Paper Type

Doctoral Dissertation


Brooks College of Health

Degree Name

Doctor of Clinical Nutrition (DCN)


Nutrition & Dietetics

NACO controlled Corporate Body

University of North Florida. Department of Nutrition & Dietetics

First Advisor

Dr. Lauri Wright

Second Advisor

Dr. Andrea Y. Arikawa

Third Advisor

Dr. Jody Nicholson-Bell

Fourth Advisor

Dr. Jenifer Ross

Fifth Advisor

Dr. James Epps

Department Chair

Dr. Lauri Wright

College Dean

Dr. Curt Lox


Multidimensional determinants influence use of negative nutrition coping strategies and tradeoffs in households accessing food relief. The objective of this study is to examine negative nutrition coping strategies and tradeoffs at different levels of food insecurity in households accessing food relief and investigate how these behaviors relate to experience-based food insecurity dimensions and populations at risk. This secondary data analysis is from the cross-sectional Sunshine State Hunger Survey (SSHS) conducted June 2018 to August 2018. Over 600 adults were surveyed capturing households of Floridians who accessed 18 direct service charities and community groups that provide food relief across the Tampa Bay tri-county area - including Hillsborough, Pasco and Pinellas and Jacksonville’s Duval County. The survey collected client demographics, health, coping strategies and tradeoffs, well-being, financial hardships, and client's participation in federal nutrition programs. One-way analysis of variance (ANOVA) test indicated a significant relationship, (F(2,483) = 102.4, p< .001) between negative nutrition coping strategies and tradeoffs and increasing levels of USDA HFSSM food insecurity status. With greater levels of food insecurity, there were increases in the frequency of use of negative nutrition coping strategies and tradeoffs. There is a significant association between each coping strategy and tradeoff (p<.001), except watering down food/drink, and USDA HFSSM food security status. An exploratory two-step cluster analysis identified three homogeneous subgroups, 1) late adult worriers, 2) middle adult traders, and 3) middle / late adult copers. Identifying experience-based food insecurity behaviors, coping strategies and tradeoffs used by participants accessing food relief is a multidimensional approach to address the determinants of household food insecurity.