BACKGROUND: The transition from adolescence to young adulthood marks a developmental period where responsibility for management of chronic conditions such as food allergy shifts from the caregiver to the young adult. Fatal food-induced anaphylaxis is most common among adolescents and young adults. However, colleges are currently not well-positioned to provide integrated support for students with food allergies. OBJECTIVE: The study objective was to explore the systems, structures, and policies that currently support students with food allergies at college, assess unmet needs, and develop pilot interventions through the use of patient-centered design processes. METHODS: Key informant interviews were conducted with stakeholders in the campus management of food allergies (N = 26) between April and May 2016. Data were coded and assessed for relative frequencies of each code to determine challenges and potential solutions. RESULTS: The convergence of stakeholder-identified themes indicated that the transition to college for students with food allergy would be improved by providing support for: 1) Notification of others in the student's campus network about food allergy; 2) Establishing clearly-defined roles/responsibilities; and 3) Increasing campus awareness of food allergy signs, symptoms, and lethality. In order to better provide comprehensive support for students, five interventions-collectively called Spotlight-were developed. CONCLUSION: The use of qualitative research methods, patient-centered design processes, and collaborations with diverse stakeholders-including pediatricians that care for adolescents-can provide a framework for designing coordinated systems and policies to provide comprehensive support to college students with food allergy. Next steps include rigorously testing implementation of the Spotlight intervention prototypes.