Abstract
Background/Objective: Food insecurity refers to social or economic challenges that limit or create uncertainty around access to enough food. Among college students, food security status is usually determined with the USDA 10-item Food Security Survey Module, which has not been validated for this population. Nutrition security refers to consistent access to food and beverages that promote well-being, prevent disease, and emphasize equitable access to healthy, safe, and affordable foods. Currently, there is no standardized measure that assesses food and nutrition security tailored to the unique experiences of college students. This study aims to evaluate the validity and reliability of a newly developed College Student Food and Nutrition Security Survey Module (CS-FNSSM). Methods: A mixed-methods approach that combined an online survey with semi-structured cognitive interviews. Participants were students aged 18 and older from U.S. public universities. Quantitative data were analyzed using RStudio (version 4.4.1), and interview transcripts were thematically analyzed. Results: Survey responses were collected from 953 participants, including a subset of 69 participants for reliability testing and 30 participants for cognitive interviews. Rasch analysis showed good item performance and structural validity. The CS-FNSSM demonstrated strong sensitivity (89.09%), specificity (76.2%), moderate test-retest reliability (0.59), and good internal consistency (Cronbach's alpha = 0.79). Qualitative findings confirmed participant understanding of the items. Conclusions: The CS-FNSSM effectively identifies food and nutrition insecurity, with nutrition security emerging as a key issue. Addressing both is crucial for promoting the overall health and well-being of college students.