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Article

Building Bobcat Bounty: The Design, Implementation, and Initial Evaluation of a Student-Led Food Pantry to Address College Student Food Insecurity †

by
Lesli Biediger-Friedman
1,
Cassandra M. Johnson
1,*,
Hannah Thornton
1,2 and
Marissa Buckley
1,3
1
Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, 601 University Drive, San Marcos, TX 78666, USA
2
Sustainable Food Center, Building C, 2921 E 17th St, Austin, TX 78702, USA
3
University Health Services, University of Texas at Austin, 100 West Dean Keeton, Austin, TX 78712, USA
*
Author to whom correspondence should be addressed.
This study was completed while Marissa Buckley and Hannah Thornton were at Texas State University.
Dietetics 2024, 3(4), 389-408; https://doi.org/10.3390/dietetics3040029
Submission received: 29 June 2024 / Revised: 27 August 2024 / Accepted: 18 September 2024 / Published: 25 September 2024

Abstract

:
Background: Campus food pantries can address food insecurity among college students, but little is known about how to create a model at a Hispanic-Serving Institution (HSI). This study evaluated a food pantry, which was part of a learning community for dietetics and nutrition students at an HSI. Methods: The Bobcat Bounty food pantry was created and evaluated using a mixed-methods approach, including food inventories before and after each pantry, observations of operations (written by volunteers at each pantry, n = 27), new client intake (n = 947) and client satisfaction surveys (n = 267)), and stakeholder interviews (n = 16 after the first year of implementation). Descriptive statistics and t-tests were used for quantitative analyses, and qualitative analyses included interview transcript coding and peer debriefing. Results: Here, 2 faculty members and a team of 19 students/dietetic interns operated the weekly campus food pantry, which served 3567 students and distributed 33,000 pounds of food. Client satisfaction surveys provided evidence for addressing food insecurity for college students. Volunteers and stakeholders generated insights for operational evolution and sustainability of the food pantry. Conclusions: Results highlighted key factors for initial efficacy and strategies for long-term success. Findings may be incorporated by dietetic education and training programs to provide research-focused and culturally relevant experiential learning.

1. Introduction

College and university students (henceforth described as “college students”) are a unique population in the life course, who navigate a shared on-campus environment and experience academic, social, and financial demands, including food insecurity. The U.S. Department of Agriculture (USDA) defines food insecurity as having consistent, dependable access to enough food for an active and healthy life [1]. In the Fall of 2018, the Hope Center for College, Community, and Justice (Hope Center) conducted a large national survey of food insecurity among U.S. college students from two- and four-year institutions and reported that 48% of college students at four-year universities experienced food insecurity in the survey period [2]. Across all institutions, the Hope Center survey found that college students who were financially independent, first-generation college students, and individuals self-identifying as a non-white race reported higher food insecurity compared to their counterparts [2]. In addition, the American College Health Association (ACHA) recognized the importance of food insecurity among college students at a Fall 2018 summit [3,4]. Systematic literature reviews from that time also estimated food insecurity prevalence to be between 35% and 43% for U.S. college students [5,6]. Though estimates have varied, food insecurity among college students has been much higher than the general population of U.S. households (e.g., based on USDA calculations, prevalence of about 11–12% depending on the year) [7]. Previous research studies have documented evidence of the negative impacts of food insecurity on mental health, such as reduced psychosocial health [8], increased psychological distress and lower perceived mental health status [9], and suboptimal academic performance among U.S. college students [8]. For example, the Hope Center findings showed that the students experiencing food insecurity reported more C grades on their transcripts compared to food-secure students [2].
To address food insecurity among college students, many colleges have created campus food pantries. The Hope Center and the College and University Food Bank Alliance (CUFBA) collaboratively surveyed campus food pantries (n = 217 campus pantries in 40 states) and reported on key operational challenges with funding, food, and volunteers [10]. Results showed that 40% of respondents identified insufficient funding, 25% insufficient food, and 17% insufficient personnel (or volunteers) as barriers to food pantry operations [10]. Their analysis indicated that the most common priority was sustainability; that is, ensuring continuity in operations [10]. However, there has been very limited research on the design, implementation, and evaluation of a student-run campus food pantry at a Hispanic-Serving Institution (HSI). A systematic literature review concluded that only 22% of peer-reviewed studies were completed at Minority Serving Institutions (MSIs) [5], including HSIs. Goldrick-Rab and Cady submitted a case study to the ERIC database for the “No Excuses Poverty Initiative”, which included an on-campus food pantry at a small HSI in Texas [11], and there has been one previous study of a campus food pantry at a large HSI in Texas [3]. Based on the authors’ knowledge, there is no published study describing a campus food pantry integrated into a nutrition and dietetics learning community at an HSI. Texas State University (TXST) is a very large HSI in Central Texas, with more than 38,000 students at the time of this study [12]. The purpose of this study was to report on the initial evaluation of a student-led, client-choice food pantry, called Bobcat Bounty, for addressing food insecurity among college students at a very large HSI in Texas. Findings can inform future policy, systems, and environmental changes to address food insecurity for college students at HSIs specifically, or at MSIs more broadly.

2. Materials and Methods

2.1. Context

In collaboration with a Steering Committee and their students, two faculty members (LBF and HT) co-created Bobcat Bounty as part of a Food Security Learning Community (FSLC). According to Gabelnick and colleagues, a learning community is defined as “any one of a variety of curricular structures that link together several existing courses, or restructure the curricular material entirely, so that students have opportunities for deeper understanding and integration of the material they are learning, and more interaction with one another and their teachers as fellow participants in the learning process” (p. 19) [13]. Learning communities foster collaborative inquiry about complex topics [13]. Undergraduate learning communities have been shown to promote student retention, engagement, and knowledge integration, as well as cultural responsiveness [14,15]. While research on graduate-level learning communities is limited, evidence demonstrates the value of learning communities in supporting professional development [16].
The Nutrition and Foods Program at TXST offers undergraduate and graduate nutrition programs, including an accredited didactic dietetics program and a dietetic internship for graduate and post-graduate students pursuing the Registered Dietitian Nutritionist (RDN) credential. The FSLC participants included undergraduate students, graduate research assistants, dietetic interns in the Nutrition and Foods Program (n = 19 total), and the two founding faculty members (LBF and HT). The Steering Committee originally included 8 people, who were faculty and staff, and served to connect faculty and students to the community of interest. The faculty directors are scholars of food and nutrition security, and the learning community was created to establish an experiential learning laboratory for nutrition students to create, implement, and evaluate solutions to food security. The initial goals of the FSLC were to identify problems of global, national, state, local, and institutional food security and explore novel policy, systems, and environmental solutions to those problems (https://dieteticinternship.fcs.txst.edu/who-we-are/food-security-learning-community.html, accessed on 29 June 2024). After the needs assessment, described next, the FSLC decided to focus on a campus food pantry.
Bobcat Bounty served as a research laboratory for the FSLC. Faculty leveraged the learning community to provide experiential learning and hands-on research experiences to students. Bobcat Bounty was designed to benefit FSLC students who were managing, operating, and evaluating Bobcat Bounty and student clients who were receiving nutritious groceries and nutrition education through the campus food pantry. In addition to the management and operations of Bobcat Bounty, FSLC activities included weekly meetings, orientation (start of semester), a celebration event (end of semester), and a student research project showcase.

2.2. Needs Assessment

In its first year, between 2016 and 2017, FSLC students collected quantitative and qualitative data as part of a needs assessment. Faculty co-founders trained and guided students in developing instruments for the needs assessment, including focus groups and an online survey, with the U.S. Household Food Security Survey Module (FSSM) short form to assess food security status [17]. Learning community students who were enrolled in a graduate course conducted the needs assessment of enrolled TXST students. Emails were sent out to approximately 5000 enrolled students across all colleges at the university. Their report showed that 40.6% of survey respondents (n = 549 of n = 1353 total) had experienced a form of food insecurity, either low (20.8%) or very low (19.8%) food insecurity, and that students were accessing food assistance programs, including WIC (Special Supplemental Nutrition Assistance Program for Women, Infants, and Children) and SNAP (Supplemental Nutrition Assistance Program), to mitigate food insecurity (unpublished data). Throughout the process, the faculty led the students to explore evidence-based strategies to address assessment findings. The needs assessment demonstrated need and interest for an on-campus food pantry and informed the pantry implementation model and the logic model. Both models were developed in collaboration with FSLC students, faculty, and community stakeholders (Figure 1, logic model). Additional details about the two models are available by request from the first author (LBF).

2.3. The Bobcat Bounty Model

At the time of creation and currently, Bobcat Bounty is an academic model, or a campus food pantry that is student-led and faculty-mentored. Figure 1 presents the initial logic model for Bobcat Bounty, with inputs, activities, outputs, and expected outcomes. Inputs included funding, marketing, food goods, supplies, and people/partners. For example, internal funding for the FSLC, future grants, and human capital, facilities, and supplies were required to lead (e.g., FLSC faculty), manage, and operate (e.g., FSLC students and interns) Bobcat Bounty. The FSLC co-founders/faculty directors created a Steering Committee, with members from different community organizations off campus, and built relationships with faculty and staff on campus, who could provide institutional support for a new food pantry. As designed, Bobcat Bounty was supported through ongoing donations from a local food bank. FSLC students managed and operated the food pantry. The model engaged interns (undergraduate students completing a senior-level career exploration course for course credit), graduate/post-graduate students completing a dietetic internship, graduate students taking courses for the master’s in nutrition program, and a variety of student volunteers from across the university. Examples of student-led activities included setting-up/breaking down the pop-up food pantry, transporting food from a local food bank, checking temperatures and monitoring food safety logs, stocking and inventory management, developing media campaigns and marketing, and collecting programmatic data and analyzing data for monitoring and evaluation. Activities were defined as food distributions, food drives, nutrition education, and staffing. Additional examples of outputs were weekly food distribution, nutrition education, marketing through social media, printed flyers, and campus events. Nutrition education was a key activity for Bobcat Bounty. Dietetic interns created nutrition education materials and shared materials with clients as part of the requirements of the dietetic internship. Outputs included food distribution, nutrition education, marketing, and evaluation, which are described in the data collection section of this manuscript. Expected outcomes were shown for the first semester, first year, and beyond. The Bobcat Bounty model integrated a feedback loop of assessment, diagnosis, intervention, and monitoring and evaluation, based on the Nutrition Care Process, for continuous improvement [18,19].

2.4. Study Design

This study is an initial evaluation of the Bobcat Bounty food pantry, based on quantitative and qualitative data collected at the end of the first year of implementation. The TXST Institutional Review Board (IRB) approved this study on 11 December 2018 (IRB protocol number #6228). A version of this manuscript has been published in a master’s thesis in the Texas State Digital Collections [20] and conference abstract [21].

2.5. Data Collection Procedures

All data were collected between the Spring semester of 2018 and Spring semester of 2019.

2.5.1. New Client Intake and Satisfaction Survey

There were two surveys to evaluate student usage: (1) a new client intake survey and (2) a client satisfaction survey. A convenience sample was used for both surveys. Clients who decided to complete surveys provided informed consent, and survey participation was not required to be able to shop with Bobcat Bounty. The new client intake survey provided baseline data about participants. The new client intake survey included 18 items related to sociodemographic data, a measure of food security (the U.S. FSSM) [17], and nutrition knowledge. The client satisfaction survey had 40 items and assessed clients’ perceptions of food pantry operations in addition to the U.S. FSSM for food security status. Surveys were administered online using Qualtrics and exported into Microsoft® Excel (version 16 for 2019/2020). After completing the client satisfaction survey, clients were entered into a raffle for a kitchen appliance or similar item.

2.5.2. Volunteer Observations and Food Inventory Protocol

On a weekly basis, student volunteers collected data on student usage and item inventory [22] using observations and through a food inventory protocol. Data were used to understand food pantry operations. All student volunteers were trained to make and record observations from food pantry setup and during the first 30 min of operations, final pantry operations, and clean-up. Volunteers also wrote general observations, insights, or reflections about that week’s operations. All observations were written by hand in a Bobcat Bounty observations notebook. A graduate research assistant (MB) transcribed handwritten observations.
The local food bank provided data on the amount and type of food for food pantry operations. Before and after each pantry, volunteers used a scale to weigh foods in different food categories, including fruits, vegetables, dairy, protein, miscellaneous, and sweets. Within a food group category, perishable and non-perishable foods were inventoried separately. Each week, volunteers recorded the total weight of food by category using a Qualtrics survey. Quantitative data were exported into an Excel file. The food inventory protocol generated data on food distribution on a weekly and per semester basis.
In September of 2018, volunteers were trained in the Food Assortment Scoring Tool in food pantries (FAST) inventory system and implemented the FAST protocol [23]. The FAST assessment tool was used to determine the nutritional quality of foods [23] distributed through Bobcat Bounty. FAST includes 13 food group categories: fresh fruits and vegetables; processed fruits and vegetables; whole grains; non-whole grains; vegetable proteins; meat, poultry, fish, and eggs; high processed meat; mixed meals and side dishes; dairy; condiments, baking and cooking; baby food and infant formula; beverages; desserts and snacks [23]. A higher score indicated greater nutritional value. Volunteers and staff weighed and categorized foods each week. A data report was shared with the food bank partner and the Steering Committee each semester. The team used data from FAST to assess changes over time [23] and inform decisions about which food categories to focus on for distribution and campaigns for fundraising and food drives. Overall, the FAST tool helped promote foods and dietary patterns outlined in the Dietary Guidelines for Americans [24].

2.5.3. Interviews

Interviews were completed at the end of the first year of implementation of Bobcat Bounty. Interviews explored the role of public health champions in the sustainability or long-term support of Bobcat Bounty, as a student-led, client-choice food pantry. A research assistant (MB) developed an interview guide based on Social Cognitive Theory, the Health Belief Model, the Precede-Proceed Model, and the Socioecological Model [25]. The interview guide included open questions about food insecurity, health champions, and sustainability, including personal, behavioral, and environmental factors (SCT and SEM), perceived benefits and barriers (HBM), and predisposing, reinforcing, and enabling factors (PPM) related to addressing food insecurity on campus and serving as a health champion. Predisposing factors consisted of attitudes, beliefs, values, and motivating factors. Self-efficacy, support, and accessibility functioned as enabling factors that act as facilitators. Reinforcing behaviors included rewards or incentives that matter for repetition or continuation. Probes or prompts were used to elicit additional information from interview participants. A modified interview guide is shown in Supplementary Figure S1.
Faculty, staff, and students working with Bobcat Bounty and the FSLC were invited to participate in an interview. Because the food pantry was new, there was no predetermined minimum number of interview participants. Interested participants completed informed consent and a sociodemographic survey online using Qualtrics. A research assistant (MB) conducted and audio-recorded interviews remotely using Zoom. She used an interview guide to facilitate the semi-structured interview and collect data systematically across participants. Each interview was designed to last 30 to 45 min. Interview recordings were transcribed for analysis.

2.6. Evaluation and Data Analysis

The initial evaluation of Bobcat Bounty was based on the RE-AIM framework of evaluation, which includes reach, effectiveness, adoption, implementation, and maintenance [26]. Quantitative data from surveys and food inventories and qualitative data from observations and stakeholder interviews were used for evaluation. Reach was assessed using an electronic sign-in from weekly food pantries and sociodemographic surveys of new clients in the first year. Effectiveness was assessed through food inventories, client satisfaction surveys, and stakeholder interviews. Adoption, or food pantry operations, was examined using volunteer observations and stakeholder interviews. Implementation and maintenance were evaluated with qualitative data from stakeholder interviews.
For the quantitative analysis, food security status was determined using The Guide, or the USDA protocol for scoring the U.S. FSSM short form with six items [17]. Statistical tests were used to compare differences in sociodemographic characteristics by food security status. Likert-scale categorical variables were analyzed via chi-square tests. All statistical analyses were completed using SPSS (Released 2016. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY, USA: IBM Corp). The level of significance (p) was less than 0.05.
For the qualitative analysis, a team analyzed data from food pantry observations and interviews with potential health champions. Trained undergraduate and graduate research assistants reviewed observation and interview data and wrote initial memos. Peer debriefing was used to discuss observations between co-founders of Bobcat Bounty and student research assistants. An iterative process was used to create and develop a codebook used for additional qualitative analysis. Codes reflected constructs based on the theories used to develop the interview guide and initial observations based on reviewing and discussing the qualitative data. Two coders applied codes independently to interviews using NVivo qualitative data analysis software (Released 2017. Version 12. QSR International: Burlington, MA, USA). A third or master coder (MB) reviewed coding and discussed disagreements in coding. The team worked to resolve coding disagreements. The inter-rater reliability of the interview coding was calculated by dividing the total number of agreements for all codes by the total number of codes [27]. The overall inter-rater reliability score was 86.4%.

3. Results

3.1. Overview

The Bobcat Bounty model uses a student-led, client-choice food pantry to address food insecurity on campus. During the first year of Bobcat Bounty, there were 5 undergraduate students, 2 graduate students, and 12 dietetic interns engaged in the FSLC. Internal funding covered start-up and operation costs for the FSLC and Bobcat Bounty food pantry, which were limited to faculty salary for the Summer term. Food was provided by a local food bank and purchased through charitable donations to an account set up through university advancement. A team of students and interns set up, operated, and broke down the pop-up campus food pantry for one day each week (Thursday 5–7 pm) in the Foods Lab in the Nutrition and Foods building. Faculty co-founders/directors engaged with stakeholder members of the Steering Committee in regular meetings. The Steering Committee included four faculty from two colleges across campus, four staff, and at the time of this publication, six of the original members (75%) remain. The next sections describe findings for each component of the RE-AIM framework [22,26].

3.2. Reach

Using the RE-AIM framework, reach, or the total number of client participants, was estimated to be 3567 clients in the first year (4643 interactions with non-unique participants). Table 1 presents results from the intake survey of first-time clients (n = 947 respondents). Most respondents were categorized as food insecure (65%, n = 619) and identified as female students (64%, n = 607). About 45% of all respondents were first-generation college students (n = 424), and 39% (n = 370) self-reported Hispanic ethnicity. Graduate students were a minority of respondents (about 4%, n = 35). Among all respondents, clients utilized Bobcat Bounty for themselves (35%) and parents/relatives (18%), and a combination of recipients (26%). New clients reported different reasons for participating in the food pantry, including dealing with hunger (21%), accessing healthy foods (17%), or a combination of reasons (23%).

3.3. Effectiveness

In its first year, Bobcat Bounty distributed more than 33,000 pounds of food. Figure 2 shows the proportion by weight for each food group category based on the total food distributed between Summer of 2018 and Spring of 2019. The weights of the fruits and vegetables, grains, and proteins categories represented about 50%, 19%, and 21% of all food distributed. Details on distribution of food categories are shown in Supplementary Table S1. Between the first semester and last semester, the food pantry distributed more fruits and vegetables compared to other categories. Trends in nutritional quality, using the FAST tool, showed that nutrition quality ranged from 56.0 to 65.4 during the Fall of 2019. Observational data highlighted the positive impact Bobcat Bounty had for students, as volunteers wrote about students being “excited to see a pantry on campus”. Qualitative data from stakeholders also provided evidence for the effectiveness of the new campus pantry.
Primarily, findings for effectiveness were from client satisfaction surveys. Table 2 presents data from the client satisfaction surveys by semester (n = 267). In terms of overall satisfaction, respondents indicated a high level of satisfaction with the healthfulness (50% vs. 87.8%), variety (54.5% vs. 83.7%), and quality of the food offered (36.4% vs. 82.7%), with higher scores in the Spring of 2019 compared to the Summer of 2018. Regarding pantry operations, respondents reported higher scores for satisfaction with the check-in process (50% vs. 86.7%) and overall services (54.5% vs. 91.8%) between the launch and one year later. Satisfaction surveys also provided preliminary evidence of the impacts of a campus food pantry. For example, respondents indicated that by receiving food from Bobcat Bounty, they were able to put money toward other necessities (83.7%), feel less financial strain (89.8%) and less stress and anxiety (74.5%) in the Spring of 2019.

3.4. Adoption

Undergraduate students, graduate students, and dietetic interns from the FLSC managed and operated the weekly food pantry. A client-choice model allowed clients to select their foods from available food stocks, and this approach aligned with a rights-based approach to address food insecurity [28]. The food pantry utilized a first in, first out flow. Food distribution was available to any member of the university community, including students, staff, or faculty. Since its launch, Bobcat Bounty has maintained weekly operations during the Fall and Spring semesters, and intermittently during the Summers. Details on student/dietetic intern leadership for the management and operations of Bobcat Bounty are available from the first author.

3.5. Implementation

During the first semester of operations, staffing was made possible mostly through students participating for course credit and volunteer labor. There was no paid permanent staff member overseeing the food pantry. The two faculty co-founders/directors served pro bono and counted their labor as institutional service. They provided leadership, training, and mentoring to interns and volunteers involved with food pantry operations. In year 2, funding was received from the university for one paid nutrition graduate student who worked 20 h per week managing operations and volunteers. In subsequent years, funding was secured through crowd sourcing and increased to include stipends for undergraduate students. Additional funding for students/interns came from an internal grant for college learning communities. Each week, the number of paid students and volunteers ranged from two to eight.
Food sourcing required ongoing problem solving on the part of faculty directors. While food was occasionally purchased from local grocery stores, a local food bank provided most of the perishable and non-perishable food for the weekly distributions. The types and amounts of food varied from week to week based on food bank inventory and demand. When the food bank supply was low, the student staff shopped for additional food at a local grocery store with funds obtained through crowd sourcing. On the day of pantry operations, students picked up food from a local food bank, completed food safety inspections, transported the food to campus, unloaded and weighed the food, and set up the pantry. Perishable foods were transported in coolers, and temperature checks were conducted at pick-up and throughout transfer. All foods were taken to the campus Foods Lab, a large laboratory for nutrition and foods courses with eight fully equipped cooking stations and large tabletops for teaching students in courses, functioning as counters or workspaces. While the Foods Lab contained refrigerators, freezers, and storage spaces, those were dedicated to classes. Pantry foods were stored in coolers (perishables) and on tabletops (non-perishables), with students continuing temperature checks and restocking the pantry throughout operations. Student staff sorted, inspected, and weighed the foods and documented the inventory before storing food appropriately based on protocols for food safety and food handling. No food storage issues occurred during the first year. All students completed a Food Handler’s Certification course offered through the university, and student interns were required to have completed the Food Production Management course prior to their internship.
Bobcat Bounty operated as a client-choice pantry, meaning there were no restrictions or requirements for the type of food shoppers could take home. Prior to the opening of each pantry, students divided the total count of items available for distribution by the total number of anticipated shoppers and set a maximum number of items per shopper. To engender a spirit of trust and community, shopper selections, including adherence to the item limit, were not policed. During food distribution, each shopper filled a bag (or bags, depending on food inventory) with a specified number of food items in each category. Healthier foods (e.g., fruits and vegetables) were displayed earlier in the shopping route compared to foods in other categories (e.g., desserts). Student staff helped shoppers move through the market appropriately.
Key factors related to implementation were adequate staff and food supply for food distribution. Volunteer observations demonstrated positive and negative aspects of food distribution. For example, observations showed that clients desired perishable proteins, such as previously frozen or fresh meat, but that the food supply of perishable proteins was sometimes limited. Analysis of observation data highlighted several themes, including the first foods to go, or the desired food groups running out quickly. When there was a greater food supply, some volunteers recorded that the amount of food enabled clients who shopped later to obtain enough food in the preferred food group categories: fresh fruits, fresh vegetables, and perishable (fresh and frozen) proteins or meats. Based on findings from observation data, a new policy was created that limited items for the following food group categories: perishable proteins, fresh fruits, and fresh vegetables. This adaptation helped ensure that the pantry could accommodate demand, while considering limited resources. Using data from volunteer observations and peer debriefings in FSLC meetings, other modifications were made in the first year. For example, a back-stock food closet was maintained with non-perishable foods, which were either donated or purchased, which provided additional food when the demand from shoppers was greater than the supply received from the food bank. Adaptions were similar to those in another RE-AIM paper on a campus food pantry [22].

3.6. Maintenance

Findings for maintenance, or the sustainability of the campus food pantry, were based on qualitative data from stakeholder interviews. Participants included 8 faculty/staff and 8 students (n = 16 total), who were Steering Committee members (n = 5) and Bobcat Bounty staff (n = 6). Regarding race and ethnicity, interview participants self-identified as white, non-Hispanic (n = 7), Hispanic (n = 7), or Black (n = 2). Table 3 shows key quotations by theme.
Calls to action were defined as faculty/staff observing students’ challenges with food insecurity and hunger, or students describing their lived experiences and stakeholders’ desire for involvement. Participants also described several perceived benefits, such as the FSLC in building community, Bobcat Bounty for cultivating belonging (or ensuring an inclusive and welcoming environment for staff and clients), and helping others and making a difference (satisfaction). For example, one participant, who was a student and Bobcat Bounty staff member, described how Bobcat Bounty created a sense of belonging: “I started grad school at Texas State, and I just felt very inadequate, but overwhelmed like I thought I was just gonna fail all my classes and literally, was not going to make it through. I guess just having Bobcat Bounty and having the community that I showed up [to] every Thursday to the Food Security Learning Community (FSLC) meeting and… a group of people at Texas State to belong to and to check in with”. Interviews highlighted self-efficacy, such as when participants confidently described taking actions that supported Bobcat Bounty, such as soliciting charitable donations. They described environmental barriers and facilitators to implementation, such as relying on word of mouth or posted print flyers at selected campus locations, rather than more resource-intensive marketing efforts to increase awareness on and off campus. Additional concerns were related to the location and operating hours. For example, interview participants shared concerns about the location of Bobcat Bounty, because the food pantry was not held in a central location on campus and there was limited parking available before, during, and after pantry operations. Participants mentioned barriers to accessing Bobcat Bounty as a challenge for implementation and maintenance. There were concerns about the food pantry hours because the pantry was only open one day a week, on Thursdays, between 5 and 7 pm. One participant said: “Although it is on campus, a lot of people talk about, ‘Oh well, it’s on the end of campus’. or ‘It’s all the way up hill’, or you know, ‘xyz’. And maybe even offering it on more days than just Thursdays, because maybe some people may not be able to attend on Thursdays”. Lastly, stakeholders discussed the need for institutional support at the university level for long-term sustainability. Interview participants specifically described ways to address barriers and transform them into facilitators of long-term success, such as needing a permanent and central location, such as in the student center and near a bus stop. For example, a stakeholder shared: “Making it [Bobcat Bounty] part of our culture too… There has been some positive feedback… so creating traction and momentum through that to help bring awareness and then… make it [a] more sustainable part of the infrastructure of our campus community”.

4. Discussion

There were three key findings. First, this student-led, client-choice campus food pantry served the intended priority population of students; that is, students who were financially independent, first-generation college students, students self-identifying as non-white, and students more likely to be dealing with food insecurity. Bobcat Bounty clients reported a high degree of satisfaction related to food pantry operations and food distribution, and volunteer observations provided support for a positive environment. Second, volunteer labor of faculty and students in leadership, management, and operations were critical for launch and continued operations. Similar findings were reported in another study [3] and in a 2018 national survey of campus food pantries, where most pantries benefited from involving students (70%), staff (82%), faculty (54%), and community partners (41%) [10]. Previous studies have described the importance of food bank volunteers in creating positive socioemotional environments for clients [29]. Third, this study showed the important role of health champions in the launch and continued success of a campus food pantry. Stakeholders described reasons for their motivation and personal benefits for involvement with Bobcat Bounty, and these factors may help faculty, staff, and university leaders identify potential people to help establish and maintain a campus food pantry [22]. Findings are generally supported by the Swipe Out Hunger CUFBA 2018 report, which identified a permanent central location, support, and funding as challenges to campus food pantries [10]. Data from this study highlighted similar challenges. The success of Bobcat Bounty can be summed up by the adage “where there’s a will, there’s a way”. The faculty and initial team of students began work without buy-in or investment from the university. The team began by utilizing the resources that were immediately available and leveraging their own desires to make a difference to fill in the gaps. For long-term sustainability, policy changes or other environmental supports are needed to ensure sufficient funding, food, and volunteers [10]. A couple of points require additional discussion.
TXST is a very large HSI, defined by enrollment of at least 20,000 undergraduates [10], with a large proportion of first-generation college students (42% in the Fall of 2018), or incoming first-year undergraduate students whose parents or primary caretakers did not earn a degree from a four-year college or university [30]. At the same time, TXST has a large proportion of Latino/a/e (37.1% in Fall 2018) compared to white (45.3%) students [31]. First-generation college students and students who self-identify as non-white race or ethnicity experience greater food insecurity compared to their counterparts [32]. College students are a heterogeneous population comprised of first-generation college students, as well as racial and ethnic minority students, including international students; military and veteran students; students who are parents (or have dependents); and students from sexual and gender minority groups who have not been intentionally included in related research [32]. College students are also one subgroup of adolescent and young adults (AYAs), defined as individuals between 15 and 39 years [33], and an important life course population for public health. Future research will benefit by engaging with diverse groups of college students to understand their experiences, using mixed methods approaches, and collaboratively advancing solutions for food insecurity.
The Bobcat Bounty food pantry is an academic model, a student-led and faculty-mentored model, built into a learning community for nutrition and dietetics students. A campus food pantry at the University of Texas San Antonio (UTSA), another large HSI in Texas, utilized a very different model [3]. At TXST, Bobcat Bounty faculty directors guided food pantry operations, including training and supervising students, in addition to their responsibilities for research, teaching, and service, and without paid permanent staff dedicated to the food pantry. In the first year, Bobcat Bounty had one paid graduate student/dietetic intern and one undergraduate student that received a stipend (and no paid student staff for the first semester). In contrast, UTSA had university funding for permanent staff who oversaw the food pantry, along with a paid graduate student and three student workers [3]. There were other key differences, too. Bobcat Bounty operated a food pantry one day per week for 2 h, while the UTSA food pantry operated three days per week for 12 h before expanding hours to four days per week for 16 h [3]. However, the UTSA food pantry provided less food to students compared to Bobcat Bounty: students with a valid identification card self-selected up to five items per food pantry visit [3]. Bobcat Bounty clients obtained different items from several categories of food groups and provided each student with a bag or bags of food weekly. Both food pantries have benefited from a collaborative relationship with a local food bank. The UTSA study mentioned the lack of adequate storage, especially for perishable foods such as fresh fruits and vegetables, and lack of protocols for handling perishable foods as barriers for a campus food pantry [3]. Bobcat Bounty was able to leverage the unique knowledge of nutrition faculty and students to overcome this barrier without requiring an investment of infrastructure. For example, TXST students, majoring in nutrition and foods, completed training in food handling through coursework, which bolstered the knowledge and skills of the interns and volunteers operating. From the conception through the planning and operations of Bobcat Bounty, it was clear that students at all levels were highly motivated to help other students experiencing food insecurity. The Bobcat Bounty model provided students with a path to channel this motivation into action and positive impact. Understanding each university’s unique strengths and challenges is essential to creating an effective model.

Implications

This study has important implications for research, practice, and policy. First, preliminary evaluation demonstrated effectiveness and key factors related to the initial success of Bobcat Bounty, but additional policy changes or environmental support, including institutional support to transition from a pop-up to a university-sustained permanent food pantry, will be essential for long-term maintenance. After the roll-back of pandemic-era policies, food insecurity has spiked for the general population (e.g., 12.8% in 2022 vs. 11.1% in 2018 based on USDA calculations) [7]. Though there is no university-wide food insecurity assessment, it is likely that food insecurity on campus at TXST is higher than pre-pandemic levels (e.g., 40.6%, based on the needs assessment in 2017). Other universities have supported campus food pantries with funded staff and student positions, including HSIs in Texas, even though donations and volunteer labor were still required to maintain food pantry operations [3,11]. Some literature exists related to the role of campus food pantries for food security in a peri-pandemic period [34,35]. Future research needs to consider the most effective model for addressing students’ needs in a sustainable way.
Second, because the Bobcat Bounty model worked through a FSLC for nutrition and dietetic students, this study offers implications for dietetics education, training, and practice. Considering the workforce development needs within dietetics, specifically to prepare students to serve varied populations of individuals in community and public health settings [36,37], findings from this study can inform the creation of additional learning communities, especially at HSIs, MSIs, and universities serving distinct groups of students, including first-generation students, students who are active military or veterans, and students who are parents. By exposing students to significant issues facing their communities and supporting them as they problem solve to address those issues, learning communities can inspire a new generation of nutrition and dietetics students to practice in the field of community/public health nutrition. In addition, learning communities provide mentorship, which may help students to overcome barriers to academic success, including not feeling a sense of belonging or inadequate knowledge related to professional development [38]. Thornton and colleagues have outlined a new framework for educating dietetics students based on cultural humility, with implications for training and mentoring of dietetics students [38].
Third, this study’s findings showed that 65% of surveyed students were experiencing food insecurity at this HSI in Texas, which is much higher compared to estimates from previous studies (i.e., 21% at a university in Hawaii [39], nearly 25% at a large urban university in Massachusetts [40], and 59% at a rural university in Oregon [41]), and compared to an average food insecurity prevalence of 32.9% for U.S. studies from a systematic literature review [5]. Going forward, HSIs specifically and MSIs generally may consider opportunities to integrate permanent campus food pantries, as part of a holistic approach to supporting the well-being and success of all students. As the cost of living and cost of college continue to increase, more research is also warranted to understand how to equitably support students, including the creation of person-centered training and mentoring initiatives [38,42].
The study had limitations. Data were cross-sectional and from the first year of implementation, with a convenience sample of survey respondents and stakeholder interview participants. The convenience sample of client intake and participation satisfaction surveys represented the student population at the time in terms of race/ethnicity, first-generation college student status, and other key characteristics. However, the university was not collecting data about food insecurity at the time of the study. The 2018 national report of campus food pantries also reported that only 39% of campus pantries knew of food insecurity measurement efforts [10]. Advocacy is needed to support food insecurity monitoring among college students. This study was not able to consider issues of social desirability or stigma in survey responses, which may have influenced how student clients responded to surveys. Interviews were completed with stakeholders, faculty, staff, and students who were already involved with Bobcat Bounty, and do not necessarily represent the perspective of all stakeholders involved in campus food insecurity efforts. The current study reported on the initial evaluation with data collected between 2018 and 2019, but additional data have been collected from 2019 through present, even during the COVID-19 pandemic. Findings from forthcoming evaluation studies will provide important insights into the effectiveness and sustainability of Bobcat Bounty. Future analyses of longitudinal data will be required to demonstrate any effect of Bobcat Bounty on food insecurity for a representative sample of current students. In addition, the Bobcat Bounty model is unique as a student-led, faculty-mentored food pantry embedded into a learning community at an HSI. Findings are not generalizable to all campus food pantries, but findings may inform other models.
Strengths of this study included use of a community-engaged research and mixed-methods approach for evaluation and integration of the RE-AIM framework into evaluation activities [26], which has been applied in a previous evaluation of a campus food pantry at a large Midwest university [22]. There are also strengths of the Bobcat Bounty logic model, informed by theories and the Nutrition Care Process [18] and embedded into a FSLC for nutrition and dietetic students. Considering the limited number of evaluation studies for campus food pantries, at HSIs specifically or MSIs broadly, this study makes valuable contributions to the literature.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/dietetics3040029/s1, Figure S1: Modified stakeholder interview guide for faculty, staff, and students involved with Bobcat Bounty; Table S1: Food distribution by food group category and semester during the first year of implementation of Bobcat Bounty.

Author Contributions

Conceptualization, L.B.-F. and H.T.; formal analysis, M.B.; funding acquisition, L.B.-F. and H.T.; investigation, L.B.-F., C.M.J., H.T. and M.B.; methodology, L.B.-F., C.M.J. and H.T.; project administration, L.B.-F.; resources, L.B.-F. and H.T.; supervision, L.B.-F.; visualization, C.M.J. and M.B.; writing—original draft, C.M.J. and M.B.; writing—review and editing, L.B.-F., C.M.J., H.T. and M.B. All authors have read and agreed to the published version of the manuscript.

Funding

This work was supported through internal funding for the Food Security Learning Community from the College of Applied Arts and the School of Family and Consumer Sciences at Texas State University, and in part by the U.S. Department of Agriculture (USDA) National Institute of Food and Agriculture (NIFA), Hispanic-Serving Institutions (HSI) Education Grants Program, 2021-77040-34877, Food Security LEADers (July 2021 to August 2024). In addition, this work was supported through generous donors and the Hays County Food Bank. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the view of the Texas Health and Human Services Commission nor the U.S. Department of Agriculture.

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Texas State University (protocol number 6228 was approved on 11 December 2018).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data presented in this study are not available to share. Analyses are ongoing and findings will be presented in forthcoming manuscripts.

Acknowledgments

The authors wish to acknowledge the contributions of the students involved with this work, including Sawyer Cobb, Miriam Manboard, Kasandra Perez, and Kelsey Walling, and members of the Bobcat Bounty Steering Committee. Thank you to Maryam Ghasemian for her assistance with manuscript preparation.

Conflicts of Interest

The authors declare no conflicts of interest.

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Figure 1. Logic model for the creation of Bobcat Bounty.
Figure 1. Logic model for the creation of Bobcat Bounty.
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Figure 2. Proportion of weight of all food distributed by food group category between Summer of 2018 and Spring of 2019. This figure shows the proportion of the total weight for foods distributed by food group over a three-semester period. Perishable and non-perishable food groups were combined into a single food group for fruits, vegetables, and dairy. Details on weights for each food group category are shown in Supplementary Table S1.
Figure 2. Proportion of weight of all food distributed by food group category between Summer of 2018 and Spring of 2019. This figure shows the proportion of the total weight for foods distributed by food group over a three-semester period. Perishable and non-perishable food groups were combined into a single food group for fruits, vegetables, and dairy. Details on weights for each food group category are shown in Supplementary Table S1.
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Table 1. Sociodemographic characteristics of first-time Bobcat Bounty clients by food security status (n = 947).
Table 1. Sociodemographic characteristics of first-time Bobcat Bounty clients by food security status (n = 947).
CharacteristicsFood Secure
(n = 328)
Food Insecure (n = 619)Total
(n = 947)
p-Value
Gender 0.018 *
 Female 158 (48.2%)449 (72.5%)607 (64.1%)
 Male 85 (25.9%) 149 (24.1%) 234 (24.7%)
 Not Female or Male 3 (0.9%) 7 (1.1%) 10 (1.1%)
Age, years 21.7 21.6 0.810
Race and Ethnicity 0.440
 Hispanic 102 (31.1%) 268 (43.3%) 370 (39.1%)
 White, non-Hispanic 77 (23.5%) 162 (26.2%) 239 (25.2%)
 Black or African American 37 (11.3%) 81 (13.1%) 118 (12.5%)
 Asian and Pacific Islander 5 (1.5%) 23 (3.7%) 28 (3.0%)
 Two or more categories 17 (5.2%) 47 (7.6%) 64 (6.8%)
Living Arrangement 0.843
 Off campus 146 (44.5%) 379 (61.2%) 525 (55.4%)
 On-campus residence hall or apartment60 (18.3%) 147 (23.7%) 207 (21.9%)
 Parent/relative house 11 (3.4%) 29 (4.7%) 40 (4.2%)
 No permanent housing 2 (0.6%) 7 (1.1%) 9 (1.0%)
Student Status 0.971
 Full-time student 216 (65.9%) 535 (86.4%) 751 (79.3%)
 Part-time student 24 (7.3%) 60 (9.7%) 84 (8.9%)
Year in School 0.806
 Freshman 24 (7.3%) 76 (12.3%) 100 (10.6%)
 Sophomore 44 (13.4%) 102 (16.5%) 146 (15.4%)
 Junior 74 (22.6%) 168 (27.1%) 242 (25.6%)
 Senior or completed ≥ four years89 (27.1%) 227 (36.7%) 316 (33.4%)
 Graduate student 8 (2.4%) 27 (4.4%) 35 (3.7%)
First-Generation Student 0.366
 Yes 114 (34.8%) 310 (50.1%) 424 (44.8%)
 No 116 (35.4%) 274 (44.3%) 390 (41.2%)
Obtain Food 0.108
 Self-only105 (32.0%)230 (37.2%)335 (35.4%)
 Parents/relatives 45 (13.7%)123 (19.9%)168 (17.7%)
 Both responses 55 (16.8%)192 (31.0%247 (26.1%)
Purpose for Visit to Bobcat Bounty 0.167
 Hunger 46 (14.0%)155 (25.0%)201 (21.2%)
 Healthy food 52 (15.9%)106 (17.1%)158 (16.7%)
 Curious 47 (14.3%)109 (17.6%)156 (16.5 %)
 Attended with a friend 31 (9.5%)68 (11.0%)99 (10.5%)
 More than one response 60 (18.3%)155 (25.0%)215 (22.7%)
This table presents data from the new client intake surveys for first-time clients. For some variables, the total proportion does not add up to 100% due to missing data. * p-value < 0.05.
Table 2. Results from client satisfaction surveys by semester (n = 267).
Table 2. Results from client satisfaction surveys by semester (n = 267).
Survey Item Spring
2018
(n = 119)
Summer
2018
(n = 22)
Fall
2018
(n = 28)
Spring
2019
(n = 98)
Total
(n = 267)
By getting food from Bobcat Bounty a
I was able to put money toward other necessities 81.5% (97)54.5% (12)75.0% (21)83.7% (82)79.4% (212)
I was able to focus more time and energy on class 70.6% (84)40.9% (9)71.4% (20)83.7% (82)73.0% (195)
Class attendance improved 31.9% (38)50.0% (11)25.0% (7)37.8% (37)34.8% (93)
Concentration improved 58.8% (70)31.8% (7)42.9% (12)60.2% (59)55.4% (148)
Grades improved 37.0% (44)27.3% (6)17.9% (5)34.7% (34)33.3%
(89)
Helped me to stay enrolled this
semester
39.5% (47)50.0% (11)39.3% (11)42.9% (42)41.6% (111)
Felt less financial strain 80.7% (96)54.5% (12)78.6% (22)89.8% (88)81.6% (218)
Felt less stress and anxiety 74.8% (89)50.0% (11)71.4% (20)74.5% (73)72.3% (193)
Felt physically healthier 58.8% (70)45.5% (10)53.6% (15)60.2% (59)57.7% (154)
Eat meals with more variety 66.4% (79)50.0% (11)64.3% (18)NA40.4% (108)
Helped me get through the week (without skipping meals) 74.8% (89)45.5% (10)71.4% (20)NA44.6% (119)
Changed as a result of the food received from BCB b
How healthy the diet is NANA46.4% (13)50% (49)23.2% (62)
Variety of food eaten 61.3% (73)54.5% (12)57.1% (16)69.4% (68)63.3% (169)
Amount of vegetables eaten 65.5% (78)54.5% (12)57.1% (16)64.3% (63)63.3% (169)
Amount of fruit eaten 58.0% (69)54.5% (12)64.3% (18)70.4% (69)62.9% (168)
Amount of whole grains eaten 42.0% (50)50.0% (11)32.1% (9)53.1% (52)45.7% (122)
Amount of meat eaten 37.8% (45)54.5% (12)7.1% (2)21.4% (21)30.0%
(80)
Amount of plant-based protein NA(0)39.3% (11)46.9% (46)21.3% (57)
Amount of sweets/desserts eaten 24.4% (29)40.9% (9)21.4% (6),20.4% (20)24.0% (64)
Amount of time spent cooking 48.7% (58)50.0% (11)46.4% (13)56.1% (55)51.3% (137)
Amount of meals eaten at home 73.9% (88)54.5% (12)64.3% (18)75.5% (74)71.9% (192)
Amount of skipped meals NANANA9.2% (9)3.4% (9)
Overall satisfaction with c
The healthfulness of the food
offered
NA50.0% (11)53.6% (15)87.8% (86)41.9% (112)
The variety of food offered NA54.5% (12)64.3% (18)83.7% (82)41.9% (112)
The quality of food offered NA36.4% (8)53.6% (15)82.7% (81)39.0% (104)
The check-in process NA50.0% (11)75.0% (21)86.7% (85)43.8% (117)
The overall services received NA54.5% (12)78.6% (22)91.8% (90)46.4% (124)
The hours of operation NA36.4% (8)71.4% (20)77.6% (76)39.0% (104)
The location NA40.9% (9)67.9% (19)84.7% (83)41.6% (111)
Ability to utilize food and resources a
I know how to use food 77.3% (92)50.0% (11)75.0% (21)89.8% (88)79.4% (212)
Resources available to use food 77.3% (92)50.0% (11)71.4% (20)85.7% (84)77.5% (207)
Support to use food 78.2% (93)54.5% (12)64.3% (18)83.7% (82)76.8% (205)
Confidence in ability to use food 74.8% (89)54.5% (12)75.0% (21)86.7% (85)77.5% (207)
I feel comfortable at Bobcat Bounty. NA(0)75.0% (21)87.8% (86)40.1% (107)
Positive interaction with Bobcat Bounty staff and volunteers NA(0)82.1% (23)92.9% (91)42.7% (114)
Data show the distribution of positive responses. The initial client satisfaction survey did not include items that were added after the first semester. Items shown as NA were not asked in the initial survey completed in the first semester of Bobcat Bounty (Spring of 2018). NA: not applicable. BCB: Bobcat Bounty. a Response options included “strongly disagree, disagree, neutral, agree, and strongly agree”. The positive responses included response options of “agree” and “strongly agree”. b The positive response option included “increased”. c Response options included “very unsatisfied, unsatisfied, neutral, satisfied, and very satisfied”. The positive response options included “satisfied” and “very satisfied”.
Table 3. Emergent themes and key quotations from stakeholder interviews.
Table 3. Emergent themes and key quotations from stakeholder interviews.
ThemeKey Quotation
Call to Action
Faculty and staff seeing students struggling with hunger firsthand“Hearing from my student staff about students that they work directly with who are food insecure… hearing those stories and trying to find ways to get students connected to a basic need has really motivated me to participate more”.
Students’ personal experience with
food insecurity and hunger
“There was a point in my time like when I first started college where I [didn’t] think I [could] finish school, I can’t even afford food”.
Community Health Champion
Caring about students’ well-being“I just feel like food is something that no one should ever really have to worry about. I just think that it’s something that everyone should come across easily”.
Positive reinforcement of continued
assistance
“I really enjoyed volunteering for [BCB], and I think that a lot of people even when they do volunteer for places, they do it more for their resume and not for the feeling of satisfaction and feeling good… every time I volunteer… I leave in a really good mood and I know that I did a really good thing for the day”.
Self-efficacy“I organized a donation to Bobcat Bounty on behalf of student nutrition organization because we wanted to make a charitable donation”.
Observed University Support
A lack of support from the university“I reached out to the dean of students group because that was the avenue that I felt was necessary to take to maybe get this ball rolling and the email I got back was [that] we don’t have the funds for this, we don’t have the man power, we don’t have the resources, so good luck, and I was taken back from that because I thought okay who doesn’t want to feed student[s] in need”.
Lack of communication to students on available campus resources“I really don’t think a lot of people are aware of Bobcat Bounty as like I think they should be, because whenever I try to explain it to people, they have no idea that it existed”.
Sustainability
Integrate Bobcat Bounty into TXST culture“I think just making it part of our culture too… there has been some positive feedback that the community has had on Bobcat Bounty, so creating traction and momentum through that to help bring awareness and then… make it [a] more sustainable part of the infrastructure of our campus community”.
Increase access and availability of
Bobcat Bounty to students
“Providing a central location… [which] can protect the privacy of the student… [and] will help better, be proximity to a lot more classes, a lot more parking”.
Permanent space and location“I definitely believe Bobcat Bounty needs a permanent space whether it’s in LBJ student center or closer to campus… maybe by the bus stop… I think that that’s one of the biggest problems that the pantry has”.
College Students’ Awareness of Bobcat Bounty
Word of mouth“I think word of mouth is (a) big way I think students find out about it. It’s like they build their own community within this group for this population of students”.
This table presents key quotations by theme, based on stakeholder interviews conducted with faculty, staff, and students (n = 16).
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Biediger-Friedman, L.; Johnson, C.M.; Thornton, H.; Buckley, M. Building Bobcat Bounty: The Design, Implementation, and Initial Evaluation of a Student-Led Food Pantry to Address College Student Food Insecurity. Dietetics 2024, 3, 389-408. https://doi.org/10.3390/dietetics3040029

AMA Style

Biediger-Friedman L, Johnson CM, Thornton H, Buckley M. Building Bobcat Bounty: The Design, Implementation, and Initial Evaluation of a Student-Led Food Pantry to Address College Student Food Insecurity. Dietetics. 2024; 3(4):389-408. https://doi.org/10.3390/dietetics3040029

Chicago/Turabian Style

Biediger-Friedman, Lesli, Cassandra M. Johnson, Hannah Thornton, and Marissa Buckley. 2024. "Building Bobcat Bounty: The Design, Implementation, and Initial Evaluation of a Student-Led Food Pantry to Address College Student Food Insecurity" Dietetics 3, no. 4: 389-408. https://doi.org/10.3390/dietetics3040029

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