OBJECTIVE: To benchmark the university food environment and explore students\' experiences with food insecurity and healthy eating in order to inform interventions to improve access and affordability of healthy foods for university students.
METHODS: A food environment audit was conducted on the university campus using the Uni-Food tool from April to May 2022 and was comprised of three main components, university systems and governance, campus facilities and environment, and food retail outlets. A qualitative study design was also used to conduct focus groups and semi-structured interviews with students to explore key themes regarding their experiences with food insecurity and healthy eating.
METHODS: Macquarie University, Australia.
METHODS: For the food environment audit 24 retail outlets on campus and for the qualitative component 29 domestic and international students enrolled at Macquarie University.
RESULTS: The university only scored 27% in total for all components in the food environment audit. The results showed the need for better governance and leadership of the food environment. The qualitative component suggested that the main barriers to accessing healthy foods were related to availability, pricing, and knowledge of healthy foods. Future intervention ideas included free fruits and vegetables, food relief, discounts, improved self-catering facilities, education, and increased healthy food outlets.
CONCLUSIONS: Improving governance measures related to healthy eating on campus are a core priority to strengthen the food environment and students identified pricing and availability as key issues. These findings will inform effective and feasible interventions to improve food security and healthy eating on campus.

OBJECTIVE: Food insecurity is a social determinant of health (SDOH) affecting 1 in 10 households per year in the United States and has major impacts on the course of chronic health conditions. It is beneficial to introduce screening and appropriate treatment plans to medical students. This study utilized a novel case-based learning exercise (CBLE) to assess confidence, attitudes and improvements in knowledge on recognizing and addressing food insecurity.
METHODS: A CBLE focused on food insecurity was developed to be implemented in a 2-h session as part of the curriculum for all first-year medical students at the Medical University of South Carolina. The CBLE included a case for discussion, followed by an interview with a standardized patient. Students received invitations to complete pre- and post-CBLE assessment surveys.
RESULTS: Completion of both pre- and post-surveys was achieved by 29% of students (48 out of 166). Knowledge around the formal definition of \"food insecurity,\" how to recognize food insecurity versus hunger, and how to screen for food insecurity all increased significantly (P < .05). Responses relating to the association between certain chronic diseases and food insecurity did not change pre and post-CBLE.
CONCLUSIONS: This novel CBLE was successfully implemented within a 2-h teaching session and improved knowledge on recognizing food insecurity in practice. However, additional learning exercises are likely needed to improve knowledge of the relationship between food insecurity and chronic disease states. Nonetheless, the CBLE structure provided students with multiple formats of learning and integration of skills, which shows promise and may be applicable to improve knowledge of other SDOHs.

Socioeconomic determinants of risky sexual behaviors in sub-Saharan Africa are well known. The socioeconomic determinants of the sexual behaviors of university students, however, remain unclear. This case control study aimed to investigate the socioeconomic determinants of risky sexual behavior and HIV seropositivity among university students in KwaZulu-Natal (KZN), South Africa. Participants (N = 500; 375 HIV uninfected and 125 HIV infected) from four public higher educational institutions in KZN were recruited, using a non-randomized strategy. Socioeconomic status was assessed by food insecurity, access to the government loan scheme, and sharing of the bursary/loan with family. The findings of this study suggest that students reporting food insecurity were 1.87 times more likely to have multiple sexual partners; 3.18 times more likely to engage in transactional sex for money; and presented a fivefold higher risk of engaging in transactional sex for basic needs other than money. Accessing the government financing for education and sharing of the bursary/loan with family was also significantly associated with an increased risk of having an HIV seropositive status. A significant association between socioeconomic measures, risky sexual behavior, and HIV seropositivity is demonstrated in this study. Moreover, the socioeconomic risks and drivers when determining and/or developing HIV prevention interventions, including preexposure prophylaxis use, should be considered by healthcare providers based at campus health clinics.

UNASSIGNED: The 2019 novel coronavirus epidemic (COVID-19) is a highly contagious viral disease with a high rate of morbidity and mortality. Food insecurity has frequently been linked to the emergence of infectious diseases. The present study was conducted to determine the association of food insecurity and socioeconomic status with COVID-19 in the Iranian population.
UNASSIGNED: The study was a case-control study including 248 participants (124 COVID-19-infected people with a positive PCR test and a history of clinical symptoms of COVID-19 and 124 non-infected people with a negative PCR test and no history of clinical symptoms of COVID-19 infection) aged 20 to 60 years. The participants in the two groups were matched based on age, sex, and BMI. Anthropometric and socioeconomic data were collected. Individuals\' food insecurity status during the previous 12 months (before the disease for the case group) was assessed using a validated 18-item USDA questionnaire.
UNASSIGNED: About 44% of the controls and 76% of the case group were food-insecure (P < 0.001). After controlling for any possible confounders, only food insecurity and poor economic level increased the risk of COVID-19, by about three times (OR = 3.10; 95% CI = 1.44-6.68; P = 0.004) and 9.5 times (OR = 9.53; 95% CI = 3.73-24.30; P < 0.001), respectively.
UNASSIGNED: Food insecurity and poor economic status are linked to an increased risk of COVID-19. Future prospective studies are needed to confirm these outcomes and identify the underlying mechanisms.

Despite the increasing global concern of improving food security, the determinants of food insecurity at household level in the rural areas have been poorly known. Therefore, the aim of this study was to analyze determinants of food insecurity at household level. A total of 383 households were selected using multistage sampling techniques. The logistic regression model was used to analyze the data. The result revealed that odds of illiterate households were 2.376 times more likely than educated households to experience food insecurity in the rural areas (ref. (Coef. = 0.865, OR = 2.376, P = 0.006)). Households with landholdings of more than half hectare were less likely to experience food insecurity. (ref. (Coef. = 1.982, OR = 7.260, P = 0.000)). Odds of households who engaged in off-farm activities were 0.204 times less likely to experience food insecurity. (ref. (Coef. = -1.588, OR = 0.204, P = 0.000)). Households who adopt farm technologies were less likely to experience food insecurity than those who do not adopt farm technology (ref. (Coef. = -1.086, OR = 0.337, P = 0.001)). Odds of higher-aged household heads were 6.141 times more likely to experience food insecurity than younger-aged household heads (ref. (Coef. = 1.815, OR = 6.141, P = 0.000)). Larger household sizes were less likely to experience food insecurity (ref. (Coef. = -2.423, OR = 0.089, P = 0.000)). In conclusion, understanding determinants of food insecurity at household level is essential to achieve food security in rural areas. Results suggest implementation of the effective developmental programs are needed to reduce food insecurity in rural areas.

A large body of research suggests that neighborhood disparities in food access persist. Emerging evidence suggests that the global COVID-19 pandemic likely exacerbated disparities in food access. Given the potential role that alternative food networks (AFNs) and local food sources may play during times of extreme scarcity, this study examines urban agriculture (e.g., community farms and gardens) as a sustainable strategy to address food insecurity. In-depth qualitative interviews with fifteen community stakeholders revealed several major themes including food insecurity as a feature of systemic racism, food affordability and distance to food as major barriers to food security, and the role of AFNs in creating community empowerment. Our findings indicate that urban agricultural practices help build social capital, inform and educate community members about healthy eating behaviors, and facilitate the distribution of affordable food. Implications for future research and policy targeting sustainable food distribution in marginalized communities of color are discussed.

Most of the sub-Saharan African countries including Ethiopia were affected by the food insecurity issue. This study aimed to analyze the drivers of food insecurity, the choice of livelihood strategies, and factors that impact the choices of food security strategies in response to food insecurity in Abay Chomen District of Ethiopia\'s Oromia region, Ethiopia. The result of this study is based on primary data and obtained from 150 randomly chosen sample households and secondary data generated from various sources. As for the technique of data analysis, this study employed descriptive statistics for the food insecurity index, as well as a binary logistic model and a multinomial logit model for the choice of household livelihood techniques. The findings of the survey showed that 51.3% of the households were found to be food-insecure and 48.7% food-safe in the study area. Furthermore, the result indicated that the average calorie consumption of the households surveyed was 2008.54 kcal for each adult equivalent per day, which is below the lowest calorie necessity of 2200 kcal. The estimated logistic model outcome on the drivers of household food insecurity confirmed the oldness of the household leader, larger family holder, and off-farm income affects negatively, while the gender of the household leader, the size of the built-up area, the number of livestock holdings (except oxen), the number of oxen owned, access to credit, the participation in the sale of cattle, and others affect positively. In addition, the multinomial logit model result indicates that the educational status of the household leader, the size of livestock farming, the number of oxen possessed, access to credit, remoteness to the market, and monthly agricultural earning are the main drivers of the choice of livelihood strategies of concern for the food insecurity of households. As a result, this research attempted to produce a result of analysis with a defined scope, although many questions remain unsolved. Future studies should concentrate on presenting fundamental data on the factors that affect food security status and livelihood strategy, the social, political, natural, and environmental aspects, the descriptive information on the shopping habits of people who experience food insecurity, and the key aspects that increase the vulnerability of the rural poor to food insecurity.

Evidence on the association between children\'s food insecurity (FI) and dietary patterns (DPs) is scarce. This study assessed the association between children\'s FI and a priori and a posteriori-defined DPs in a Portuguese population-based sample of children. A cross-sectional study including 2800 children from the 10-year-old follow-up of the Generation XXI birth cohort was performed. Data on food security status, assessed by the Self-administered Food Security Survey Module for children (SAFSSMC), dietary intake and socio-demographics were collected. A previously developed Healthy Eating Index (HEI) was adapted for this study. Using the HEI score and its food groups, linear and logistic regression models were performed. Using latent class analysis, five a posteriori-defined DPs were identified. The DPs names considered an overall picture of the DP. Food security status as a categorical (food security/FI) and continuous variable (SAFSSMC raw score: higher scores representing higher FI) was used. Multinomial logistic regression models were used to assess the association between food security status and DPs. Children\'s FI (9·4 %) was inversely associated with the HEI score (β=-0·695;95%CI:-1·154,-0·235), representing worse diet quality. A higher SAFSSMC raw score was associated with low fruit and vegetables (OR=1·089;95%CI:1·023,1·159) and seafood and eggs consumption (OR=1·073;95%CI:1·009,1·142) and high consumption of meat and meat products (OR=1·091;95%CI:1·026,1·160), salty snacks (OR=1·067;95%CI:1·003,1·136) and soft drinks (OR=1·097;95%CI:1·031,1·168). The SAFSSMC raw score was positively associated with \'Low consumption\' (OR=1·119;95%CI:1·016,1·232), \'Energy-dense foods\' (OR=1·155;95%CI:1·028,1·298) and \'Snacking\' (OR=1·119;95%CI:1·006,1·245) DPs. FI was associated with worse dietary choices. Intervention strategies targeting food insecure children should be developed to promote healthy dietary habits.

BACKGROUND: Conflict reduces availability of production input and income, increases the number of days households had to rely on less preferred foods, and limits the variety of foods eaten and the portion size of meals consumed. While existing studies examine the impact of conflict on different food security measures (e.g., Food Consumption Score, Food Insecurity Experience Scale), the relationship between these measures as well as their relationship with political, economic, and agricultural factors remain under explored. Food insecurity may not only be an externality of conflict but also food deprivation may be utilized as a weapon to discourage residency in contested territories or to incentivize rebellions.
METHODS: This paper examines the association between political factors (e.g., violence, policies that require permit for passage in one\'s own hometown), economic factors (e.g., loss of assets, unemployment), agricultural factors (e.g., shortage of water, poor weather conditions), and food insecurity experience and dietary diversity in a conflict setting-that of the occupied Palestinian territory (oPt). The study employs generalized structural equation models to analyze the \'Survey on socio-economic conditions for Palestinian households 2014\' dataset compiled by the Palestinian Central Bureau of Statistics-which contains a representative sample of the population in the oPt at governorate and locality levels.
RESULTS: We find that in the West Bank, residence in Area C-administered by Israel in both civil and security issues and contains illegal Israeli settlements and outposts-is associated with a higher level of agricultural hardship (p < 0.01) but lower economic hardship (p < 0.01) and a higher dietary diversity (p < 0.001), as compared to those living outside of Area C. In the Gaza Strip, living within one kilometer to a buffer zone is associated with lower dietary diversity (p < 0.01), higher level of political hardship (p < 0.01), and higher level food insecurity experience (p < 0.01) compared to not living in close proximity to a buffer zone. Concomitantly, in the Gaza Strip, food insecurity experience is associated with approximately a one-point reduction in dietary diversity as measured by the food consumption score (p < 0.01).
CONCLUSIONS: The results suggest that broader socio-political conditions in the oPt impact different aspects of food security through augmenting the economic and agricultural hardships that are experienced by the residents. As such, it is important to address these broader political and economic structures in order to have more sustainable interventions in reducing food insecurity.

Produce prescription programs within clinical care settings can address food insecurity by offering financial incentives through \"prescriptions\" for fruits and vegetables to eligible patients. The electronic health record (EHR) holds potential as a strategy to examine the relationship between these projects and participant outcomes, but no studies address EHR extraction for programmatic evaluations. We interviewed representatives of 9 grantees of the U.S. Department of Agriculture\'s Gus Schumacher Nutrition Incentive Grant Program\'s Produce Prescription Projects (GusNIP PPR) to understand their experiences with and capacity for utilizing EHR for evaluation. Five grantees planned to use EHR data, with 3 main strategies: reporting aggregate data from health clinics, contracting with external/third party evaluators, and accessing individual-level data. However, utilizing EHRs was prohibitive for others due to insufficient knowledge, training and/or staff capacity; lack of familiarity with the Institutional Review Board process; or was inappropriate for select target populations. Policy support for produce prescription programs requires a robust evidence base, deep knowledge of best practices, and an understanding of expected health outcomes. These insights can be most efficiently and meaningfully achieved with EHR data, which will require increased financial support and technical assistance for project operators.