Doctoral Dissertation Research: Biosocial Consequences of Food Insecurity Among Chronic Disease Patients

随着慢性病的增加，迫切需要了解社会和经济不平等如何影响疾病管理。作为人类的一项基本需求，食物为了解这些动态提供了一个宝贵的窗口。粮食不安全和与饮食有关的慢性疾病之间的关系已经有了很好的记录，但这种关系背后的途径仍然知之甚少。这一博士论文项目旨在通过探索食物在管理与饮食相关的慢性疾病的个人的日常生活中作为一种具有营养和社会意义的媒介来更好地阐明这种关系。除了为研究生提供科学培训外，该项目还涉及合作机构伙伴关系，这扩大了科学参与，并允许与那些塑造临床实践的人直接分享见解和数据。这些发现将广泛传播给学术和非学术受众、健康和营养从业者以及社区组织，对改进临床实践、营养咨询和食品安全工作具有重要意义。具体地说，本研究运用生物社会学的理论视角来调查1)医疗保健提供者对食品不安全和饮食的认知和做法；2)患者对食品不安全的生活体验的归因；3)患者获得食物的途径、偏好和选择；以及4)这些因素对患者健康结果的影响。将采用定性和定量相结合的方法，包括与提供者和患者的访谈、结构化调查和生物测量(身高、体重、血压、胆固醇和糖化血红蛋白)，以实现这些研究目标。这项研究将与一家农村社区卫生诊所合作进行。营养学和社会科学的理论途径和方法的结合为检查食品不安全和慢性疾病提供了一种新的方法。这一奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

Amid a rise in chronic diseases, there is a pressing need to understand how social and economic inequalities impact disease management. As a fundamental human need, food provides one valuable window into these dynamics. The relationship between food insecurity and diet-related chronic disease is well-documented, yet the pathways that underlie this relationship remain poorly understood. This doctoral dissertation project aims to provide greater clarity on this relationship by exploring food as a vehicle of both nutritional and social significance in the everyday lives of individuals managing diet-related chronic disease. In addition to providing scientific training for a graduate student, this project involves cooperative institutional partnerships, which broaden scientific participation and allow for insights and data to be directly shared with those who shape clinical practice. The findings will be disseminated widely to academic and non-academic audiences, health and nutrition practitioners, and community organizations, with important implications for improving clinical practice, nutrition counseling, and food security efforts. Specifically, this research applies a biosocial theoretical lens to investigate 1) healthcare providers’ perceptions and practices related to food insecurity and diet; 2) meanings patients attribute to the lived experience of food insecurity; 3) patients' food access, preferences, and choices; and 4) the effects of these factors on patients’ health outcomes. A combination of qualitative and quantitative methods, including interviews with providers and patients, structured surveys, and biological measurements (height, weight, blood pressure, cholesterol, and glycated hemoglobin), will be used to achieve these research aims. The study will be conducted in collaboration with a rural community health clinic. This combination of theoretical approaches and methods from nutrition and the social sciences provides a novel approach to the examination of food insecurity and chronic disease.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.