A High Prevalence of Food Insecurity Among University Students in Appalachia Reflects a Need for Educational Interventions and Policy Advocacy.

To measure prevalence and correlates of food insecurity among college students in Appalachia, compare food-insecure and food-secure students on correlates, and identify predictor variables.Cross-sectional, online questionnaire.University in Appalachia.Nonprobability, random sample of 1,093 students (317 male [30.1%]; 723 females [68.4%]).Food insecurity, coping strategies, money expenditure, academic progress, and demographics.Correlational, chi-square, and regression.A total of 239 students experienced low food security (21.9%) whereas 266 had experienced very low food security (24.3%) in the past 12 months. Predictor variables were higher money expenditure and coping strategy scale scores, lower grade point averages, male gender, receiving financial aid, fair or poor self-rated health status, and never cooking for self or others. These variables accounted for 48.1% of variance in food security scores. Most frequently used coping strategies included purchasing cheap, processed food (n = 282; 57.4%), stretching food (n = 199; 40.5%), and eating less healthy meals to eat more (n = 174; 35.4%).Food-insecure students need interventions that teach budgeting skills and how to purchase and prepare healthy foods, as well as policies that increase access to food resource assistance.