Tracing the Roots of Nutrition Access: University to Community (2024-2025)

Background

Food insecurity is a public health emergency in the United States due to its adverse impact on human health and well-being. Locally, one in 10 families in Durham reports skipping a meal because they did not have enough money to buy food. This rate increases drastically for Black and Hispanic households. 

In 2022, the White House held its first Conference on Hunger, Nutrition and Health to develop strategies to end hunger, improve nutrition and reduce diet-related diseases by 2030. Billions of federal dollars are annually allocated to a suite of nutrition assistance programs, including its flagship Supplemental Nutrition Assistance Program (SNAP), Women, Infants and Children (WIC) food assistance program, and school lunch programs.

In North Carolina, Medicaid allocated $650 million to the state’s Healthy Opportunities Pilot to test and evaluate nonmedical interventions related to food and other social determinants of health. Dozens of organizations, including Duke University Health System's Root Causes program, address food insecurity through charitable food provision, education and outreach. 

Despite these federal, state and local investments, food insecurity persists in Durham. Additional research is needed to understand and integrate the roles of the local food systems (e.g., charitable food sector), food waste mitigation and local health systems to generate solutions that draw upon the strengths of all sectors while optimizing resources and ensuring equitable access to services for Durham residents.

Project Description

This project team will explore Durham's organizational and resident barriers and facilitators to addressing food insecurity with a focus on federal programs and funding use. Building upon the findings of the 2023-2024 team, this team will work to support larger systems-level changes through two interrelated goals:

  1. Identifying community-driven, cross-sector strategies to increase food access, reduce food waste and improve food security for Durham residents. 
  2. Obtaining community member input on identified strategies, including formalizing a Community Advisory Board to provide support and guidance for putting identified strategies into action.

To reach these goals, team members will divide into two subgroups focused on organizations and residents. The “organizations” subgroup will focus on strengthening connections between Duke Health and other community organizations. Students will draw upon the data collected in 2023-2024 and will gather additional data from Duke and other organizational personnel. Ultimately, this workstream will develop recommendations for Duke to work collaboratively with community organizations to better leverage state and federal policies and to streamline, pool or re-allocate resources to address food insecurity and food waste in Durham. These recommendations will be shared with and refined by community members and Duke personnel. 

The “residents” subgroup will focus on engaging community members in developing action plans to carry out identified strategies. The team will leverage organizational relationships formed during 2023-2024 to recruit community members from across Durham. Team members will systematically elicit community input, including recruiting and providing incentives for approximately 10 residents to serve as a Community Advisory Board for this work moving forward. 

Both subgroups will learn about community-engaged research methods (e.g., PhotoVoice) and students will select the methods they want to use to elicit feedback. The team will work to ensure that voices of historically underrepresented populations are central in this inquiry.

Anticipated Outputs

Peer-reviewed manuscript; report describing cross-sector solutions to food insecurity and food waste mitigation; outreach products (e.g., exhibit, podcast, op-eds, public media) that capture community members' voices 

Student Opportunities

Ideally, this team will include 4 graduate students and 10 undergraduate students with backgrounds or interests in community-engaged research, social determinants of health, health/healthcare policy, economics, medicine, nutrition, global public health, sociology, law, social sciences, and/or food systems. Team members should also be interested in applying intersectionality lenses to concepts such as inequality, immigration, disability, race(ism), ethnic/cultural studies and/or settler-colonialism in food systems and nutrition policy. Ideally, this team will include students from diverse cultural and linguistic backgrounds, including individuals with Spanish and Dari/Pashto language fluency.

All team members will learn how to conduct literature reviews, and team meetings will include primers on understanding local food systems, community-engaged research methods, health impacts of food insecurity, governmental policy impact upon food insecurity, food waste mitigation, health communication, health systems thinking and the social determinants of health. 

Through subgroup-specific work, undergraduate students will gain skills in collecting and interpreting qualitative data (e.g., surveys or interviews) and reporting results, conducting literature searches, carrying out community-engaged research methods, health communication, social drivers of health, systems thinking, and scholarly writing for publication. Graduate students will hone their skills in teaching, research appraisal, community-engaged research methods, health communication, social drivers of health, project management, systems thinking, and scholarly writing for publication.

All team members will meet together once a week; subgroups will also meet once per week. One graduate student team member will lead each subgroup with the support of one undergraduate student project manager to help maintain momentum and ensure progress on outputs. This project manager will be selected by the team leaders.

Timing

Fall 2024 – Spring 2025

  • Fall 2024: Learn research methods and review prior team’s data; refine team charter; finalize research questions, logic model and project plan; complete data analysis and initiate additional data collection; select and convene community advisory board
  • Spring 2025: Finish data collection and iterative analysis; learn health communication methods and data visualization; develop reports and dissemination strategies; convene community advisory board and formalize board structure

Crediting

Academic credit available for fall and spring semesters

See related team Tracing the Roots of Nutrition Access, Implementation and Policy (2023-2024).

Food.

Team Leaders

  • Scott Brummel, Science & Society
  • Ryan Kane, School of Medicine-Medicine: General Internal Medicine
  • Hannah Lane, School of Medicine-Population Health Sciences
  • Norbert Wilson, Divinity School|Sanford School of Public Policy

/graduate Team Members

  • Isabella Bouklas, Sociology-PHD
  • Noah Gibson, Sociology-PHD, Sociology-AM

/yfaculty/staff Team Members

  • Saskia Cornes, Franklin Humanities Institute
  • Elaijah Lapay, Trinity College of Arts and Sciences–Undergraduate Student
  • Scarlet Soriano, Duke University Health System-Duke Health and Well-Being