States Department of Agriculture (USDA) 6-item short food security module, monthly CFP visits, and self-reported frequency of F/V intake (daily). STATISTICAL ANALYSES PERFORMED: T-tests were performed to compare differences in mean daily frequency of F/V intake by food security status. Generalized linear models were used to examine associations between monthly CFP visits and mean daily frequency of F/V intake. Using a post hoc Wald test, an interaction term (monthly CFP visits × food security status) was included to the models to determine whether food security status modified associations. RESULTS: Students experiencing food insecurity consumed total F/V 0.48 fewer times per day compared with students who were food secure (2.64 ± 2.11 vs 3.12 ± 2.01; P < .001). Among students experiencing food insecurity, each monthly CFP visit was associated with higher daily frequencies of intake for total F/V (ß = 0.06), whole fruit (ß = 0.03), 100% fruit juice (ß = 0.01), and leafy greens (ß = 0.01); however, no associations were found among the food-secure group. CONCLUSIONS: Findings suggest that CFPs may be supporting students in need of nutritional assistance increase their daily frequency of F/V intake. Future studies are needed to validate these findings to inform investment in campus food pantries and support university students in need of nutritional assistance.

Food Insecurity, Memory, and Dementia Among US Adults Aged 50 Years and Older.

Importance: Despite existing federal programs to increase access to food, food insecurity is common among US older adults. Food insecurity may affect Alzheimer disease and Alzheimer disease-related dementias via multiple mechanisms, yet there is almost no quantitative research evaluating this association. Objective: To examine whether food insecurity in older adults is associated with later-life cognitive outcomes. Design, Setting, and Participants: This cohort study of US residents aged 50 years and older from the US Health and Retirement Study was restricted to respondents with food insecurity data in 2013 and cognitive outcome data between calendar years 2014 and 2018. Analyses were conducted from June 1 to September 22, 2023. Exposure: Food insecurity status in 2013 was assessed using the validated US Department of Agriculture 6-item Household Food Security Module. Respondents were classified as being food secure, low food secure, and very low food secure. Main Outcomes and Measures: Outcomes were dementia probability and memory score (standardized to 1998 units), estimated biennially between 2014 and 2018 using a previously validated algorithm. Generalized estimation equations were fit for dementia risk and linear mixed-effects models for memory score, taking selective attrition into account through inverse probability of censoring weights. Results: The sample consisted of 7012 participants (18 356 person-waves); mean (SD) age was 67.7 (10.0) years, 4131 (58.9%) were women, 1136 (16.2%) were non-Hispanic Black, 4849 (69.2%) were non-Hispanic White, and mean (SD) duration of schooling was 13.0 (3.0) years. Compared with food-secure older adults, experiencing low food security was associated with higher odds of dementia (odds ratio, 1.38; 95% CI, 1.15-1.67) as was experiencing very low food security (odds ratio, 1.37; 95% CI, 1.11-1.59). Low and very low food security was also associated with lower memory levels and faster age-related memory decline. Conclusions and Relevance: In this cohort study of older US residents, food insecurity was associated with increased dementia risk, poorer memory function, and faster memory decline. Future studies are needed to examine whether addressing food insecurity may benefit brain health.

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.

Breastfeeding Duration and Timing of Bottle Supplementation: Associations with Body Mass Index from Childhood to Young-Adulthood.

Evidence for the association between breastfeeding (BF) duration and later body mass index (BMI) is inconsistent. We explored how BF duration and BF type (exclusive or partial) related to BMI from childhood to young adulthood in a Chilean cohort. Infants were recruited at 6 months between 1994 and 1996 in Santiago, Chile (n = 821). Mothers reported date of first bottle and last BF; anthropometry was measured at 1, 5, 10, 16, and 23 years. We tested whether: (1) type of BF at 6 months (none, partial, exclusive) and (2) duration of exclusive BF (<1 month, 1 to <3 months, 3 to <6 months, and ≥6 months) related to BMI. At 6 months, 35% received both breastmilk and formula ("partial BF") and 38% were exclusively breastfed. We found some evidence of an association between longer BF and lower BMI z-scores at young ages but observed null effects for later BMI. Specifically, BF for 3 to <6 months compared to <1 month related to lower BMI z-scores at 1 and 5 years (both p < 0.05). Our results are in partial accordance with others who have not found a protective effect of longer BF for lower BMI.

The 7-day Beverage Intake Questionnaire for Latino Children: Validation of a Culturally Tailored Tool.

OBJECTIVE: To validate a culturally tailored 7-day beverage intake questionnaire for Latino children (BIQ-L). DESIGN: Cross-sectional. SETTING: Federally qualified health center in San Francisco, CA. PARTICIPANTS: Latino parents and their children aged 1-5 years (n = 105). VARIABLES MEASURED: Parents completed the BIQ-L for each child and three 24-hour dietary recalls. Participants' height and weight were measured. ANALYSIS: Correlations between the mean intake of beverages in 4 categories as determined by the BIQ-L and three 24-hour dietary recalls were assessed. Multivariable linear regression examined the association between sugar-sweetened beverages (SSB) servings as determined by the BIQ-L and child body mass index z-score. RESULTS: Mean daily intake of SSB (r = 0.52, P < 0.001), 100% fruit juice (r = 0.45, P < 0.001), flavored milk (r = 0.7, P < 0.001), and unflavored milk (r = 0.7, P < 0.001) from the BIQ-L were correlated with intake assessed via three 24-hour dietary recalls. In the multivariable model, weekly servings of SSBs were associated with child body mass index z-score (ß = 0.15, P = 0.02). Culturally specific beverages comprised 38% of the SSB intake reported on the BIQ-L. CONCLUSIONS AND IMPLICATIONS: The BIQ-L is a valid tool for assessing beverage intake among Latino children aged 1-5 years. The inclusion of culturally specific beverages is critical for accurately assessing beverage intake among Latino children.

Adolescent sedentary behavior and body composition in early adulthood: results from a cohort study.

BACKGROUND: This study investigates the cross-sectional and prospective associations between accelerometer-measured sedentary behavior and body composition from adolescence to early adulthood. METHODS: Data from the Santiago Longitudinal Study were analyzed (n = 212). Sedentary time was measured at age 16 years, and body composition (body mass index [BMI], waist circumference, waist-to-height ratio [WHtR], fat mass percentage, and lean mass percentage) was examined at both age 16 and 23 years. Adjusted linear regression models estimated associations between sedentary time, sedentary bout duration, and body composition, overall and by sex. RESULTS: In all analyses, mean sedentary bout duration was not associated with body composition. In cross-sectional analyses, more sedentary time during adolescence was significantly associated with lower BMI, waist circumference, WHtR, fat mass percentage, and higher lean mass percentage (p < 0.05). One standard deviation increase in daily sedentary time was prospectively associated with lower body mass index (ß = -1.22 kg/m2, 95% CI: -2.02, -0.42), waist circumference (ß = -2.39 cm, 95% CI: -4.03, -0.75), and WHtR (ß = -0.014, 95% CI: -0.024, -0.004). Sedentary time at 16 years was not associated with changes in body composition from 16 to 23 years. CONCLUSIONS: Sedentary behavior in adolescence is not adversely associated with body composition profiles in early adulthood. IMPACT: Little is known about the effect of device-measured sedentary behavior on body composition during the transition from adolescence to early adulthood. Among participants in the Santiago Longitudinal Study, more accelerometer-measured sedentary time during adolescence was associated with lower BMI, waist circumference, and waist-to-height ratio in early adulthood though point estimates were generally small in magnitude. Sedentary behavior in adolescence was not detrimentally associated with healthy body composition profiles in early adulthood. Public health interventions aimed at reducing obesity rates could consider other behaviors, such as physical activity and healthy diet, instead of sitting time.

Understanding the Role of CalFresh Participation and Food Insecurity on Academic Outcomes among College Students during the COVID-19 Pandemic.

Food insecurity (FI) is associated with many adverse outcomes in college students. The Supplemental Nutrition Assistance Program (SNAP, known as CalFresh in California) has been observed to alleviate FI; however, on college campuses, the benefits of food assistance programs are not well understood. This study investigated whether college students benefit from CalFresh participation. It was hypothesized that students would experience increased FI over time and that CalFresh participation would moderate the effect of FI on grade point average (GPA). A comprehensive FI and CalFresh questionnaires were distributed during the 2020-2021 academic year to 849 students. The chi-square test of independence assessed differences between FI and student factors. A Friedman test assessed differences in FI during the three quarters. Moderation analysis assessed whether CalFresh participation moderated FI's effect on GPA. Differences were observed among food security scores in Winter 2021 (median = 1.69) and Fall 2020 (median = 2.14; p = 0.013) and Spring 2020 (median = 2.17; p = 0.009). In the moderation model, the interaction of FI score and CalFresh participation was positively correlated with GPA (B = 0.11; p = 0.002). These results indicate that SNAP/CalFresh participation was particularly beneficial for mitigating the negative effects of FI on GPA. Given these benefits, encouraging SNAP/CalFresh enrollment should be a priority for university administrators.

Screen-related discord and dismay in low-income Mexican American families with toddlers: A qualitative study.

PURPOSE: Understanding parental experiences with managing their toddler's screen use is important to inform the design of interventions addressing early childhood screen use, yet current evidence is limited. To enhance our understanding of the context of toddler screen use, this study characterizes the screen-related discord and dismay parents experience in families with toddlers. DESIGN AND METHODS: In-depth interviews were conducted to explore everyday experiences with screen use among low-income Mexican American caregivers of toddlers (21 mothers, 10 fathers, 1 grandmother). Transcripts were content analyzed to identify prominent themes. RESULTS: Three themes were identified. Experiences of screen-related discord and dismay arose (1) between parent and child, (2) between parents, and (3) surfaced as parental internal dissonance about toddler screen use. Parent-child discord resulted from parental limit setting and child reactions to parental screen use, which often included tantrums. Parent-partner discord included patterns of agreeing to disagree and direct disagreement between partners. Parents also reported their own feelings of ambivalence and dismay as they struggled to reconcile their preferences against their toddler's actual screen use, while living in a screen-saturated world. CONCLUSIONS: Findings offer insight into types of screen-related discord and dismay low-income Mexican American parents experience as they attempt to manage their toddler's screen use. PRACTICE IMPLICATIONS: Although discord in families is normal, the screen-specific discord reported by participants warrants consideration in efforts promoting healthy screen use in families. Providers can tailor their counseling to consider the range of screen-related discord families of toddlers may experience.

Household and social characteristics associated with COVID-19 vaccine intent among Latino families in the San Francisco Bay Area.

BACKGROUND: Latinos have had higher case counts, hospitalization rates and deaths during the COVID-19 pandemic nationally and in the state of California. Meanwhile, Latino vaccination rates remain lower than those of non-Hispanic Whites. COVID-19 vaccine nonintent, defined as intent to not vaccinate against COVID-19, among Latino individuals continues to be an issue in the state of California. METHODS: Families from three Latino longitudinal mother-child cohorts previously recruited in the San Francisco Bay Area were surveyed telephonically from February to June 2021 to assess attitudes towards vaccination against COVID-19 and prior vaccination, in general, for themselves and their children. Risk for vaccine nonintent was assessed using the Mann-Whitney rank sum non-parametric test for continuous predictors and chi-squared tests for categorical ones. RESULTS: Three hundred and nineteen families were surveyed from the Telomere at Birth (TAB), Hispanic Eating and Nutrition (HEN) and Latino Eating and Diabetes Cohort (LEAD). Approximately 36% from TAB and 28% from HEN/LEAD indicated COVID-19 vaccine nonintent for themselves and/or their children. Risk factors for vaccine nonintent included lower maternal age (p = 0.01), concern about vaccine side effects (p < 0.01) and prior history of a household members being infected with SARS-CoV-2 (p < 0.01) and indexes of household crowding including number of people sharing a bathroom (p = 0.048). Vaccine intent was also associated with receiving vaccine input from friends (p = 0.03), family (p < 0.01) and/or coworkers (p = 0.02) compared with those who were not planning on getting vaccinated against COVID-19. CONCLUSIONS: Latino families living in crowded living situations who may not have received any COVID-19 advice from family, coworkers or friends are at particular risk for nonintent for vaccinatation against COVID-19. Community-based grassroots or promotor/a based interventions centered on trusted individuals with close community ties and counseling concerning vaccination against COVID-19 could help boost vaccination rates in this population group.

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.

Evaluating Knowledge, Attitudes, and Practices Regarding CalFresh Participation in University Students.

Objective: (1) Identify demographic and academic differences among university students who are food secure or food insecure and (2) explore CalFresh knowledge, attitudes, and practices (KAPs) among university students. Design: A questionnaire, including the 10-item USDA Adult Food Security Survey Module, CalFresh KAPs, and student factors was distributed in Winter 2020 to 10,000 university students. Chi-square test of independence, logistic and linear regressions were used to assess associations between food-secure status and student factors. Exploratory factor analysis determined factors relating to CalFresh KAPs. Kendall's tau assessed association between CalFresh KAPs factors. Setting: A public research university in California. Participants: Enrolled undergraduate and graduate/professional students (n = 10,000). 1535 responses with 1408 included in analysis for having complete data. Results: Food insecurity was associated with: race/ethnicity (Latino/a, OR = 1.97; p < 0.001); first-generation status (OR = 2.01; p < 0.001); and transfer status (OR = 1.58; p = 0.01). Exploratory factor analysis identified five factors related to CalFresh knowledge and attitudes: (1) CalFresh knowledge, (2) Positive attitudes around participating in CalFresh, (3) Negative attitudes around participating in CalFresh, (4) Negative attitudes around others participating in CalFresh, and (5) Fortunate attitudes for not participating in CalFresh. CalFresh knowledge was correlated with positive attitudes towards CalFresh participation (τb = 0.15, p = 0.025); negative attitudes towards other individuals' CalFresh participation (τb = −0.28, p < 0.001); feeling fortunate for not needing CalFresh (τb = 0.12, p = 0.004); and CalFresh participation OR = 1.40; p = 0.02). Conclusions: CalFresh knowledge may influence program participation. Populations who are most impacted by food insecurity should be a focus for improving CalFresh knowledge to promote CalFresh participation.

Style of meal service and feeding practices among Mexican American fathers and mothers: An analysis of video-recorded children's evening mealtime at home.

The aim of this study was to examine video-recorded observations of evening family mealtime at home among Mexican American children to help elucidate style of meal service, fathers' and mothers' feeding practices and child's eating behavior. Consistent with guidelines for coding behaviors, we analyzed observational data of evening mealtimes of 71 Mexican American children aged eight to 10 years. Regarding style of meal service, in almost all cases (96%), parents plated the child's food, with more available on the table or counter in 40% of the observations. Mothers almost always served the child (94%). Regarding parental feeding practices, parents used positive involvement in meals (80%), pressure to eat (42%) and restriction of food (9%). Using food as a reward to control behavior was never used by either parent. The majority (75%) of children requested or negotiated to eat less food, or only eat certain items. In Mexican American families, both mothers and fathers play a role in family mealtimes and both use positive involvement in child's meals, and to a lesser extent pressure to eat, with their children aged eight to 10 years. To help reduce the obesity epidemic, intervention strategies are needed, which integrate the family, a plating style of meal and parental feeding practices that promote healthy eating in the home. To reduce obesity among Mexican American children, interventions that focus on parental positive involvement in child's meal and maintenance of home cooked meals could have a positive impact on the entire family.

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.

No food for thought: Food insecurity is related to poor mental health and lower academic performance among students in California's public university system.

This study examined the relationships between food insecurity, mental health, and academic performance among college students in a California public university system (N = 8705). Structural equation modeling was performed to examine a direct path from food insecurity to student grade point average and an indirect path through mental health, controlling for demographic characteristics. Food insecurity was related to lower student grade point average directly and indirectly through poor mental health. These findings support the need for future interventions and policy on the importance of providing students with the basic needs to succeed both academically and in the future.

Mechanisms linking childhood weight status to metabolic risk in adolescence.

BACKGROUND: Obesity is a risk factor for insulin resistance (IR) and metabolic disease. OBJECTIVE: To examine potential metabolic pathways linking childhood weight status to adolescent IR and metabolic risk. METHODS: Participants were 600 low- to middle-income Chilean adolescents from a cohort studied since infancy as part of an iron deficiency anemia preventive trial and follow-up study. We examined body mass index z-score at 10 y (BMIz-10y) and blood pressure, total fat, and fasting glucose, adiponectin to leptin ratio (A:L), ghrelin, and HOMA-IR at 16 y. A total count for metabolic risk factors (MRF) was calculated using the International Diabetes Federation criteria. We used path analysis to estimate pathways and model indirect effects from BMIz-10y, controlling for child age and sex and maternal body mass index (BMI). RESULTS: Participants were 54% male; mean BMIz-10y of 0.53 (SD = 1.02); mean MRF of 1.3 (SD = 0.9); mean HOMA-IR of 1.8 (SD = 1.3). Path analysis showed that BMIz-10y directly and indirectly related to increased MRF via A:L and HOMA-IR. Ghrelin was not in the metabolic pathway from BMIz-10y to MRF but was related to MRF via HOMA-IR. CONCLUSION: These results elucidate metabolic pathways involving child weight status, IR and metabolic risk in adolescents. Childhood BMI was an indirect risk factor for adolescent cardiometabolic risk via several pathways that involved BMI, appetite hormones, markers of inflammation, and insulin resistance during adolescence. Findings illustrate the adverse effect that childhood obesity has on adolescent health outcomes, which sets precedence for health outcomes over the life course.