Investigation On Food Assistance Programs and Dietary Behavior Among Texas Tech Students, A Case Study of Raiders Red’s Food Pantry

Background: Food insecurity (FI) is a complex issue in the United States (US) and is highly prevalent among college students. This has led to the implementation of various food assistance programs on US campuses. However, there is still an increasing level of FI despite establishing a university food pantry on Texas Tech University (TTU) campus. Also, there is limited evidence to show how the usage of campus food pantries contributes to reducing food insecurity among US college students. This study assessed the prevalence of FI among campus food pantry users, determined dietary intake, and how pantry usage influenced dietary behavior, perception, and lived experiences of users regarding access and utilization of the campus food pantry at TTU. Methods: A mixed-method study design was used for this study. Participants were frequent Raider Red food pantry (RRFP) users who were ≥18 years old. The quantitative assessments in the form of a self-administered online questionnaire using a cross-sectional study design, and 460 frequent users of the campus pantry were recruited after consenting to study participation. Ethical approval was obtained from the Texas Tech Institutional Review Board, IRB2024-62. The online questionnaire included socio-demographic information (such as age, gender, marital status, student classification, student residence type), 6-item United States Department of Agriculture (USDA) household food security survey module, dietary and nutrition behavior, perception, and usage experience of the food pantry and dietary intake were assessed. The sociodemographic characteristics of participants were surveyed using the 12-questions from the 2018 National Health and Nutritional Examination Survey (NHANES) survey. Food insecurity was measured using the 6-item USDA household food security survey module, pantry usage was evaluated using adopted food pantry usage scale with 4 close-ended questions from Liu et al. (2019). The perception of services received from Raider Red’s Food Pantry was measured using the 9-item perception scale for the food assistance programs adapted from the FAO 2015 survey. Participant dietary intake was measured using self-reported 24-hour dietary recall instrument from Kansas Medical Center Nutrition Clinic and analyzed using the Elizabeth Stewart Hands and Associates food processor assessment software. Also, dietary and nutrition behaviors were evaluated using the NHANES 2018 survey. The food insecurity of participants was classified as high/ marginal, low, and very low food security and compared with the general student population in TTU. SPSS version 29 was used for descriptive statistics (including sociodemographic, food insecurity, perception, usage experience, dietary behavior, and dietary intake) SPSS 29 and inferential statistics to determine associations were done using R Version 4.4.1, at a two-sided test and P<0.05. The qualitative method, we conducted in-depth interviews among 20 participants. The interviews were done via Zoom, and transcripts from interviews were used to generate codes using thematic analysis. Two independent researchers concluded the five themes that emerged from developed codes using Nvivo 15, Windows. Results: Most participants were 21-29 years,47% (216) and 51.1% were male. Overall, 66.7% were food insecure, among whom 37.2% (171) and 29.6% (136) had very low food security, and low food security, respectively. The prevalence of FI at 66.7% among pantry users was significantly higher than 53% of the campus-wide prevalence of FI at TTU. Participants' usage experiences with RRFP were strongly associated with their perception (χ² = 56.26, p < 0.001), and most students who rated their usage experience as poor primarily had a negative perception of the food pantries (51.3%). The percentage contribution of energy, fat, and carbohydrates from food obtained at RRFP was 38.1%, 45.4%, and 20.6%, of total dietary intake. The median dietary intake of macronutrients and micronutrients was lower among students in the low and very low food security (P<0.001). The analysis of dietary behavior and intake revealed that individuals who dined out or consumed fast foods, including pizza, for more than four times in a month had a higher fat intake and lower levels of vitamin E, folic acid, magnesium, and iron compared to those who did not eat out or consume fast foods. Qualitative findings revealed restrictions on pantry visits, unclear eligibility for pantry access, and limited access to diverse, nutrient-dense foods like meat, fruits, and vegetables, students’ hesitation to seek assistance from fear of being judged by peers as highlighted barriers. However, the welcoming reception by pantry staff was an enabler of student visits. Improvement suggestions were flexible opening hours, an increase in number of visits, and kinds of food available in the pantry. Most participants echoed the need for stable fresh produce, cultural and diverse food options on pantry shelves and have campus-wide campaigns on access to and normalizing the use of campus food assistance to reduce the social stigma associated with food pantry visits. Conclusion: Food insecurity remains persistent among pantry users of Raider Red’s Food Pantry which may be attributed to significant associations of food insecurity with low-income levels (below $14,580), off-campus living conditions, marital status, and households with more than two dependents among the students who utilize Raider Red’s Food Pantry. Also, the experiences of pantry users showed significant concerns regarding the predominance of packaged and canned foods, and the perception that these foods do not encourage healthy dietary behavior, the pantry food items may help to alleviate food insecurity as it contributed more than one-third of the total energy intake and almost a third of the total protein intake on the day the survey was completed.