The aim of this research was to explore the complexity of college student food insecurity through eating patterns, food assistance, and health of food-insecure university students. A mixed-methods ...

Community health improvement plans (CHIPs) are foundational public health practice, yet no studies have been conducted to understand implementation of these plans. This evaluation study of the Kansas City CHIP aims to 1) identify implementation strategies used in the CHIP, 2) assess changes in implementation, service, and client outcomes, 3) assess contextual factors associated with implementation, and 4) understand social networks of coalitions who implement the Kansas City CHIP. This study protocol uses a unique, mixed methods approach to evaluating process and outcomes of the Kansas City CHIP. This study is supported by Proctor's Model of Implementation, RE- 10.13039/100003582 AIM (reach, effectiveness, adoption, implementation, maintenance), and the practical, robust implementation and sustainability model (PRISM). Staff and community members involved in implementing the Kansas City, Missouri CHIP will be invited to participate in an annual online survey, a series of focus groups, and quarterly implementation logs to assess implementation and sustainability. RE-AIM and PRISM constructs are the primary and secondary outcomes of interest. Results of this study will be available from the first year of implementation in 2023, with future results provided annually. This project will fill a much-needed gap in the literature by understanding how large-scale coalitions implement projects that aim to improve population health and health equity. CHIPs have the potential to improve population health, yet few studies have been conducted on CHIPs, with no studies to date assessing outcomes. To support effective implementation and sustainability as well as improve public health outcomes, researchers need to evaluate CHIPs and develop models of implementation that can quickly be integrated into practice to improve populations’ health.

The objective of this study was to examine food insecurity and knowledge of the Supplemental Nutrition Assistance Program (SNAP), including barriers to and facilitators for enrolling in SNAP among college students in the Midwest. An obser­vational, cross-sectional online survey was admini­stered during Fall 2021 to Spring 2022. Participants included 844 college students from nine higher education institutions across Missouri. Of students who participated, 44.9% reported being food insecure, 67.9% reported knowing what SNAP was, and only 34.3% knew if they were eligible for SNAP. Students at private colleges [unadjusted odds ratio (OR) and 95% confidence interval (CI) = 4.79 (2.45-9.36), p<0.001)], community colleges [OR 3.21 95% CI (2.26-4.56), p<0.001)], technical schools [OR 2.21 95% CI (1.08-4.53), p=0.031], and Historically Black Colleges and Universities (HBCUs) [OR 2.05 95% CI (1.37-3.07)., p<0.001] reported higher odds of food security compared to public institutions. College students reported lack of knowledge of SNAP in general as the main barrier for enrollment and campus assistance as the main facilitator. Food insecurity is highly prevalent in Missouri college students, where SNAP knowl­edge and enrollment barriers persist. Findings sup­port a need for increased attention and resources to target college food insecurity.

JAFSCD: Journal of Agriculture, Food Systems, and Community Development. Publication of the Thomas A. Lyson Center for Civic Agriculture and Food Systems

The intersections between hunger and health are beginning to gain traction. New interventions emphasize collaboration between the health and social service sectors. This study aimed to understand the nutrition and physical activity (PA) needs as perceived by food pantry stakeholders to inform a health intervention approach. The study used formative research incorporating mixed methods through surveying and semi-structured interviews with three food pantry stakeholder groups: Clients (n = 30), staff (n = 7), and volunteers (n = 10). Pantry client participants reported; high rates of both individual (60%, n = 18) and household (43%, n = 13) disease diagnosis; low consumption (0–1 servings) of fruits (67%, n = 20) and vegetables (47%, n = 14) per day; and low levels (0–120 min) of PA (67%, n = 20) per week. Interviews identified five final convergent major themes across all three stakeholder groups including food and PA barriers, nutrition and PA literacy, health status and lifestyle, current pantry operations and adjustments, and suggestions for health intervention programming. High rates of chronic disease combined with low health literacy among pantry clients demonstrate the need to address health behaviors. Further research piloting the design and implementation of a comprehensive health behavior intervention program in the food pantry setting is needed.

Background: Food Is Medicine (FIM) interventions are on the rise nationally to address high rates of diet-related chronic disease. As a result, partnerships between the charitable food and health care sectors are emerging to support food access needs among food insecure patients managing chronic disease. Objective: Evaluating FIM programming partnerships between a midwestern regional food bank and its health care partners examining program components and partnership satisfaction. Design: Cross-sectional research design via an electronic survey among charitable food and health care partners engaged in FiM programming. Setting: A large midwestern regional food back and their health care partners. Participants: include both charitable food and health care staff involved in collaborative FIM interventions. Main Outcome Measures: Program components of collaborative FIM programs, collaborator satisfaction, differences in satisfaction between the 2 stakeholder groups (charitable food and health care partners). Results: The study included 23 participants (health care [n = 11], charitable food [n = 12]). Majority of FIM programs were on-site pantries (62%) or pre-prepared food boxes (38%). When combined, both stakeholder groups demonstrated a relatively high level of partnership satisfaction with a score of 3.96 out of 5. Charitable food partners had a statistically significantly higher rate of agreement ( $\bar{\mathrm{X}}$ = 4.00) that the partnership contributed to their ability to achieve higher funding compared to the health care group ( $\bar{\mathrm{X}}$ = 3.00). Conclusions: This study begins to explore a potential evaluation tool for multi-sector FIM partnerships. More research is needed to understand how these partnerships are evolving in practice and how to effectively evaluate them.