Tracing the Roots of Nutrition Access: University to the Triangle (2025-2026)

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

Building on the work of a previous team, this project will aim to identify community-driven, cross-sector strategies to increase food access, reduce food waste and improve food security for Triangle residents. Priorities will include food waste reduction, streamlining communication across sectors and capitalizing on Duke Health and N.C. Medicaid initiatives.

Team members will divide into two subteams focused on community organizations and Triangle residents. The “organizations” subteam will focus on strengthening connections between Duke Health and other community organizations. Team members will reach out to 400 community organizations in the Triangle, draw upon the data collected in previous years and collect additional data with Duke and other organizational personnel. Team members 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” subteam will focus on engaging community members in developing action plans to carry out identified strategies. Team members will leverage organizational relationships formed during 2024-2025 to recruit community members from across the Triangle, systematically elicit their input and recruit approximately 10 organizations to serve as a Community Advisory Board moving forward.

Throughout this work, the team 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 and there will be strong focus on defining Duke’s roles and responsibilities within community-driven solutions.

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 subteam-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.

There will be journal club/work sessions for each subteam and weekly meetings for everyone. One graduate student will lead each subteam with the support of one undergraduate student project manager.

This project includes a summer component for a graduate student who wants to work on project plan, IRB, and community partnership development.

Timing

Summer 2025 – Spring 2026

• Summer 2025 (optional):  Graduate student: Build syllabus, identify key partners and prepare IRB based on anticipated methods
• Fall 2025: Teach key background content and review prior data; refine team charter; finalize research questions, logic model and project plan
• Spring 2026: Finish data collection and iterative analysis; learn health communication methods and data visualization; develop reports and dissemination strategies

Crediting

Academic credit available for fall and spring semesters

See earlier related team, Tracing the Roots of Nutrition Access: University to Community (2024-2025).