CORE Posters Fall 2025

Nutrition and Health Priorities Among Residents of Transitional Housing: New Perspectives from DO Students: Preliminary Research Connor Blevins, Brittany Blitstein, Neal Fleming, Richard Mueller, Tej Patel, Varun Patel, Arundhati Rajpurohit, Jessica Nicholson, Dr. Bernard Kadio Edward Via College of Osteopathic Medicine – Virginia Campus

Group V

Purpose This project aims to understand the interconnection between food choices in a community with members of low socioeconomic status who live in transitional housing. By better understanding the factors that drive their food decisions, we can develop better programs to address the need of communities like Linden Green in future studies, improve future medical education curricula. It is our goal that this will also lead to better patient/physician trust, and long-term health improvements for vulnerable communities.

Introduction Food insecurity and housing instability are public health concerns that directly impact dietary choices and overall health outcomes. Additionally, individuals with lower socioeconomic status face greater barriers to accessing nutritious food, which contribute to greater health consequences.¹ • Sustaining long term changes can be due to a lack of medical presence within these communities • Only 14% of physicians feel adequately prepared and comfortable with discussing nutrition with their patients.² o Lack of confidence in conversations with patients about nutritional and lifestyle decisions can further mistrust in Physicians Physician discomfort in these situations may be attributable to inadequate nutritional education within the medical school curriculum, thus leading to a lack of medical student engagement within their communities. • 75% of United States medical schools do not have required clinical nutrition.² While this knowledge is essential to a physician’s ability to practice, it is also necessary to properly educate and establish trust with patients to ultimately improve long term health outcomes.

Discussion

Connection Between Food and Housing Instability and Health Outcomes • Social determinants like food insecurity and unstable housing contribute to poor dietary choices and impact long term health outcomes. • Diet-related barriers that prevent individuals in low-SES communities from accessing nutritious food were assessed. Addressing these root causes is essential for public health strategies, as these barriers contribute to chronic disease and perpetuate health inequities. • Our results showed that availability and sensory appeal were significant nutritional priorities for the Linden Green residents when compared to the other categories measured. Perspective of Osteopathic Medical Students • As osteopathic students, we aimed to understand the nutritional needs of the community members to bridge the gap in clinical care and communication. • The collective Word Cloud analysis shows trust and empathy were important values, especially when dealing with sensitive, lifestyle-related topics. Long-Term Vision: Bridging Clinical Practice and Public Health • Empowering physicians and exposing them to communities at an early time during their education can create lasting health improvements in underserved populations. Limitations : This research is limited by small sample size and lack of generalizability. In the future, we would like to include more questions for each category to identify specific, implementable changes. Conclusion and Future Direction Our preliminary research indicates potential research in the health and nutrition of residents of transitional housing could identify some of the barriers this population faces in food security and healthy food choices. We also assessed our own pre-conceived notions about this community and how they evolved over our time spent at Linden Green. The next step in this research is to expand the study population for the survey to possibility validate the findings from our preliminary data. Once confirmed, these insights can be used to develop targeted strategies addressing the specific nutrition and health priorities of residents in transitional housing much like the figure below.

Results

Linden Green Demographics: • 84 units • 186 residents • 42 households have children o 33 are single parent • 56.99% of the population is female • 27 seniors (55+)

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Figure 1. Map of Food Deserts in Appalachian Region.

Methods A mixed methods study was implemented from January 2025 until September 2025. Monthly Community Nourishment events were held at Linden Green Community: a transitional housing infrastructure in Christiansburg, VA. A preliminary survey was conducted during July 2025 at the monthly event. The survey "Utilizing the Food Choice Questionnaire to Explain Variation in Dietary Intake" was adapted and given to the residents of the community. ⁴ Inclusion criteria for participants included members of the community, adults above the age of 18, and attendees of the monthly events. Exclusion criteria included children. Questionnaire data was organized into eight categories to examine the importance of each category to the residents of transitional housing. Means and standard deviations were calculated for each category, and statistical analysis was conducted using paired-samples t-tests to compare each group with one another. The statistical analysis was conducted using Microsoft Excel. Qualitative data reflection was performed by the group members in September 2025 to evaluate the changed attitudes of medical students after connecting with the community at Linden Green. Participants compiled words to thematically reflect their learned experiences.

Figure 2. Mean Importance Scores Based on Modified Food Choice Questionaire Among Residents of Transitional Housing. * indicates the importance score of Availability is statistically significantly greater ( p < 0.05) among this sample compared to the importance scores of Convenience in Preparation, Content & Ingredients, Health & Diet, Emotional & Physiological Impact, and Cultural & Personal Familiarity, individually. ** indicates the importance score of Sensory Appeal is statistically significantly greater (p < 0.05) among this sample compared to the importance scores of Convenience in Preparation and Cultural & Personal Familiarity, individually.

Acknowledgements and Resources We would like to thank Dr. Wendy Welch, MPH, PhD with SVGME Consortium and Morgan Boone with Linden Green for their continued support. We would also like to thank Dr. Bernard Kadio, MD, PhD, MPH and Jess Nicholson, MAT. 1. Parekh T, Xue H, Cheskin LJ, Cuellar AE. Food insecurity and housing instability as determinants of cardiovascular health outcomes: A systematic review. Nutr Metab Cardiovasc Dis. 2022;32(7):1590- 1608. 2. Krishnan S, Sytsma T, Wischmeyer PE. Addressing the Urgent Need for Clinical Nutrition Education in PostGraduate Medical Training: New Programs and Credentialing. Adv Nutr. 2024;15(11):100321. doi:10.1016/j.advnut.2024.100321 3. Figure 1 from NCAHD Healthcare Workforce Research 4. Pollard TM, Steptoe A, Wardle J. Motives underlying healthy eating: using the Food Choice Questionnaire to explain variation in dietary intake. J Biosoc Sci. 1998 Apr;30(2):165-79. doi: 10.1017/s0021932098001655. PMID: 9746823. 5. Figure 4 from SWVAGMEC website Figure 4. SWVA-GMEC Diagram of Obstacles in Developing Healthy Food Choices in Underprivileged Communities

Figure 3. Word Cloud Summarizing Osteopathic Students Perspectives. This cloud represents the perspectives of osteopathic medical students, describing what they have learned following nine months of interaction with residents of transitional housing.