College students may be vulnerable to food insecurity due to limited financial resources, decreased buying power of federal aid, and rising costs of tuition, housing, and food. This study assessed the prevalence of food insecurity and its sociodemographic, health, academic, and food pantry correlates among first-year college students in the United States. A cross-sectional study was conducted among first-year students (n = 855) across eight U.S. universities. Food security status was assessed using the U.S. Department of Agriculture Adult Food Security Survey Module. Cohen’s Perceived Stress Scale, Pittsburgh Sleep Quality Index, and Eating Attitudes Test-26 were used to assess perceived stress, sleep quality, and disordered eating behaviors, respectively. Participants self-reported their grade point average (GPA) and completed questions related to meal plan enrollment and utilization of on-campus food pantries. Of participating students, 19% were food-insecure, and an additional 25.3% were at risk of food insecurity. Students who identified as a racial minority, lived off-campus, received a Pell grant, reported a parental education of high school or less, and did not participate in a meal plan were more likely to be food-insecure. Multivariate logistic regression models adjusted for sociodemographic characteristics and meal plan enrollment indicated that food-insecure students had significantly higher odds of poor sleep quality (OR = 2.32, 95% CI: 1.43–3.76), high stress (OR = 4.65, 95% CI: 2.66–8.11), disordered eating behaviors (OR = 2.49, 95% CI: 1.20–4.90), and a GPA < 3.0 (OR = 1.91, 95% CI: 1.19–3.07) compared to food-secure students. Finally, while half of the students (56.4%) with an on-campus pantry were aware of its existence, only 22.2% of food-insecure students endorsed utilizing the pantry for food acquisition. Food insecurity among first-year college students is highly prevalent and has implications for academic performance and health outcomes. Higher education institutions should screen for food insecurity and implement policy and programmatic initiatives to promote a healthier college experience. Campus food pantries may be useful as short-term relief; however, its limited use by students suggest the need for additional solutions with a rights-based approach to food insecurity. Retrospectively registered on ClinicalTrials.gov , NCT02941497.

Background: In the absence of federal programs and policies to alleviate college student food insecurity, the number of food pantries has grown rapidly in the United States. Yet, no studies, to date, have qualitatively examined students’ experiences with this resource.Objective: To explore college students’ perspectives on barriers to using an on-campus food pantry and provide insights into student-suggested solutions.Methods: In this qualitative study, 41 college students were recruited from a large public university in the southeastern US with a campus food pantry. Students participated in one-on-one, in-person, semi-structured interviews. All interviews were audio-recorded, transcribed verbatim, managed using NVivo 12, and analyzed using inductive, semantic thematic analysis.Results: Most students were classified as food insecure (n = 33, 82.5%), and two-thirds identified as pantry users (at least once). The students’ reasons for not using the food pantry indicated resistance and access barriers. Students either ‘chose not to use’ the campus food pantry due to (i) stigma and shame, (ii) perceived insufficient need, (iii) and unsuitable food or they experienced ‘barriers’ due to (i) lack of knowledge and (ii) limited food access. The main reason reported by food insecure non-pantry users was feelings of stigma and shame while that of food insecure pantry users was limited food access. Students suggested three solutions to minimize barriers experienced when utilizing the campus food pantry. These included (i) spreading awareness about the pantry through positive marketing messages that de-stigmatize use, (ii) improving accessibility of fresh produce and protein options, and (iii) improving access through satellite locations and online ordering systems.Conclusion: These barriers need to be systematically addressed to normalize food pantry use. Consideration of student recommendations by university program developers and policymakers may be of added value to expand access to food by college students with food insecurity.

This study assessed food choice priorities (FCP) and associations with consumption of fruits and vegetables (FV), fiber, added sugars from non-beverage sources, and sugar-sweetened beverages (SSB) among college students. Freshmen from eight U.S. universities (N = 1149) completed the Food Choice Priorities Survey, designed for college students to provide a way to determine the factors of greatest importance regarding food choices, and the NCI Dietary Screener Questionnaire. Changes in FCP and dietary intake from fall 2015 to spring 2016 were assessed. Multiple regression models examined associations between FCP and log-transformed dietary intake, controlling for sex, age, race, and BMI. Participant characteristics and FCP associations were also assessed. FCP importance changed across the freshmen year and significantly predicted dietary intake. The most important FCP were price, busy daily life and preferences, and healthy aesthetic. Students who endorsed healthy aesthetic factors (health, effect on physical appearance, freshness/quality/in season) as important for food choice, consumed more FV and fiber and less added sugar and SSB. Busy daily life and preferences (taste, convenience, routine, ability to feel full) predicted lower FV, higher added sugar, and higher SSB consumption. Price predicted lower FV, higher SSB, and more added sugar while the advertising environment was positively associated with SSB intake. FCP and demographic factors explained between 2%–17% of the variance in dietary intake across models. The strongest relationship was between healthy aesthetic factors and SSB (B = −0.37, p < 0.01). Self-rated importance of factors influencing food choice are related to dietary intake among students. Interventions that shift identified FCP may positively impact students’ diet quality especially considering that some FCP increase in importance across the first year of college.

Background: Understanding how older, minoritized patients attend to cues when interacting with web-based health messages may provide opportunities to improve engagement with novel health technologies. We assess acceptance-promoting and acceptance-inhibiting cues of a web-based, intervention promoting colorectal cancer (CRC) screening with a home stool test among Black women. Materials and methods: Focus group and individual interview data informed iterative changes to a race- and gender-concordant virtual health assistant (VHA). A user-centered design approach was used across 3 iterations to identify changes needed to activate cues described as important; such as portraying authority and expertise. Questionnaire data were analyzed using non-parametric tests for perceptions of cues. Analysis was guided by the Technology Acceptance Model. Results: Perceptions of interactivity, social presence, expertise, and trust were important cues in a VHA-delivered intervention promoting CRC screening. Features of the web-based platform related to ease of navigation and use were also discussed. Participant comments varied across the 3 iterations and indicated acceptance of or a desire to improve source cues for subsequent iterations. We highlight the specific key changes made at each of three iterative versions of the interactive intervention in conjunction with user perception of changes. Discussion: Virtual agents can be adapted to better meet patient expectations such as being a trustworthy and expert source. Across three evolving versions of a Black, VHA, cues for social presence were particularly important. Social presence cues helped patients engage with CRC screening messages delivered in this novel digital context. Conclusions: When using a VHA to disseminate health information, cues associated with acceptability can be leveraged and adapted as needed for diverse audiences. Patient characteristics (age, identity, health status) are important to note as they may affect perceptions of a novel health technologies ease of use and relevancy according to the leading models.

Many interventions aim to improve dietary patterns but not all are able to maintain these changes long term. Interventions informed by theory may facilitate dietary behavior changes and maintenance of these changes for longer periods of time. PubMed and PsychInfo were searched for theory-based interventions with long-term assessments of fruit and vegetable (FV) and fat intake. We identified 335 unique titles; 20 were included for review. Most interventions (65%) were based on social cognitive theory. Assessments of FV and fat ranged from 12 to 72 months postrandomization, and 15 studies reported significant intervention effects. Only 6 studies directly tested theory in relation to diet and of those, significant findings indicated self-efficacy, motivation for dietary change, perceived competence to eat more FV and less fat, and multiple processes of change were associated with long-term maintenance of healthy eating. Overall, this review indicates that theory-informed interventions are generally successful for long-term improvements in diet quality, although such improvements are often modest. Most studies did not directly measure theoretical constructs in relation to diet outcomes, thus limiting our ability to describe how theory-based interventions specifically promote long-term diet change. Recommendations for future research and practical recommendations for long-term maintenance of diet change are discussed.