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Bennett BL, McKee SL, Burkholder K, Chafouleas SM, Schwartz MB. USDA's Summer Meals During the COVID-19 Pandemic: A Mixed-Methods Examination of Participants and Non-Participants in 2021. J Acad Nutr Diet 2024; 124:495-508.e9. [PMID: 37482269 DOI: 10.1016/j.jand.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND The US Department of Agriculture's school meal programs have wide reach during the school year, but food insufficiency among households with children increases during summer months. The US Department of Agriculture summer meal programs are designed to fill this gap, yet participation has historically been low. OBJECTIVE To examine the facilitators and barriers to participation in a 2021 summer meal program while the COVID-19 pandemic regulation waivers were in place. DESIGN Cross-sectional mixed-methods survey research. PARTICIPANTS/SETTING All parents/guardians of children enrolled in a school district in Connecticut were invited to participate in an online survey in December 2021. The respondents included summer meal participants (n = 622) and nonparticipants (n = 294). MAIN OUTCOME MEASURES Survey respondents reported demographic variables, current food sufficiency, communication preferences, satisfaction with the program, reasons for using or not using the program, and whether they found the program helpful financially. The survey included three open-ended questions about barriers to participation. RESULTS Respondents who used the summer meal program indicated that the pandemic-related regulatory waivers were key to their decision to participate. Reported barriers included lack of awareness of the program, inability to travel to sites during the times they were open, lack of transportation, concerns about dietary restrictions, and lack of variety in the menu, and concerns about wasting food. Parents/guardians expressed strong preferences for receiving communication about summer meals directly from their child's school and being able to access meals outside of typical work hours. CONCLUSIONS The pandemic waivers allowed sponsors to test different models of distribution. Parents/guardians responded positively to the opportunity to access grab-and-go meals, multiple meals at once, and meals without a child present. These findings can be used to inform potential policy changes to reduce barriers and increase participation.
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Affiliation(s)
- Brooke L Bennett
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut.
| | - Sarah L McKee
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut; Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut
| | - Kara Burkholder
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut; Department of Public Health Sciences, University of Connecticut, Storrs, Connecticut
| | | | - Marlene B Schwartz
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut; Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut
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Bennett BL, Cohen JF, Andreyeva T, Esposito J, Burkholder K, Chafouleas SM, Schwartz MB. Predictors of Participation in the U.S. Department of Agriculture Summer Meal Programs: An Examination of Outreach Strategies and Meal Distribution Methods During COVID-19. AJPM FOCUS 2023; 2:100124. [PMID: 37790948 PMCID: PMC10546601 DOI: 10.1016/j.focus.2023.100124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Significantly fewer children participate in the U.S. Department of Agriculture-sponsored summer meal programs than in the federal school meal programs during the academic year. During the summer of 2021, several pandemic-related waivers supported more flexible operations for summer meal programs, such as allowing grab-and-go meals and the distribution of meals for multiple days at once. This study assessed how summer meal site characteristics and geographically targeted outreach methods were associated with summer meals served in 2021 in Connecticut. Methods Weekly meal count data were requested from all sponsors of the Summer Food Service Program and the National School Lunch Program Seamless Summer Option. Data were received from 78 sponsors with 763 sites. Geographically targeted outreach (e.g., billboards, bus ads, and flyers) was tracked by location each week. Mixed methods ANOVA was used to examine the predictive value of outreach efforts, program characteristics, and meal distribution methods on meals served each week. The program characteristics examined included the hours open per week, the number of weeks serving meals, the maximum number of meals distributed at one time, and the number of open and closed sites in a school district. Results Between June 21 and August 20, 2021, a total of 1,188,669 breakfasts and 1,389,347 lunches were served. Sites that were open more hours per week (mean=7.60 hours per week; range=0.17-35) and gave multiple meals to parents at each visit (mean=4.68 meals; range=1-15) reported greater rates of meal distribution. The outreach efforts assessed were not significantly associated with changes in meal distribution at nearby sites. Conclusions The U.S. Department of Agriculture's waivers in response to COVID-19 permitted extended operating hours and multiple-meal distribution. These operational flexibilities should be considered for permanent regulation changes owing to their positive association with summer meal participation.
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Affiliation(s)
- Brooke L. Bennett
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, Connecticut
| | - Juliana F.W. Cohen
- Center for Health Inclusion, Research and Practice (CHIRP), Merrimack College, North Andover, Massachusetts
- Department of Public Health and Nutrition, Merrimack College, North Andover, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Tatiana Andreyeva
- Department of Agricultural and Resource Economics, Rudd Center for Food Policy and Health, University of Connecticut, Hartford, Connecticut
| | - Julia Esposito
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, Connecticut
| | - Kara Burkholder
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, Connecticut
| | - Sandra M. Chafouleas
- Department of Educational Psychology, University of Connecticut, Storrs, Connecticut
| | - Marlene B. Schwartz
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, Connecticut
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut
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Harper K, Bode B, Gupta K, Terhaar A, Baltaci A, Asada Y, Lane H. Challenges and Opportunities for Equity in US School Meal Programs: A Scoping Review of Qualitative Literature Regarding the COVID-19 Emergency. Nutrients 2023; 15:3738. [PMID: 37686770 PMCID: PMC10490348 DOI: 10.3390/nu15173738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/15/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
The emergency school meals program provided free meals to children in the United States (US) during COVID-19-related school closures. This scoping review aims to synthesize the existing qualitative empirical evidence published between March 2020 and January 2023 on the operations and utilization of emergency school meal programs during the pandemic. Qualitative, US-based peer-reviewed literature was collected from three sources: (1) parent review of all federal nutrition assistance programs; (2) systematic search of four databases; and (3) manual search of grey literature. Identified scientific articles and grey literature reports (n = 183) were uploaded into Covidence and screened for duplicates and inclusion/exclusion criteria. Our final sample included 21 articles/reports, including 14 mixed methods and seven qualitative-only projects. Articles spanned all U.S. states. Articles had similar research questions to understand school meals and/or general food access during COVID-19, with an emphasis on long-term policy implications. Hybrid deductive/inductive analytic coding was used to analyze data, utilizing domains from the Getting to Equity Framework (GTE). GTE considers multi-level factors that influence nutrition behavior while centering more equitable pathways to improve nutrition security and reduce adverse health. Findings were sorted into two categories: operational challenges during the pandemic and solutions to address inequities in school meal distribution during and after the pandemic, particularly during school closures such as summers or future emergencies. Key challenges related to supply chain issues, safety, and balancing families' needs with limited staff capacity. Programs addressed equity by (a) reducing deterrents through federally issued waivers and increased communications which allowed the serving of meals by programs to families who previously did not have access, (b) building community capacity through collaborations and partnerships which allowed for increased distribution, and (c) preparing and distributing healthy options unless barriers in supply chain superseded the effort. This review highlights the importance of emergency school meal programs and provides insights into addressing challenges and promoting equity in future out-of-school times. These insights could be applied to policy and practice change to optimize program budgets, increase reach equitably, and improve access to nutritious meals among populations at highest risk for nutrition insecurity.
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Affiliation(s)
- Kaitlyn Harper
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Bree Bode
- Michigan Fitness Foundation, Lansing, MI 48906, USA
| | - Kritika Gupta
- Department of Nutrition & Hospitality Management, University of Mississippi, Oxford, MS 38677, USA
| | - Ally Terhaar
- Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63103, USA
| | - Aysegul Baltaci
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Yuka Asada
- Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60607, USA
| | - Hannah Lane
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC 27708, USA;
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Harper K, Everett J, Borman R, Gross J, Lu SV, Wilson MJ, Gross SM. Summer Food Service Program Meal Participation in Maryland Increased during the COVID-19 Pandemic. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2101412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Kaitlyn Harper
- Doctoral Candidate, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | - Julia Gross
- Maryland Hunger Solutions, Baltimore, Maryland
| | - Stacy V Lu
- Doctoral Student, Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Susan M. Gross
- Doctoral Student, Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Distributing Summer Meals during a Pandemic: Challenges and Innovations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063167. [PMID: 35328855 PMCID: PMC8948912 DOI: 10.3390/ijerph19063167] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/15/2022] [Accepted: 03/03/2022] [Indexed: 02/01/2023]
Abstract
The USDA summer food programs provide meals for children when school is not in session. Although the COVID-19 pandemic has created challenges for food distribution programs, many regulations have been waived, providing opportunities for new approaches to meal distribution. The aim of this study was to identify practices designed to increase program participation during the summer of 2021. Semi-structured interviews were conducted with food service directors (N = 16) in a northeastern state. Questions addressed meal distribution methods; perceptions about facilitators and barriers to family participation; communication strategies used to reach families; and engagement with community partners. The responses were analyzed using an immersion-crystallization approach and four themes emerged: new opportunities for innovation due to the waivers; the importance of collaboration with community partners to increase reach; ongoing logistical challenges due to the pandemic; and the challenge and importance of reducing the stigma of participation. These findings underscore how the USDA waivers increased food service directors’ ability to flexibly and creatively solve problems related to summer meal delivery. The FSDs believed that several of the waivers helped them increase participation in the summer meal program, suggesting that permanent changes to the summer meal regulations may be appropriate.
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Harper K, Lu SV, Gross J, Obudulu C, Wilson MJ, Gross SM. The Impact of Waivers on Summer Meal Participation in Maryland. THE JOURNAL OF SCHOOL HEALTH 2022; 92:157-166. [PMID: 34939191 DOI: 10.1111/josh.13116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/24/2021] [Accepted: 05/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The Summer Food Service Program (SFSP) is a federally funded program that serves free, nutritious meals during the summer months. In 2019, 6 federal waivers that previously helped sponsors serve meals were rescinded. The purpose of this mixed methods study was to assess the impact of the waiver rescission on the experiences of SFSP sponsors in Maryland. METHODS This study analyzed responses from Maryland SFSP sponsors in a quantitative online survey and linked meal participation data for 2018 and 2019 (n = 29) and in-depth interviews (n = 11) about their experiences serving summer meals. RESULTS Most respondents reported that the waiver rescission significantly impacted their experience serving meals, including increases in workload, spending and staffing; reductions in meal types (eg, breakfast); fewer meals served; and changing closed sites to open. Sponsors expressed desire for the state to apply for waivers on behalf of all SFSP sponsors in future years. CONCLUSION The federal rescission of USDA summer meals waivers created substantial barriers for sponsors. To address the issues created by policy decisions, school food authorities and other SFSP should continue to work with researchers and antihunger advocates to share their experiences in order to shape state programs and policies.
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Affiliation(s)
- Kaitlyn Harper
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street-Room E4543, Baltimore, MD, 21205-2103
| | - Stacy V Lu
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street-Room E4543, Baltimore, MD, 21205-2103
| | - Julia Gross
- Maryland Hunger Solutions, 711 W. 40th Street Suite 360, Baltimore, MD, 21211
| | - Chinwe Obudulu
- Maryland Hunger Solutions, 711 W. 40th Street Suite 360, Baltimore, MD, 21211
| | - Michael J Wilson
- Maryland Hunger Solutions, 711 W. 40th Street Suite 360, Baltimore, MD, 21211
| | - Susan M Gross
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street-Room E4543, Baltimore, MD, 21205-2103
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Lane HG, Turner L, Dunn CG, Hager ER, Fleischhacker S. Leveraging Implementation Science in the Public Health Response to COVID-19 : Child Food Insecurity and Federal Nutrition Assistance Programs. Public Health Rep 2020; 135:728-736. [PMID: 33031712 PMCID: PMC7649993 DOI: 10.1177/0033354920959285] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 01/16/2023] Open
Affiliation(s)
- Hannah G. Lane
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Lindsey Turner
- College of Education, Boise State University, Boise, ID, USA
| | - Caroline Glagola Dunn
- Department of Health Policy and Management, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Erin R. Hager
- Division of Growth and Nutrition, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
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