WISH4Campus: Evaluating College Food Insecurity and Promoting Solutions for Student Wellbeing

Introduction: Interest in college food insecurity has increased in previous years, however, little research focuses on the Appalachian and Southeastern regions of the United States resulting in limited understanding of food insecurity’s impact on college students in these regions. Additionally, resources to help food insecure students are often sparse with universities lacking evidence-based programming to implement for student benefit. Aims: This dissertation aims to (1) investigate the correlates and behavioral consequences of food insecurity on college students at an Appalachian university, (2) expand college food insecurity research to a regional investigation in the Appalachian and Southeastern regions, and (3) develop and evaluate a toolkit of food insecurity initiatives that can assist higher education institutions in providing adequate resources for food insecure students. Methods: A 56 item, cross sectional survey was utilized for aims 1 and 2. Surveys were distributed to students attending 10 public universities in the Appalachian and Southeastern Regions between Spring 2016 and Spring 2018. Food security status was measured using the United States Department of Agriculture Adult Food Security Screener (USDA AFSS). This survey also included demographic, behavioral, health, and economic independent variables. Forward selection logistic regression was used to determine variables that increased the likelihood of being food insecure. Aim 3 used online survey data collection to capture feedback on the WISH4Campus (Wellbeing Increased by Security from Hunger) toolkit. Experts (n=126) from land-grant universities were sent a 27-question survey to determine perceptions of food insecurity and evaluation of specific toolkit components. Descriptive statistics and frequency analyses were performed on quantitative data and thematic analysis was used to analyze qualitative data. Results: Students at an Appalachian university (n=692) reported food insecurity prevalence at 36.6%. Results of the forward selection logistic regression showed money expenditure (MES), coping strategies (CSS), health, and academic year were significant predictors of food insecurity in college students. When expanded to a regional investigation of 13,642 college students, prevalence of food insecurity at the universities ranged from 22.4-51.8% with an average prevalence of 30.5%. From the forward selection logistic regression model, MES, CSS, academic performance (APS), grade point average (GPA), academic year, perceived health status, race/ethnicity, financial aid, cooking frequency, and health insurance were significant predictors of food security status. For aim 3, thirty experts completed the toolkit evaluation survey. Evaluation feedback covered four main topics: layout, overall content, initiatives, and application. Eight themes emerged from the coding and categorization of responses: visual appeal, organization, value, provoking, comprehensive, barriers, collaboration, and efficiency. Conclusion: Limited research has focused on college food insecurity in the Appalachian and Southeastern regions. Findings from these studies suggest food insecurity is a public health problem among college students in this region, and that continuing efforts are needed to assist affected students in getting greater access to safe, nutritious food. The developed toolkit is suggested to be a potential tool to help university personnel provide resources to students. Future research should aim to implement and evaluate food insecurity initiatives