Background Food insecurity refers to uncertain access to food on a consistent basis and the stress experienced by families who worry about having sufficient resources to provide balanced meals in their households. Food insecurity has a disproportionate influence on people of color. A robust body of evidence links food insecurity to poor health outcomes.Objective To document experiences of food insecurity among linguistically and ethnically diverse residents of the East Harlem neighborhood of New York City by exploring the ways in which food availability and cost intersect with household budgets, personal preferences, and shopping strategies.Design In-depth qualitative interviews were conducted with adult residents of New York City's East Harlem neighborhood to provide insights about the links between food insecurity, well-being, and quality of life.Participants/setting Thirty-seven adult residents of East Harlem were recruited through purposive sampling. Eligibility requirements included living in an East Harlem zip code (10029 or 10035); being aged 18 years or older; being the main food shopper and food decision-maker in the household; and speaking English, Spanish, or Mandarin Chinese. The study was conducted from February to May 2018. Statistical analyses performedInterviews were analyzed using a grounded theory approach. Codes were organized into broad thematic topics and cross-case analyses were conducted. ResultsParticipants discussed overall perceptions of food insecurity and seven themes related to the challenges of and strategies for coping with food insecurity: intermittent vs chronic food insecurity, shopping and budgeting strategies, pantries as a vital community resource, social support systems, food insecurity and health, frustration with an unjust system, and pride in "making it work."Conclusions To manage food insecurity, many study participants carefully managed food spending, dedicated substantial time to visiting stores and accessing food pantries, and relied on a public benefits cycle that left many without sufficient financial resources at the end of each month.

Community-based nutrition and health promotion programs play an important role in improving neighborhood health. This article presents findings from an exploratory qualitative evaluation of Eat Healthy, Live Life, a community-based nutrition and health promotion program in East Harlem, a low-income neighborhood of color in New York City. Focus group findings showed that participants adopted new healthy behavior changes and Health Bucks coupons helped increased affordability of fresh produce. This program may be an effective model for impacting health behavior through promotion of good nutrition, physical activity, and utilization of farmers' markets in lowincome neighborhoods of color.

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