Land and Food Systems, Faculty of
DSpace
University of British Columbia. Faculty of Land and Food Systems
University of British Columbia. UBC Wellbeing
University of British Columbia. Campus and Community Planning
Chan, Rachel
Cui, Betty
Hsu, Fang-Yu
Kwasniak, Anna
Meng, Kiki
Perera, Malki
Currently, over 30% of UBC students are food insecure mainly due to high tuition and low income. Food insecurity compromises students’ physical and mental health, and contributes to social exclusion, stigma, and poor diet quality. Food insecurity also disproportionately affects international students, transgender/nonbinary individuals, those with underlying health conditions, and students using student loans. Our group partnered with the UBC Food Security Initiative to conduct a Health Equity Impact Assessment for the UBC Meal Share Program. The goal of the project is to improve food security of equity-seeking groups at UBC through the Meal Share Program. We conducted focus groups discussion with food-insecure UBC Thunderbirds residents to investigate the potential unintended negative and positive health impacts of the UBC Meal Share Program. Participants’ discussion provided the foundation for the Health Equity Impact Assessment. Through the Health Equity Impact Assessment, we hope to increase the Food Security Initiative’s knowledge on the health impacts of and factors promoting participation in the UBC Meal Share Program. Beyond our project, it is hoped that the UBC Meal Share Program would implement more equity-based measures to improve program equity so that the Program can reach people who need it the most. To achieve our objectives, we reviewed literature, conducted focus groups with UBC students, and consulted with a program strategist from a similar program, Swipe Out Hunger. We found that focus group participants appreciated the low-barrier and stigma-free nature of the Meal Share Program. However, most would appreciate more flexibility in the funding source and more extensive promotion of the program. To evaluate our focus group question, we consulted with the Project Manager of the Food Security Initiative and Program Strategist at Swipe Out Hunger, for their feedback. To evaluate our focus group interviews, we assessed the number of participants reached versus aimed and their perceived level of opportunity to share during the focus group through a closing survey. Disclaimer: “UBC SEEDS provides students with the opportunity to share the findings of their studies, as well as their opinions, conclusions and recommendations with the UBC community. The reader should bear in mind that this is a student project/report and is not an official document of UBC. Furthermore readers should bear in mind that these reports may not reflect the current status of activities at UBC. We urge you to contact the research persons mentioned in a report or the SEEDS Coordinator about the current status of the subject matter of a project/report.”
Health Equity Impact Assessment for UBC’s Meal Share Prepared by: Rachel Chan, Betty Cui, Fang-Yu Hsu, Anna Kwasniak, Kiki Meng, Malki Perera Prepared for: UBC Food Security Initiative Course Code: FNH 473 University of British Columbia Date: 12 April 2021 Disclaimer: “UBC SEEDS Sustainability Program provides students with the opportunity to share the findings of their studies, as well as their opinions, conclusions and recommendations with the UBC community. The reader should bear in mind that this is a student research project and is not an official document of UBC. Furthermore, readers should bear in mind that these reports may not reflect the current status of activities at UBC. We urge you to contact the research persons mentioned in a report or the SEEDS Sustainability Program representative about the current status of the subject matter of a report”. University of British Columbia Social Ecological Economic Development Studies (SEEDS) Sustainability Program Student Research Report 1 Health Equity Impact Assessment for UBC’s Meal Share Program: SEEDS/UBC Food Security Initiative FNH 473 CBEL Project April 12th, 2021 Client Organization: Food Security Initiative Partner Information: Sara Kozicky (Food Security Initiative), Nelly Leo (SEEDS) Teaching Team: Dr. Gail Hammond, Kelsey Cochrane Project Team Member: Rachel Chan, Betty Cui, Fang-Yu Hsu, Anna Kwasniak, Kiki Meng, Malki Perera 2 Table of Contents Table of Contents 2 Executive Summary 4 Introduction 5 Problems & Behaviours Contributing to Problems 6 Mediating Factors 8 Community Assets 9 Project Goals & Objectives 12 Outputs 13 I. Health Impacts (for short-term objective 1) 13 II. Factors that Promote or Discourage Participation (for short-term objective 2) 15 Evaluation Plan 17 Short-Term Outcomes 17 Medium-Term Outcomes 18 Long-Term Outcomes 18 Conclusions 19 Authors’ Contributions 20 References 22 Appendices 26 Appendix A: Recruitment 26 Appendix B: Application & Closing Surveys 27 Appendix C: Consent Form 32 Appendix D: Demographics 33 Appendix E: Focus Group Guide 38 Appendix F: Raw Results 42 Appendix G: Coded Results (Table) 51 Appendix H: Coded Results (Figures) 58 Appendix I: Select Screenshots of Result Matrix Showing Layout 65 Appendix J: Health Equity Impact Assessment 70 Appendix K: Participant Recommendations 74 3 Appendix L: Logic Model 77 Appendix M: Newsletter 78 4 Executive Summary Currently, over 30% of UBC students are food insecure mainly due to high tuition and low income. Food insecurity compromises students’ physical and mental health, and contributes to social exclusion, stigma, and poor diet quality. Food insecurity also disproportionately affects international students, transgender/nonbinary individuals, those with underlying health conditions, and students using student loans. Our group partnered with the UBC Food Security Initiative to conduct a Health Equity Impact Assessment for the UBC Meal Share Program. The goal of the project is to improve food security of equity-seeking groups at UBC through the Meal Share Program. We conducted focus groups discussion with food-insecure UBC Thunderbirds residents to investigate the potential unintended negative and positive health impacts of the UBC Meal Share Program. Participants’ discussion provided the foundation for the Health Equity Impact Assessment. Through the Health Equity Impact Assessment, we hope to increase the Food Security Initiative’s knowledge on the health impacts of and factors promoting participation in the UBC Meal Share Program. Beyond our project, it is hoped that the UBC Meal Share Program would implement more equity-based measures to improve program equity so that the Program can reach people who need it the most. To achieve our objectives, we reviewed literature, conducted focus groups with UBC students, and consulted with a program strategist from a similar program, Swipe Out Hunger. We found that focus group participants appreciated the low-barrier and stigma-free nature of the Meal Share Program. However, most would appreciate more flexibility in the funding source and more extensive promotion of the program. To evaluate our focus group question, we consulted with the Project Manager of the Food Security Initiative and Program Strategist at Swipe Out Hunger, for their feedback. To evaluate our focus group interviews, we assessed the number of participants reached versus aimed and their perceived level of opportunity to share during the focus group through a closing survey. 5 Introduction UBC students are at great risk of food insecurity due to increases in tuition, cost of living, inadequate financial assistance, and low salaries (UBC Wellbeing, n.d.). At UBC Vancouver, 1297 (38.35%) of undergraduates and 227 (30%) of graduate students reported experiencing food security (Board of Governors [BoG], 2019; BoG, 2020). Food insecurity in students compromises their physical and mental health, quality of diet, and academic performance (Farahbakhsh et al., 2017; Maynard et al., 2018). The UBC Meal Share Program was a four-month pilot program initiated in January 2021 by the Food Security Initiative to alleviate food insecurity among students. The goal of the Program is to provide low-barrier and stigma-free emergency relief for UBC students experiencing food insecurity. Applicants can apply twice through an easy online application process, and $100 will be automatically deposited to their UBC student cards (UBC Wellbeing, n.d.). Our audience was initially international graduate students, since they are twice as likely to experience food insecurity than domestic students at UBC (BoG, 2020). However, we shifted our focus to UBC students who self-identified as food-insecure, because there were international students who applied to join our focus groups who did not express food insecurity, thus we prioritized hearing from food-insecure students, regardless of whether they were international or domestic. The pilot program initially had $10,000 and assisted 97 UBC students. While the Program is relatively low-barrier and stigma-free compared to other forms of food relief programs at UBC (i.e., food banks), it was paused due to insufficient funding and a high number of applications. Our project, in collaboration with Sara Kozicky, Food Security Project Manager, aimed to improve the equity of this Program through the creation of a Health Equity Impact Assessment. It entails identifying equity-seeking groups, identifying potential unintended negative and positive health impacts of partaking in the Program for these equity-seeking groups, and making recommendations to alleviate the negatives and maximize the positives. “Equity-seeking groups” in this report refers to UBC students experiencing food insecurity and facing barriers to equal opportunity, access, and resources due to disadvantages. 6 Situational Assessment and Planning Framework Problems & Behaviours Contributing to Problems I. Social exclusion & stigma prevents use of resources for food insecurity Perceived social exclusion and stigma can perpetuate food insecurity among university students. Maynard et al. (2018) interviewed 14 post-secondary students at the University of Waterloo in Canada and found that many students felt shame and stigma associated with accessing campus food banks due to the lack of anonymity. Students reported feeling inferior, embarrassed, undeserving of food bank provisions, and furthermore isolated as they struggled to participate in social activities involving spending money (Maynard et al., 2018). Students were also unaware of programs available to them on campus and who to ask for help (Maynard et al., 2018). The resulting behaviour is students not using food insecurity relief programs, which was due to stigma around food insecurity in a systematic review (Shi et al., 2021) and fear of taking resources from others in worse circumstances (Maynard et al., 2018). II. Mental health contributes to poor dietary quality, an aspect of food insecurity Anxiety and stress regarding food quality and accessibility was a key concern among university students assessed with the Household Food Security Survey Module, through which students described poor quality food to be “low-cost, energy-dense, frozen or canned, and old or unsafe” (Maynard et al., 2018, p. 135). Poor diet quality and stress increase university students’ risk of poor mental health (BoG, 2019). Behaviours contributing to this problem include health-compromising behaviours, identified in a study on U.K. university students (El Ansari et al., 2014). Reported stress and anxiety was positively associated with consuming more “unhealthy foods”, while perceived depressive symptoms was negatively correlated with consuming healthier foods like fresh fruits, salad, cooked vegetables (El Ansari et al., 2014). III. Student debt also contributes to poor diet quality Greater debt was associated with higher risk for food insecurity among college students, and this held true even when students with greater debt ($10,000 vs. under $1000) received financial support from family and were employed (Knol et al., 2018). This agreed with the high 7 rate of food insecurity among UBC students funding their university education mainly with student loans (BoG, 2019). Behaviours contribute to food accessibility and diet quality suffering near the end of semesters when financial aids are more likely depleted (Maynard et al., 2018). For this reason and the higher ratio of convenience food to “healthy food” on campus, students are more likely to consume cheaper, low quality food than healthy, costly food (Maynard et al., 2018). IV. Food Insecurity Disproportionately Affects Some Student Populations at UBC Among UBC students, prevalence of food insecurity is higher among international students than domestic students (45.1% vs. 37.3%), transgender/nonbinary than women or men (59.8% vs 39.5 and 39.7), those with a mental health condition than without (46.2 vs 36.1), those with a disability than without (45.4 vs. 36.1), and those who mainly pay for school with student loans than those who partly pay for school with student loans or those who do not use student loans (53% vs 46.7 vs. 31.8) (BoG, 2019). While behaviours do not fully explain the complex issue of food insecurity among specific demographics, some may contribute and are described here, with particular focus on international students, student loan bearers, and LGBTQIA2+ students, which were some identities that we would later encounter in our project. International students experience higher levels of anxiety and stress compared to domestic students (Forbes-Mewett & Sawyer, 2016). Some stressors included having to adjust to daily life in a different culture and environment, and developing skills to manage a new academic system (Forbes-Mewett & Sawyer, 2016). Furthermore, international students found that fast and convenient foods were much cheaper than traditional food items, which ultimately led them to consume more fast food due to its low price and closer proximity to campus (Alakaam et al., 2015). The combination of stress, and the convenience and price of fast foods on campus, lead international students to choose foods that are less nutritious and traditional to their culture, which ultimately contributes to the food insecurity among international students. Food-insecure transgender and gender non-conforming populations have been deterred from using food pantries as they reported feeling unwelcome at food pantries run by 8 religious groups denouncing transgender and gender non-conforming people (Russomanno & Jabson Tree, 2020). UBC’s Meal Share Program aims to be confidential and welcoming, so it will be important to evaluate perceived safety. As mentioned previously, those with student loans experience poorer diet quality than those without, especially near the end of semesters when their dietary choices are more limited by depleted funding (Maynard et al., 2018). Mediating Factors Mediating factors affect how likely individuals will partake in interventions (Hammond, 2021). Understanding the drivers and barriers to participating in the UBC Meal Share Program is a key part of ensuring equitable access. I. Individual-Level Factors Individual factors include mental health, work, and acute financial need. Mental health issues may discourage food-insecure students from using program funds to buy food. Anxiety and depression, reported at higher rates among food-insecure versus food-secure post-secondary students (Bruening et al., 2016), was suggested to result in withdrawal from dining halls and unused meal plan dollars among food-insecure college students in Texas (van Woerden et al., 2019). Work may discourage food-insecure students from using campus program funds. Students in Texas reported that working off-campus reduced the utility of campus meal plan dollars (van Woerden et al., 2019), and students in Wisconsin reported that work limited time to eat (Broton et al., 2018). Students who work more are more likely to be food-insecure (Willis, 2019), and food-insecure students may work more hours, even in place of attending class to afford food (Henry, 2017; Lee et al., 2018). Times of heightened financial need, for instance at the start of term before receiving financial assistance, or later when it is depleted (Henry, 2020) may encourage or discourage food-insecure students from using campus program funds, depending on proximity to campus. UBC students with mental health issues, work, and/or acute financial need may be less likely to partake or benefit even if partaking in the UBC Meal Share Program. II. Interpersonal-Level Factors 9 Interpersonal factors include perceived norm and shame which, if perpetuated, may discourage food-insecure students from using program funds. Perceived norms of eating poorly and having financial struggles, and avoidance of these topics in student conversations was found in many of Henry’s (2017) interviews and focus groups with food-insecure college students in Texas. Shame around inability to be financially independent prevented them from reaching out for support (Henry, 2017). When receiving support, they preferred to have earned what they receive, rather than receiving charitable support (Henry, 2017). Although UBC’s Meal Share Program aims to be discreet and stigma-free, unawareness of the Program may be an issue if norms and shame prevent students from learning about existing support. III. Environmental-Level Factors Proximity to food that meets dietary needs, cost of food, cooking skills, and level of welcome of the program may affect participation in the program. First, students may need specific foods not widely available at outlets accepting UBC card payment (e.g., fruits). Some receive specific types of foods from others (Henry, 2020) or have dietary restrictions (e.g., food allergies, vegetarianism). Both the high cost of food and lack of opportunities to cook could increase the likelihood of using the UBC Meal Share Program. International students have reported higher costs of ready-to-eat foods in Canada, compared to their home countries. Also, students might have limited kitchen skills, time, or knowledge to cook Western meals (Henry, 2020). Finally, feeling unwelcome at food pantries run by religious groups denouncing transgender and gender non-conforming people has deterred these groups from using these resources (Russomanno & Jabson Tree, 2020). UBC’s Meal Share Program aims to be inclusive and requested us to assess the inclusivity of the Program. These problems, behaviours, and mediating factors from literature informed our data-gathering from focus groups, which sought community involvement. Community Assets To help relieve the financial burden of students, one asset available to them is the UBC’s Meal Share Program. Another asset is access to Enrolment Services Advisors, which help students manage their finances, create a financial plan, apply for scholarships, bursaries, and student loans. For emergency food relief, students can access the AMS Food Bank for free, 10 where they would receive one bag of groceries as individuals, or two bags as families (Alma Mater Society, 2020). Some other inexpensive food options for students include Sprouts and Agora Cafe, which provide free meals once every week for students pre-COVID. To support students’ mental health, UBC Counselling offers free counselling services and referrals to other forms of help if needed (Student Services, n.d.). Methods of Analysis While assessing literature, we categorized information into populations affected by food insecurity, factors worsening the situation (problems and behaviours), and mediating factors. Our chosen populations were largely based on grey literature (i.e. BoG reports) from UBC to maintain relevance to our community project. Problems, behaviours, and mediating factors were derived from academic literature, including quotes from focus groups. Limitations We found academic literature that reflected our own target population at UBC; however, we recognize there are limitations to using these studies. Different university campuses around the world may have different environmental factors and demographics. Thus, factors that contribute to food insecurity on other campuses may not be applicable to UBC. We only used two UBC-specific grey literature (BoG, 2019; BoG, 2020). More diverse sources and thorough situational assessment is needed in future. Health Behavior Theory Our project is guided by Community Organization Theory, which emphasizes community-driven approaches to assess and solve health and social problems (Glanz & Rimer, 2005). The community in our context is UBC and its stakeholders (including Food Security Initiative, students, and decision-makers), and the problem is food insecurity. Community organizing at UBC can look like community groups helping to identify reasons why students experience food insecurity, and subsequently mobilizing resources to address this (Glanz & Rimer, 2005). Then, the community could develop and implement strategies to reduce food insecurity among equity-seeking groups at UBC (Glanz & Rimer, 2005). In our context, the Food Security Initiative is implementing the Meal Share Program, and our group is evaluating it with 11 a Health Equity Impact Assessment. Since our project aims to reflect the community’s priorities, we believe Community Organization, and its components below fit our project. I. Empowerment We aimed to empower equity-seeking students to inform priorities of the Meal Share Program through participatory research in our focus groups. Participants offered suggestions to improve the Program. II. Community capacity The success of the Health Equity Impact Assessment relied on the feedback and lived experiences of our participants, funds from SEEDS which we used to compensate participants in our focus groups (grocery gift cards), and our connection with a Thunderbird Residence Advisor who connected us with potential participants. III. Participation We utilized participatory research by seeking out students likely to use the Meal Share Program and listening to issues and suggestions relevant to them, as we saw them as equal partners with valuable insights. IV. Relevance & Issue Selection Participant input revealed their priorities, so we could focus on relevant and specific issues in our recommendations. For example, the Health Equity Impact Assessment supported us in improving the Meal Share Program by reducing negative impacts and maximizing positive impacts of equity-seeking groups (Hyndman et al., 2012). V. Critical consciousness Critical consciousness was crucial in identifying root causes of food insecurity. We analyzed the target population (e.g., international students, employment status, food accessibility issues) and identified relevant determinants of health as part of our Health Equity Impact Assessment. This helped us make suggestions that benefit as many groups as possible. 12 Project Goals & Objectives Goals 1. To improve food security of equity-seeking groups at UBC through the Meal Share Program. Objectives I. Short-term (up to 1 year) 1. To increase Food Security Initiative’s knowledge on the unintended positive and negative health outcomes of the current UBC Meal Share Program design as perceived by equity-seeking groups at UBC, by April 2021. 2. To increase Food Security Initiative's knowledge on factors that would encourage and discourage participation in the UBC Meal Share Program by equity-seeking groups at UBC, by April 2021. II. Medium-term (from 1 to 5 year) 1. To enact a Food Security Initiative policy stating that more funds will be provided to self-identified equity-seeking groups at UBC than to those who did not self-identify as these groups, by 2022 (to be completed by our project partner). III. Long-term (more than 5 years) 1. To increase equity in the UBC Meal Share Program’s accessibility and fund allocation, by 2025. 13 Outputs I. Health Impacts (for short-term objective 1) The output was a Health Equity Impact Assessment, structured in five steps. 1. “Scoping” involves identifying population(s) of interest and their potential determinants of health (Hyndman et al., 2012). Populations we considered included international students, student loan bearers, and LGBTQIA2+ students, since they experience high rates of food insecurity at UBC (BoG, 2019). The population we chose changed to food-insecure students at Thunderbird Residence as explained in the introduction. Due to intersectionality of individuals, our focus groups comprised some international graduate students, student loan bearers, and/or LGBTQIA2+ students (see Appendix D). 2. “Potential Impacts” involves identifying health impacts a program could have on the population(s) of interest, both positive and negative (Hyndman et al., 2012). We obtained these from our target population. Requesting individuals likely to be affected by the Program to identify issues and recommendations aligns with our chosen theory; their participation empowers them and makes use of community capacity to focus on relevant issues. The process involved recruiting participants (see Appendix A), surveying demographics and food insecurity (see Appendix B), obtaining consent (see Appendix C), conducting focus groups (see Appendix E), surveying identities and feedback on focus group experiences (see Appendix B), typing out participants’ responses (see Appendix F), coding responses, tallying up the number of individuals who mentioned each code (see Appendices G & H), in total and by identity (for instance, a total of nine students suggested “grocery gift cards,” of whom six were international students [see Appendix I, code 91]), and summarizing findings (see Appendix J). Positive impacts suggested by focus groups (see Appendix G/H) included reduced stress around unstable income, not having to cook to save money during exams, and the low-barrier and stigma-free Program design, in addition to benefits to mental, financial, social, and nutritional health. Negative impacts (see Appendix G/H) included unhealthy dietary choices and added stress. These stemmed from two facts that many participants mentioned: 1) Funds provided via the UBC card (only usable at select UBC Food Service eateries) will cover fewer meals than 14 it has the potential to, since 2) campus eateries are unaffordable and expensive (codes 15 & 82). Consequently, individuals reported they would make unhealthy dietary choices to stretch the fund into more meals, including choosing cheap and unhealthy foods, cutting meat from the diet, cooking less often and eating less healthy (codes 138-141). This is concerning as five of the nine students in our focus groups have skipped or cut the size of meals in the last 12 months, and six cited insufficient money as the cause of their difficulty accessing food (see Appendix D). Food inaccessibility was a concern, not just due to unaffordability but also timing (i.e. UBC Food Services eateries are closed by early evening), dietary restrictions, cultural inappropriateness (i.e. few and unaffordable Halal, vegan, vegetarian, South Asian, Indian, and Middle Eastern options), and lack of varieties (codes 1-30). Stress was another issue, regarding either insufficient funds remaining, managing funds to use up every cent, funds being taken away by those not in need, and the potential to build an expensive habit of buying meals on campus (codes 132-137). 3. “Mitigation” involves offering suggestions to reduce negative impacts while maximizing positive impacts (Hyndman et al., 2012). Most participants’ suggestions were in agreement; where they conflicted, we supported the option that would benefit all participants (see Appendix K) based on our understanding of all participants’ suggestions and our discussion with Alexa Aburto. All participants suggested modifying the Program based on how expensive meals are at UBC (see Appendix G/H, code 154). This will be detailed in the next objective as it also relates to barriers to participating in the Program. Besides this, one individual requested needs-based funding; for instance, more than $100 the first time, and less the next time (code 155). Another suggested requiring a referral from Enrolment Service Advisors or targeting those with student loans or needs-based scholarships (code 156). 4. “Monitoring” involves measuring Program impacts on each identified population versus the others (Hyndman et al., 2012). We suggest conducting surveys and focus groups with each equity-seeking group, including intersecting identities, to collect ratings and descriptions of how their wellbeing is impacted by Program design (e.g., how has receiving funds in the form of gift cards affected your health? How would receiving funds only on your UBC card affect your health? Are there any other ways you would prefer to receive the funds?) 15 5. “Dissemination” of recommendations was achieved by a conversation with Sara, our community partner, and delivery of this report, an Excel file of data, and the NVivo file to Sara. II. Factors that Promote or Discourage Participation (for short-term objective 2) To pinpoint factors that would promote and discourage participation in the Program (henceforth referred to as “discouraging factors” and “promoting factors”), we asked questions (see Appendix E) regarding the application, website, outreach, and potential to participate. Coded participant responses are in (see Appendix G/H). Application-related promoting factors included the straightforward and accessible application, and informative note on Enrolment Services financial services (codes 41-46). Discouraging factors included the fear of being labelled (code 37). This was due to the application question offering to connect students with Enrolment Services for financial assistance. Individuals feared they must respond “Yes” to make their application successful, but they also feared being labelled as “in financial need” in UBC’s system. They suggested not making this a question but rather presenting helpful information about Enrolment Services. The application layout intimidated some students who could not discern how low-barrier this was at first glance (code 38). Many recommended making all questions visible on the same page (code 50), but we suggest leaving it as is to deter those who are not in need from exploiting the Program. A progress bar may also help. Due to the low-barrier design, exploitation of funds by those not in need was a common concern (code 37). Suggested solutions included outreach to those in need (code 64) and to specific audiences (codes 60-65) such as those with student loans or needs-based scholarships, and through specific avenues such as referral from Enrolment Services Advisors or UBC staff (codes 66-74). Participants agreed that the low-barrier aspect was very important (codes 87 & 144), thus they were unsure how to maintain this while preventing exploitation. We suggest targeted outreach rather than requiring a referral, to minimize stigma. Website-related promoting factors included the impression that the Program was accessible, inclusive (in general and to vegans, vegetarians, and graduate students), confidential, and stigma-free. Discouraging factors included that it would be hard to stumble 16 upon the website (obscure without a direct link), uncertainty of which outlets accept the UBC card, and whether there were any exclusion criteria (codes 123-128). Outreach-related promoting factors included previous awareness of the Program; two individuals knew about it from a friend. Discouraging factors included that six of nine participants were not previously aware and one was not sure if this was the Program they heard about. We support participants’ suggestions regarding target audiences and outreach avenues. Suggested target audiences included residences, AMS and AMS clubs (with mention of whether dietary restrictions will be met, e.g., Halal), those partaking in other UBC initiatives, international students (due to COVID-19, income and funds are disrupted), and people who need it the most (such as those with student loans and needs-based scholarships). Suggested outreach avenues included posters at residence mailboxes (with a QR code and statement about qualifying criteria to discourage exploitation of the Program), email or newsletter, social media, Enrolment Services or financial services locations, a dedicated outreach team or person, residence advisors, surveys, and department (codes 67-74). General potential to participate depended on the low-barrier Program design and the form of funds. The low-barrier design was a promoting factor and discouraging factor. Individuals said due to it, nothing would discourage or stop them from participating (code 87) but they also worried about exploitation (codes 39 & 137). The form of fund was a discouraging factor; funds provided only through UBC cards covered fewer meals than it had the potential to, did not increase access to meals that meet dietary needs or cultural preferences, and could not be used after closing hours. To mitigate this, all nine participants suggested adding the option to receive the funds as grocery gift cards or credit sent to their mailbox (code 91). Other ideas, all proposed by international students, included money, keeping the UBC card, credit on food or delivery apps, prepaid debit card, and the choice of all or several of these with choice of how much of the funds they desired on each (codes 89-96). We recommend this last suggestion as we believe it will help equity-seeking groups to access more affordable meals which meet dietary needs and are available at additional times of the day, while meeting the complex ways individuals manage food insecurity (e.g., buying fragile foods at Save On Foods UBC but bulk-shopping at No Frills). 17 Evaluation Plan Short-Term Outcomes To evaluate our focus group questions to ensure relevance and critical consciousness, we consulted Sara and Alexa Aburto, the Program Strategist at Swipe Out Hunger. Using our community capacity, Sara helped us refine our questions by providing thorough feedback for each question for relevance and issue selection to the Food Security Initiative’s current knowledge, and for sensitivity to participants’ struggles. For example, she helped us cut out trivial questions, and suggested we ask more sensitive questions towards the end of the interview/survey. Sara also suggested offering one-on-one interviews on the survey to increase engagement. Alexa provided insight to suggestions for the UBC Meal Share program, specifically unintended health impacts and the application process of similar Meal Share programs in the U.S. This helped us generate more program-specific questions on both our surveys and focus group questions. The number of participants recruited depended on our community capacity, as we were only equipped to accommodate 10 people due to the lack of funds, even though many people filled out the initial survey showing interest in our focus group. To evaluate the participation and empowerment in our focus group sessions, we analyzed the number of participants reached versus aimed, and their perceived level of opportunity to share their thoughts during the focus group. Of ten participants, nine showed up to their respective interviews, indicating a high level of interest to contribute to the Meal Share Program. Furthermore, we evaluated participant feedback given in our closing survey, administered at the end of the focus groups. Participants rated how much opportunity there was to share their thoughts, and a brief description of what would have made the rating closer to 10/10. Six participants rated 10/10, one 9/10, one 8/10, and one 7/10. For the latter question, participant responses included “I felt comfortable sharing my thoughts”, “There was enough time to share my thoughts and opinions, and I felt totally comfortable to share”, “2 minutes to rant [per question] is a good amount of time. I think I went over a bit and wasn’t stopped so that works for folks who have more to say”, and “ample time to speak”. This indicates that future focus groups could be modified to allow more equal opportunities for sharing. 18 Overall, the evaluation of our short term outcomes will be based on the verbal feedback we receive from Sara on the recommendations we curated from the focus group answers and our consultation with Alexa. Medium-Term Outcomes Our medium-term outcomes could be evaluated by confirming whether or not a policy is implemented to ensure that 50% more funds are allocated to self-identified equity-seeking groups. A further indicator is the number of recommendations the Food Security Initiative team plans on implementing into the UBC Meal Share Program within the next 5 years as our recommendations are based on providing more accessibility to equity-seeking groups (i.e. our short term outcome). Long-Term Outcomes To evaluate our long-term outcomes, we propose the Food Security Initiative team conduct regular feedback surveys (e.g. biannual if most realistic for the team) to obtain Program participants perspectives regarding the accessibility of the Program and the fund allocation, as well as to conduct another survey on food security campus-wide to gauge the reach of the Program in 2025. 19 Conclusions The project's key contributions were the creation of the Health Equity Impact Assessment and the recommendations generated from the Assessment. The UBC Food Security Initiative gained a better understanding of the health impacts and experience of using the Meal Share Program through the Assessment. The recommendations provided Food Security Initiative feasible solutions to reduce unintended negative health impacts and promote positive health impacts in the Program, which can generate equity-based improvements to the Program. Our group learned how to create a situational assessment and a Health Equity Impact Assessment for a program that addresses food insecurity in the UBC community. We incorporated community engagement by inviting UBC students to participate in the focus groups. This ensures that the recommendations we made for the Program best suit their needs. When conducting the focus groups, communicating the expectations and the confidentiality made participants more secure about sharing their feelings and experience. Also, asking casual while clear and directional questions encouraged participants to share their experience, targeting the key questions we want to address for the project. We identified that effective communication is the key to the collaboration with our community partner. Keeping them updated throughout the project helped them know the project progress and also allowed them to provide feedback if they needed to. The next step for the UBC Food Security Initiative is to implement equity-based measures within the Program. This includes targeting outreach to specific populations such as international students, allocating 50% more funds to self-identified equity-seeking groups at UBC by 2022, and using a descriptive application process where applicants can describe their situation regarding food accessibility, dependents, and other relevant information. Furthermore, the program can meet various accessibility needs by offering additional forms of funds for individuals to choose from (i.e. grocery gift cards, food or grocery delivery credit, money, and/or UBC cards). 20 Authors’ Contributions Name Contributions Rachel Chan Worked on Health Behaviour Theory and formatted some slides in the final presentation; worked on Executive Summary, Health Behaviour Theory, and Assets for Target Population in the written report; Edited the References, proofread and edited style and grammar in the written report; took part in two focus groups (one as a facilitator, one as a notetaker); did a final check of the codes; tallied up codes for the question on Food Accessibility on campus; jotted down notes in meetings. Malki Perera Worked on the Evaluation Plan on the final presentation; worked on the Evaluation Plan and the Social Exclusion and Stigma, Mental Health, Diet Accessibility sections in the Situational Assessment on the written report; worked on the Inputs, Process Indicators, Strengths and Limitations on the Draft Logic Model presentation; Formatted and designed all slides on the Draft Logic Model Presentation; worked on focus group interview questions and took part in two focus groups (one as facilitator, one as a notetaker; tallied up codes for the questions on “Website” and “Potential to Participate.” Kiki Meng Worked on Health Behaviour Theory on the final presentation and written report; wrote the relationships between our project Outputs and Health Behaviour Theory in the final presentation; worked on focus group questions and took part in two focus groups (notetaker); tallied up codes for “Positive and Negative Health Outcomes of Participating in the Program as Currently Designed”; edited the newsletter. Betty Cui Worked on the Introduction and Process Objectives on the final presentation; worked on Introduction, Conclusion and Reference on the written report; worked on Project Outputs and Process Indicator on the Logic Model presentation; worked on focus groups questions; took part in two focus groups (notetaker); tallied up codes for the question on “Outreach” and questions; communicated with Sara and Nelly via email. 21 Anna Kwasniak Worked on Social Stigma and Exclusion, Financial Debt, and Limitations sections on the situational assessment in the written report; developed the newsletter; worked on the Lessons Learned section for the final presentation; worked on the Introduction and Situation sections for the Logic Model presentation; took part in three focus groups (facilitator); created the focus group application survey and interview questions; tallied up codes for the questions on “Application”; communicated with focus group participants and Sara. Fang-Yu Hsu Worked on Mediating Factors, Methods of Analysis, Outputs, Appendices A-K on the written report; worked on the Long-term Outcomes on the Logic Model presentation; worked on the HEIA and Project Findings in the final presentation; coordinated data analysis (created Google Sheets templates with formulas, delegated work, coded data in NVivo & generated and formatted matrices); edited & hyperlinked report; emailed with Sara, Alexa, and Nelly; took part in two focus groups (one as a facilitator and another as a notetaker); created report and presentation slides for delegating parts. 22 References Alakaam, A. A., Castellanos, D. C., Bodzio, J., & Harrison, L. (2015). The factors that influence dietary habits among international students in the United States. Journal of International Students, 5(2), 104-120. https://doi.org/10.32674/jis.v5i2.428 Alma Mater Society. (2020). Food bank. https://www.ams.ubc.ca/student-services/food-bank/ Board of Governors. (2019). Addressing food insecurity at UBC. https://bog3.sites.olt.ubc.ca/files/2019/09/3_2019.09_Addressing-Food-Insecurity.pdf Board of Governors. (2020). Food insecurity update. https://bog3.sites.olt.ubc.ca/files/2020/11/5_2020.11_Food-Insecurity-Update.pdf Broton, K., Weaver, K., & Mai, M. (2018). Hunger in higher education: Experiences and correlates of food insecurity among Wisconsin undergraduates from low-income families. Social Sciences (Basel), 7(10), 179. https://doi.org/10.3390/socsci7100179 Bruening, M., van Woerden, I., Todd, M., & Laska, M. N. (2018). Hungry to learn: The prevalence and effects of food insecurity on health behaviors and outcomes over time among a diverse sample of university freshmen. The International Journal of Behavioral Nutrition and Physical Activity, 15(1), 9-9. https://doi.org/10.1186/s12966-018-0647-7 El Ansari, W., Adetunji, H., & Oskrochi, R. (2014). Food and mental health: Relationship between food and perceived stress and depressive symptoms among university students in the United Kingdom. Central European Journal 23 of Public Health, 22(2), 90-97. https://doi.org/10.21101/cejph.a3941 Enrolment Services Advisors. Student Services. (2020, December 15). https://students.ubc.ca/about-student-services/enrolment-services-advisors Farahbakhsh, J., Hanbazaza, M., Ball, G. D. C., Farmer, A. P., Maximova, K., & Willows, N. D. (2017). Food insecure student clients of a university‐based food bank have compromised health, dietary intake and academic quality. Nutrition & Dietetics, 74(1), 67-73. https://doi.org/10.1111/1747-0080.12307 Forbes-Mewett, H., & Sawyer, A. (2016). International students and mental health. Journal of International Students, 6(3), 661-677. https://doi.org/10.32674/jis.v6i3.348 Glanz, K. & Rimer, B. K. (2005). Theory at a glance: A guide for health promotion practice. U.S. Department of Health and Human Services, National Cancer Institute. https://cancercontrol.cancer.gov/brp/research/theories_project/theory.pdf Hammond, G. (2021, January 25). HP project planning: Situational assessment [PowerPoint Slides]. https://canvas.ubc.ca/courses/59879/files/12702142?wrap=1 Henry, L. (2017). Understanding food insecurity among college students: Experience, motivation, and local solutions. Annals of Anthropological Practice, 41(1), 6-19. https://doi.org/10.1111/napa.12108 Henry, L. (2020). Experiences of hunger and food insecurity in college. Springer International Publishing. https://doi.org/10.1007/978-3-030-31818-5 Knol, L. L., Robb, C. A., McKinley, E. M., & Wood, M. (2018). Food insecurity is related to financial aid debt among college students. Journal of Family and Consumer Sciences, 110(4), 35-41. https://doi.org/10.14307/JFCS110.4.35 24 Lee, S. D., Hanbazaza, M., Ball, G. D. C., Farmer, A., Maximova, K., & Willows, N.D. (2018). Food insecurity among postsecondary students in developed countries: A narrative review. British Food Journal, 120(11), 2660-2680. https://doi.org/10.1108/BFJ-08-2017-0450 Maynard, M., Meyer, S. B., Perlman, C. M., & Kirkpatrick, S. I. (2018). Experiences of food insecurity among undergraduate students: "You can't starve yourself through school". Canadian Journal of Higher Education (1975), 48(2), 130-148. Hyndman, B., Mitchell, C., Katherine, W., Tepper, J., Boychuck, L., Perry, V., Chan, I., Manson, H., Tyler, I., King, A., Srinivasan, V., Davis, S., Walker, E., Salamo, P. Carroll, G., Shedden, S., Macrae C., Schroter, M., Dault, V., … Council of Medical Officers of Health members. (2012). Health Equity Impact Assessment (HEIA) Workbook. http://www.health.gov.on.ca/en/pro/programs/heia/docs/workbook.pdf Russomanno, J., & Jabson Tree, J. M. (2020). Food insecurity and food pantry use among transgender and gender non-conforming people in the Southeast United States. BMC Public Health, 20(1), 590-590. https://doi.org/10.1186/s12889-020-08684-8 Shi, Y., Lukomskyj, N., & Allman-Farinelli, M. (2021). Food access, dietary acculturation, and food insecurity among international tertiary education students: A scoping review. Nutrition (Burbank, Los Angeles County, Calif.), 85, 111100-111100. https://doi.org/10.1016/j.nut.2020.111100 25 Statistics Canada. (2020, September 21). Tuition fees for degree programs increase in 2020/2021. https://www150.statcan.gc.ca/n1/daily-quotidien/200921/dq200921b-eng.htm Student Services. (n.d.). Counselling services. https://students.ubc.ca/health/counselling-services UBC Sustainability. (n.d.). Food security initiative. https://www.sustain.ubc.ca/food-security-initiative UBC Wellbeing. (n.d.). Campus food insecurity. https://wellbeing.ubc.ca/campus-food-insecurity#:~:text=Often%20defined%20as%20%E2%80%9Cinadequate%20or,42%25%20at%20UBC%20Okanagan%20report UBC Wellbeing. (n.d.). UBC Meal Share Program. https://wellbeing.ubc.ca/ubc-meal-share-program van Woerden, I., Hruschka, D., Vega-Lόpez, S., Schaefer, D. R., Adams, M., & Bruening, M. (2019). Food insecure college students and objective measurements of their unused meal plans. Nutrients, 11(4), 904. https://doi.org/10.3390/nu11040904 Willis, D. E. (2019). Feeding the student body: Unequal food insecurity among college students. American Journal of Health Education, 50(3), 167-175. https://doi.org/10.1080/19325037.2019.1590261 26 Appendices Appendix A: Recruitment Figure A-1. Process of Participant Recruitment for Focus Groups 27 Appendix B: Application & Closing Surveys Figure A-2. Application Survey 28 29 30 Figure A-3. Closing Survey 31 32 Appendix C: Consent Form Thank you for agreeing to participate in a focus group hosted by UBC students in FNH 473: Applied Public Health Nutrition. Your data will be used to inform equity-related improvements to the Meal Share Program at UBC. Your name will be known by the student hosts organizing this focus group, but if you wish to remain anonymous you may use a nickname on Zoom, turn your camera off, and mute your microphone (and type your responses in the chat). We encourage you to keep your camera and microphone on to facilitate better group discussion. The waiting room function will ensure that you have renamed yourself and set up your camera as desired before you enter the call. How to change your name on zoom: 1. A Participants bar will appear on the right side of the screen. Hover over your name and a "More >" button will appear. 2. Click on the "Rename" button that will appear after you click on the "More >" button. 3. Enter your new name in the "New Screen Name" field. 4. After clicking the blue "OK" button, your new name will appear. If you need to change your Zoom display name before entering a room, you can do so through the Zoom app installed on your desktop. Just find the Zoom icon on the desktop and open it up. 1. There will be an option to "Join a meeting." Click on that. 2. That will open up a window where you can manually join a meeting (instead of clicking a link). 3. Enter the Zoom room number/name if you know it and enter in the Display Name that you'd like. We will not record the focus group session. If you agree to participate under these terms, please type your full name and date. If you have any questions, please let us know by replying to this email. Full Name: Date: 33 Appendix D: Demographics 34 35 36 37 38 Appendix E: Focus Group Guide Methods During focus groups on Zoom, one person facilitated and one to two team members typed out participants’ verbal responses to Google Sheets with the help of a live transcript aid (responses were not labeled with participant names but rather their unique number we assigned to maintain confidentiality). After focus groups concluded, we collectively generated codes (i.e. distinct ideas to categorize their responses, for instance “unaffordable groceries on campus”). Then on Google Sheets, each team member took several codes and tallied up the number of individuals who had mentioned each code. One member reviewed any further changes to codes by the other members and finalized the codes in NVivo, subsequently generating a matrix to tally the codes by student identity (for instance, the number of all student loan bearers in our sample who mentioned “unaffordable groceries on campus”) (Appendix E). Actual focus group content: ● Host: Before starting call: ensure settings are waiting room function on and cameras off ● Notetakers: Before admitting anyone, send separate messages to each person in waiting room ○ Hi! Thanks for coming. Please remember to change your zoom name to a pseudonym (the one on your application form) if preferred. We will admit you after this! ● Host: Wait until each person replies, and notetakers confirm they have matched rows w/ names before admitting everyone ○ Google Sheet to write down participant answers: https://docs.google.com/spreadsheets/d/1VN6rpC7qpr5XembhLCcSY46TAAKpMLaVyiLUhNEhRH4/edit?usp=sharing ● Host: Admit everyone and Enable live transcript ● Introduction (1 min): Script: Hi everyone, thank you for coming. The purpose is to have a group discussion on your thoughts about the Meal Share Program - in particular its accessibility and potential health outcomes. We are UBC students collaborating with UBC’s Food Security Initiative to make the program more accessible to equity seeking groups on campus. We turned on subtitles and you can view a transcript of the conversation under More. This is to help the team members type out your responses. We’re not recording anything - not audio or video or subtitles. A few team members are jotting down notes but your name is not recorded with it because we use numbers instead of names to protect privacy. We will maintain your anonymity so please do not share anything discussed here with others 39 outside of this group. That way we can have an open dialogue on what you think and feel about the Meal Share program. We hope to keep this to 40 minutes, so please try to keep your answer to each question to 2 minutes max. ● Ice breaker (3 min): ○ Rose, Thorn, Bud (RTB): what was the highlight of your day, what went wrong, and what do you look forward to tomorrow? https://medium.com/philosophy-logic/rose-thorn-bud-rtb-a-5-minute-game-to-kickstart-your-mindfulness-habit-5ca54dee0e21 ○ What’s your pandemic hobby? What would be the first thing you want to do if the pandemic ends tomorrow? Official questions: 1. Let’s start with your experience getting food on UBC campus. Do you think the food is accessible, available, and affordable in the community? (2 min/person) a. Everyone can each take 2 minutes to share their experience ● Run through of program/application (1 min): ○ Explain Meal Share Program (1 time emergency fund of $100 dollars from community) ○ Script: The Meal Share program is intended to provide dignified emergency funds to students facing food insecurity. Students sign up with their student number, then will receive funds on their UBC card, so they can discreetly use the funds at any food outlet that accepts UBC cards. You do not need to provide your actual details in this test survey. QR code for test survey (actual experience applying) Application: https://ubc.ca1.qualtrics.com/jfe/form/SV_5705XvqOsw8GtCK?Q_CHL=qr& fbclid=IwAR0WqBU4Sly_0M8IiZgG8E2c_EKDS8g7KJl0FZ8GO7Pyt69HtuTDVODtRtM Website: https://wellbeing.ubc.ca/ubc-meal-share-program Questions on application (for our knowledge) ○ First last name ○ UBC student number ○ Email 40 ○ I am currently registered in undergrad or graduate program at UBCs Vancouver campus Yes/No ○ I could physically access food outlets on UBC immediately after receiving the funds Yes/No ○ Please indicate if you would like to be contacted by an Enrolment Services Advisor. By indicating yes your information will be shared with enrolment services 2. Please take 2.5 minutes on your own to explore website (2 min/person) a. Website link (notetaker sends link) i. Do you feel like you could be part of this Program? ii. Did anything make you feel like you would be excluded or don’t belong? 3. Please take 2.5 minutes on your own to explore the application (2 min/person) a. Application (notetaker sends link) i. What is your experience with this application process? ii. What are some pros of the application process? iii. What are some cons of this application process? 4. Is there anything that would stop you from using this program or anything that makes it less useful to you? (2.5 min/person) a. Examples of barriers: Time to eat (between classes etc.), proximity to UBC food outlets, work/other schedules/living off campus, proximity of food outlets offering the types of foods desired (e.g. someone regularly provides you with certain foods and you are in need of specific types of foods that some UBC outlets don’t offer), mental health condition, disability, student debt, religious reasons (maybe religious reasons for not accepting financial support technically- so maybe this program wouldn't meet that need and something like a community meal is a better fit) b. How could the Program be designed to reduce this barrier? 5. Would this Program affect your well being? (2 min/person) a. What are some positive effects? (e.g. reduce stress, anxiety?) b. What are some negative effects? 6. Before participating in this focus group, were you aware of the UBC Meal Share Program? (2 min/person) a. If yes, where did you hear about it? b. Where/who could it be promoted so that you’d see it? c. How could it be promoted to best meet you or your communities needs? 7. At which times of the year would you most likely use this one-time emergency fund? (1 min/person) Prompts for after the questions regarding UBC Meal Share Program: ● Instead of receiving money on your UBC card, would you prefer to get specific gift cards/money some other method? ● How often do you eat on campus? What factors affect this? 41 Closing survey: https://ubc.ca1.qualtrics.com/jfe/form/SV_bHGocxjJqM32PS6 (5 min) Please take a few minutes to fill out the closing survey - link in zoom chat. Your answers will help make the Program more equitable Your answers will be kept confidential We need your name and email address on the survey to send to UBC SEEDS for distributing your gift card. Thank you for participating! 42 Appendix F: Raw Results 43 44 45 46 47 48 49 50 51 Appendix G: Coded Results (Table) (Figures in Appendix H) Table A-1. Excerpt of NVivo matrix showing the number of focus group individuals who mentioned particular codes regarding perceived food accessibility on campus, factors encouraging or discouraging participation in the Meal Share Program, and potential health 52 impacts 53 54 55 56 57 58 Appendix H: Coded Results (Figures) (Tables in Appendix G) *Note some codes are cut off (see full codes in Appendix G) *the last bar of each section that lacks a code represents the code on the vertical axis Figure A-4. Number of individuals mentioning food accessibility codes 59 Figure A-5. Number of individuals mentioning application-related codes 60 Figure A-6. Number of individuals mentioning website codes 61 Figure A-6. Number of individuals mentioning outreach codes 62 Figure A-7. Number of individuals mentioning potential to participate codes 63 Figure A-9. Number of individuals mentioning potential health outcomes codes 64 65 Appendix I: Select Screenshots of Result Matrix Showing Layout Table A-2. Sections of NVivo matrix showing codes by number of mentions from specific identities 66 67 68 69 70 Appendix J: Health Equity Impact Assessment Date: April 4, 2021 Organization: UBC Food Security Initiative & FNH 473 Group 8 Name and contact information for the individual or team that completed the HEIA: FNH 473 Group 8 Project Name: Health Equity Impact Assessment of the UBC Meal Share Program Project Summary: A Health Equity Impact Assessment was conducted to examine potential health impacts of the UBC Meal Share Program on food-insecure Thunderbird residents with various and intersecting equity-seeking identities. Data was gathered through focus groups and coded using NVivo. Secondary data was gathered regarding factors that would encourage and discourage participation in the UBC Meal Share Program. Objective for Completing the HEIA: 1. To increase Food Security Initiative’s knowledge on the unintended positive and negative health outcomes of the current UBC Meal Share Program design as perceived by equity-seeking groups at UBC, by April 2021. 2. To increase Food Security Initiative's knowledge on factors that would encourage and discourage participation of the UBC Meal Share Program by equity-seeking groups at UBC, by April 2021. NOTE: This section to be filled in after completing the following HEIA template. Conclusions: To maximize potential positive health impacts and mitigate potential negative health impacts, we recommend ● Offering the fund in various forms (i.e., students choose one/more of UBC card, gift card to grocery store of their choice, credit on food/grocery delivery apps, money, prepaid debit card) ● Send gift cards to residence mailbox or another discreet method ● Distribute educational resources on healthy & inexpensive foods to buy at grocery stores ● Exclude expensive outlets that accept the UBC card ● Holistic application to help those most in need if demand exceeds supply (from Alexa Aburto) 71 Step 1. SCOPING Step 2. POTENTIAL IMPACTS Step 3. MITIGATION Step 4. MONITORING Step 5. DISSEMINATION a) Populations* b) Determinants of Health Unintended Positive Impacts. Unintended Negative Impacts. Identify ways to reduce potential negative impacts and amplify the positive impacts. Identify ways to measure success for each mitigation strategy identified. Identify ways to share results and recommendations to address equity. International (South Asian) (#14) Income Culture International students feel cared for - Covers few meals, $$$a & few vegetarian options - Unavailable campus food at night, holiday - Exploitable by those not in need - Promote to international students - Promote where financial services are - Grocery gift cards (SOFb $$$) - Survey preference, wellbeing Report International, graduate (Middle Eastern, Arab & West Asian or Prefer not to Identify) (#s 13, 24) Income Culture - Inclusive - Very useful on nights before course due dates - Great initiative - Confidential - Covers few meals, $$$ & few south asian, Halal, & Indian options - Choose cheap & unhealthy food to stretch fund - Stress about cooking during finals to save money - Reduced funds for all (since most places accepting UBC card are $$$ - The Point, Residents Canteen) - Need more during some months than others - Builds expensive habit of buying food on campus - Do not require response (ESA Q)c - Amount based on need at time - Have options: ● UBC card (cheap outlets for exam time when don’t want to cook) ● Money (suit dietary restrictions- find Halal meat, buy fragile foods at SOF and bulk at NoFrills, vending machines) ● send gift card to mailbox - Application feedback survey - # of individuals receiving funds -survey preference, satisfaction International (Middle Eastern), graduate, working, mature student, living alone (#49) Income Culture - Diet quality ↑ -financial stress reduction - Covers few meals, $$$ eateries - Not much variety, not culturally appropriate - Encourages cooking less, eating less healthy - Choose cheap & unhealthy food to stretch fund - May support businesses more than students - Grocery gift card (close to campus) - Credit for food/grocery delivery app - Survey preference, wellbeing International (Southeast Asian), graduate, student loans, living alone (#15) Income Culture - Generous, supportive, useful at due dates -Inclusive - Covers few meals, $$$ & few Indian options - Choose cheap & unhealthy food to stretch fund - Cut meat from diet to stretch fund - Exploitable by those not in need - Do not require response (ESA Q)d - Promote to international students - All money (stretches further, find most affordable Indian food off campus) - Freshmart & SOF (Harvest $$$) - Application feedback survey - Survey preference, satisfaction International (White or Caucasian), graduate, Income Culture - Helps when no - Covers few meals, $$$ vegan options - Exploitable by those not in need - Require ESA or staff referral - Target: student loans & need-based - Application feedback 72 student-loans, LGBTQIA2+, working, hidden disability, living with roommates (#18) time to cook - Discreet - Mental + social health - When one partner works can the other partner use this to support the other scholarship - Choice in % funds on UBC card, desired grocery store (including SOF & NoFrills), prepaid debit card - Not money (would lead to using for rent not food) survey - Survey preference, satisfaction Domestic (Middle Eastern & South Asian), undergrad, student loans, working, 1st gen. university student, transfer student, roommates (#30) Income Culture - ↓ Stress, anxiety from unstable income - Nutritional + mental health - Covers few meals, $$$ options - Exploitable by those not in need - Would it work for digital e card (wouldn’t have to pay for a physical one) -Exclude $$$ outlets (Point Grill, Triple Os to make funds last longer for all) -SOF gift card unless mobility issue -NoFrills gift card (better than UBC card but so far away) - Survey preference, satisfaction Domestic (White or Caucasian), undergrad, student loans, LGBTQIA2+, lives with roommates (#41) Income Culture - Stress reduction - Covers few meals (6-8), $$$ & few vegan options - Exploitable by those not in need - Stigma, bad attitude toward those who need help - Stress about how far fund goes at start of year - $100 toward grocery to stock up more food with same amount $ - Educational resources on cheap healthy food to buy at grocery - Survey preference, satisfaction - Survey knowledge Domestic (White or Caucasian), undergraduate, student loans, LGBTQIA2+, working, 1st generation university student, lives with roommates (#27) Income Culture - Extra boost - Stress of managing to use every dollar and not end up few dollars short of a meal - Covers few meals (6-8), $$$ (Browns) - Choose cheap & unhealthy food to stretch fund - Stress about having to cook during exams to save - Do not require response (ESA Q) - Provide cheap meals & grocery card (No Frills cheapest and nearby) to mailbox through UBC financial services (SOF $$$) - Application feedback survey - Survey preference, satisfaction Summary IncomeCulture Financial, Mental, Social, & Nutritional Health Benefits Low barrier Stigma-free Reduced stress & anxiety with unstable ● covers few meals; campus eateries $$$ a ● unable to use after closing hours Stress ● those not in need can exploit program ● those buying $$$ meals reduce funds for all ● managing funds to use up every dollar/cent ● may need more than $100 at times Unhealthy dietary choices ● choose cheap unhealthy meals to stretch $ ● cut meat from diet to stretch $ ● cook less and eat less healthy ● dietary needs not met (campus eateries Offer individuals choice in form of fund ● grocery store gift cards (NoFrills, Freshmart, SOFb) ● money ● UBC card ● several or all of above, choose % funds on each - Offer >$100 (can get <$100 next time) - Modify application question about ESA - Target those in financial need - require referral from ESA/staff or target those with student loans/ needs based scholarships/ international students Keep it low barrier Self reported rating of well being and experiences before / after implementing additional forms of funds and various amounts 73 employment Being cared for have few or $$$ Halal, vegan, vegetarian, South Asian, Indian, Middle Eastern food Builds expensive habit of buying meals on campus a$$$ = unaffordable & expensive bSOF=Save On Foods UBC cSeveral students were afraid of having to respond to the question about being contacted by an ESA for their application to be successful, but they also worried this would cause UBC to label them as financially in need; ESA: Enrolment Services Advisors 74 Appendix K: Participant Recommendations (suggestions for conflicting recommendations are bolded) Recommended Forms of Fund ● Individuals choose multiple or all from these suggestions from focus groups: ○ Credit on food & grocery delivery apps ○ Gift card (unspecified type) ○ Grocery gift card or credit (sent to mailbox) ○ Individuals choose how much they want on UBC card & groceries, and which grocery stores ○ Money (e.g., as cheque to mailbox through financial services) (opens access to vending machines, choice of cheaper grocery stores, cultural foods at more affordable prices) ○ Not Money - would lead to using it for rent not food ■ Include money option; it improves food accessibility for others ○ Prepaid debit card could be an option for some ○ UBC card Recommended Outlets by Focus Groups ● Exclude expensive outlets to stretch funds (e.g., Point Grill, Triple O's, Ponderosa Commons) ● Exclude Save on Foods UBC (distant for walkers & expensive) ○ Do not exclude this as other students find it most accessible ● Exclude Tim Hortons and Starbucks (not healthy) ● Freshmart ● Grocery stores close to campus ● No Frills & Cheaper Grocery Stores ● Ready-to-eat food outlets plus grocery (won't want to cook during exams like usual to save money) ● Save On Foods UBC (some can't easily leave campus, some buy fragile foods there like eggs etc and only leave campus to buy bulk items) Other Recommendations for Maximizing Positive Health Impact ● Modify program based on how expensive meals are at UBC ● Provide more one month and less another month based on need ● Require referral from Enrolment Services Advisors & target those in financial need or 75 with student loans or needs-based scholarship ● Would like educational resources on cheap healthy food to buy at grocery stores Website-related Recommendations ● Add eligibility, exclusion, & restriction criteria ● Clarify duration of pilot, how long funds are available & how many times they can apply ● Clarify how to access website if not given a direct link ● List outlets accepting UBC card ● Put 'donate' and 'apply now' at top of website ● Shorten length - long page and image; Empty space on the right Application-related Recommendations ● Add to application that individuals can only apply twice ● Don't require Yes or No to being contacted by Enrolment Services Advisors (just provide information about them) ● Fewer pages or all questions on one page ○ Students worry the application is too low-barrier and people not in need may take advantage of the Program. Therefore, leave questions on separate pages so it does not easily reveal how low-barrier it is ● Fix format on phone ● Request CWL log-in (prevent scam or prevent people stealing other's UBC card) ● Share how it works for new transfer students with only digital UBC card (only has barcode), doesn't want to pay for physical card Recommended audience to target ● AMS and or AMS clubs & specify preferences (e.g., Halal) will be accessible ● Pair with other UBC initiatives ● Promote to international students (COVID disrupted income & funds) ● Promote to people who need it the most (student loans, needs based scholarship) ● Promote to residences (including upper residences) Recommended promoters ● Department ● Email or Newsletter ● Enrolment Services Advisors or where people go for financial help (frequently contacts Enrolment Services Advisors) ● Have a dedicated team or person conduct outreach ● Posters (Residence Mailbox or Common Areas - Saying 'if you qualify, follow this QR 76 code') ● Residence Advisors should promote the program ● Social media - e.g., tik tok, UBC confessions ● Surveys Time Students Are Most Likely To Use the Program the Most ● Course due dates (throughout term) ● Fall & Winter terms (rainy, harder to get jobs) ● Finals & Midterms (e.g., less work shifts during this time. eg. after paying tuition knows how much money is left) ● Including summer (classes, lab socials) ● January and February (after little income from seasonal jobs) ● Lab socials which can occur anytime ● Not Summer (might get a job) ○ Include summer for those who find it helpful ● Start of term or year - tuition payment ● Times of physical or psychological health issues 77 Appendix L: Logic Model 78 Appendix M: Newsletter
Report
eng
Unreviewed
Vancouver : University of British Columbia Library
Attribution-NonCommercial-NoDerivatives 4.0 International
Undergraduate
UBC Social Ecological Economic Development Studies (SEEDS) Student Report
University of British Columbia. FNH 473
Finance
Food
Health
Health Equity Impact Assessment for UBC’s Meal Share
Text