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. Jen Ross

Second Advisor

Dr. Lauri Wright

Third Advisor

Dr. David Himmelgreen

Department Chair

Dr. Andrea Arikawa

College Dean

Dr. Mei Zhao


Food insecurity is an independent risk factor for adverse health outcomes; providing nutrient-dense food through the emergency food system to individuals who regularly seek assistance can impact population-level health disparities. This research explored the extrinsic and intrinsic barriers and facilitators surrounding formal nutrition policy implementation as seen by the logistical gatekeepers in a sample of Feeding Florida food banks. A secondary aim of this research was to explore the change readiness of these same logistical decision-makers in nutrition policy implementation. Research Questions included the following: What are the critical gatekeeping staff perceptions of the barriers and facilitators to implementing formal nutrition policy in disparately sized food banks in the Feeding Florida network; what are the change readiness attitudes surrounding the critical gatekeeping staff's nutrition policy in disparately sized food banks in the Feeding Florida network; and are there similarities or differences by food bank capacity or gatekeeper role formality?

A purposive sample included six Feeding Florida network food banks and a snowball sample of twenty-eight key informants. Data collection included in-person, semi-structured, one-on-one 30–90-minute interviews using an interview protocol of 5 to 10 open ended questions and associated probes that were audiotaped and transcribed verbatim with participants anonymized. Data was coded with Maxqda Qualitative Data Analysis Tool1, to explore patterns, meanings and develop additional codes. All codes were then grouped into categories reflective of the significant themes compared to the conceptual and theoretical frameworks. Member check interviews using synthesized analyzed data were conducted with a representative sample of subjects to evaluate for consistency and reliability.

Key findings included varied understanding of nutrition policy and health, leading to a lack of shared definitions. Formal nutrition policies were scarce, with most relying on implicit guiding philosophies. Implementation challenges included balancing economic sustainability with providing nutritious food, managing funding sources, and addressing logistical issues in distributing food to clients. Organizational culture, data management, and effective communication were identified as crucial factors in facilitating successful nutrition policy initiatives. Support of individual decision-making with nutrition policy systems Healthy Eating Research/Supporting Wellness at Pantries and investment in dedicated nutrition were essential in driving systems change. Implications support the idea that a formal, restrictive nutrition policy may not be the best solution for all food banks. Instead, leveraging the existing Feeding America HER/SWAP nutrition grading system will face less resistance and will allow food banks the flexibility to improve and measure the nutritional quality of their food while combating reactivity and supporting intentionality in programming, donor relations, and food sourcing. Change readiness analysis indicates that participants have the awareness and desire to implement nutrition policy systems in food banks but knowledge gaps may need to be addressed. The main differentiator between discussion and action regarding nutrition policy implementation between food banks was not resource availability but the willingness to invest in dedicated nutrition staff.