COVID-19 pandemic impact on food insecurity among college students: A mixed methods study.

Objectives: This study explores whether the COVID-19 pandemic exacerbated the prevalence of food insecurity (FI) among US college students. Participants: College students (n = 489) enrolled at a Mid-Atlantic university. Methods: A mixed methods design was utilized for data collection and analysis through an electronic survey and semi-structured interviews. Multiple regression was used to assess predictors of FI before and during COVID-19. The McNemar test determined if significant differences in FI existed. The interviews were used to explore students' personal experience with FI during the pandemic. Results: Black students (p = 0.045) and students moving in with their parents due to campus closures (p = 0.032) exhibited a higher degree of FI during the pandemic than before. Three main themes emerged from the interviews: decreased food autonomy, limited access to food, and limited access to healthful food. Conclusions: The pandemic increased the prevalence of FI among college students. Race and living arrangements were strong predictors of FI.

Mental health impacts of the COVID-19 pandemic on college students.

The COVID-19 pandemic is having profound effects on college students, and those with mental health conditions are more vulnerable to the impact of this stress. Objective: To study the impact of the COVID-19 pandemic on college students' mental health. Participants: Participants (n=489) were mostly female, undergraduate, and aged 18-25. Methods: Participants completed an online survey assessing symptoms of mental health problems including hopelessness, loneliness, sadness, anxiety, sadness, and anger. Results: Approximately 81.6 % self-reported at least one negative mental health symptom. Students reported increased feelings of hopelessness (+7.8%), loneliness (+6.7%), sadness (+8.8%), depression (+2.6%), anxiety (+5.2%), and anger (+14.6%) during the pandemic than before. LGBTQ students and Black students had significantly more mental health symptoms during the pandemic than straight and White students. Conclusions: Results of this study highlight the negative impact of the pandemic and resultant changes on college students' mental health.

Development and Validation of a Multidimensional Instrument: Assessing Barriers to Dietary Practices.

BACKGROUND AND PURPOSE: Poor dietary practices are linked to many chronic diseases. The purpose of this validation study was to develop a psychometrically sound instrument that can be administered by health practitioners to measure dietary barriers. METHODS: The Dietary Health Status (DHS) instrument, designed to measure dietary barriers is comprised of items in the National Health and Nutrition Examination Survey-What We Eat in America datasets. Content validity was established for DHS using an expert review process. Principal component analysis (PCA) was then used to assess validity and reliability as determined by Cronbach's alpha values. RESULTS: The PCA supported a 10-component solution, explaining 61% of the total variance. Cronbach's alpha was .67 for the entire instrument, ranging from .55 to .87 for the 10 subscales. CONCLUSION: Results suggest the instrument had sufficient construct and internal validity. This exploratory study is an important first step in validating the DHS instrument.

Community-Based Interventions for Stroke Provided by Nurses and Community Health Workers: A Review of the Literature.

BACKGROUND: Community-based interventions are vital for facilitating poststroke recovery, increasing community participation, and raising awareness about stroke survivors. To optimize recovery and community reintegration, there is a need to understand research findings on community-based interventions that focus on stroke survivors and their caregivers. Although nurses and community health workers (CHWs) are commonly involved in community-based interventions, less is known about their roles relative to other poststroke rehabilitation professionals (physical therapists, occupational therapists, and speech-language pathologists). Thus, the purpose of this review is to explore research focused on improving community-based stroke recovery for adult stroke survivors, caregivers, or both when delivered by nurses or CHWs. METHODS: A systematic review using Scopus, PubMed, EBSCOhost, MEDLINE, CINAHL Complete, and PsycInfo was completed to identify community-based poststroke intervention studies using nurses or CHWs through August 2018. RESULTS: Eighteen studies meeting inclusion criteria from 9 countries were identified. Details regarding nurses' and CHWs' roles were limited or not discussed. Interventions emphasized stroke survivor self-care and caregiver support and were offered face-to-face and in group sessions in the community and home. A wide range of instruments were used to measure outcomes. The results of the interventions provided were mixed. Improvements were observed in perceptions of health, quality of life, knowledge, self-efficacy, self-management, and caregiver support. CONCLUSION: Nurses and CHWs play a pivotal role in community-based care. Evidence suggests community-based interventions facilitate the necessary support for stroke survivors, caregivers, families, and communities to optimize stroke recovery. Data from this review illustrate a continued need for comprehensive programs designed to address the complex needs of stroke survivors and families when they return to their homes and communities.

Establishing content validity for a conceptualized instrument to measure barriers to eating a healthful diet in adults: a consensus approach.

BACKGROUND: A poor quality diet is a well-known risk factor for many chronic diseases. However, eating a healthful diet is not always simple as many underlying factors can impede adherence. Individuals with fewer barriers are more likely to eat a healthful diet than those who have more barriers. Accurately measuring barriers to eating a healthful diet could inform personalized interventions, particularly those aiming to prevent chronic diseases. The aim of this study was to establish content validity for selected items obtained from the National Health and Nutrition Examination Survey (NHANES) database to be considered for inclusion as items on the conceptualized Dietary Health Status (DHS) instrument, which is designed to measure barriers to eating a healthful diet in adults. METHODS: The Behavioral Change Wheel hub COM-B and the Theoretical Domains Framework (TDF) were the two theoretical frameworks underpinning the development of the DHS instrument. Seven steps were conducted to create the instrument: 1) development of operational definitions for each TDF domain; 2) identification of items from the NHANES database 2011-2012; 3) screening of items to ensure inclusion of all relevant items; 4) assigning items to a theory-based domain; 5) evaluation of the items against inclusion/exclusion criteria; 6) solicitation of feedback from expert reviewers to reach consensus on inclusion into a domain; and 7) validation of items. RESULTS: A total of 170 items representing twelve domains were identified as potential barriers to eating a healthful diet-- knowledge, optimism, beliefs about consequences, beliefs about capabilities, reinforcement, memory, attention and decision processes, environmental context and resources, social influences, emotion, behavioral regulation, health identity, and functional status. CONCLUSION: Expert review consultation and a consensus approach established content validity for 12 theory-based domains comprised of 170 items identified as potential barriers to eating a healthful diet. The use of these explanatory domains may: assist researchers to better understand barriers to adult dietary practices; inform the development of a screening tool that could be used in a community setting to measure barriers to eating a healthful diet; and inform individualized interventions.