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Burkholder K, Bennett BL, McKee SL, Cohen JFW, Xu R, Schwartz MB. Participation in the US Department of Agriculture's Summer Meal Programs: 2019-2021. THE JOURNAL OF SCHOOL HEALTH 2024. [PMID: 38258650 DOI: 10.1111/josh.13438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND The US Department of Agriculture's (USDA) summer meal programs are designed to provide meals at no cost while school is out of session. In response to the COVID-19 pandemic, several regulatory waivers were enacted to facilitate meal distribution. The aim of this study was to assess the rates of meal distribution before and after these waivers were in effect. METHODS Meal distribution patterns for 2019, 2020, and 2021 were examined through (1) a descriptive comparison of the number of participating districts, sponsors, meal sites, and meals distributed statewide, and (2) repeated measures ANOVAs to examine changes among districts in operation all years. RESULTS The waivers were associated with an increase in the total number of participating districts, sponsors, and meal sites; an increase in the total number of meals distributed to children during the summer months; and an increase in meal distribution among sponsors that had been in place since 2019. CONCLUSION Expanding the area eligibility criteria and enabling flexibility in meal distribution methods increased the number of meals provided. This study provides important preliminary evidence to suggest that the USDA should consider permanent regulatory changes to this program to maximize its reach.
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Affiliation(s)
- Kara Burkholder
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, CT; Department of Public Health Sciences, University of Connecticut, Storrs, CT
| | - Brooke L Bennett
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, CT; Department of Psychology, Clemson University, Clemson, SC
| | - Sarah L McKee
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, CT; Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT
| | - Juliana F W Cohen
- School of Nursing and Health Sciences, Merrimack College, North Andover, MA: Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Ran Xu
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT
| | - Marlene B Schwartz
- Rudd Center for Food Policy & Health, University of Connecticut, Hartford, CT; Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
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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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Toossi S. The Distribution of and Access to Free Meal Sites Serving School Aged Children During the COVID-19 Pandemic: Evidence From Texas. THE JOURNAL OF SCHOOL HEALTH 2023; 93:395-401. [PMID: 36866506 DOI: 10.1111/josh.13303] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/01/2022] [Accepted: 02/05/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The COVID-19 pandemic disrupted access to school meal programs, putting children and adolescents at greater risk for food and nutrition insecurity. In response, the US Department of Agriculture (USDA) waived restrictions on where free meal sites (FMS) operating through its summer meal programs could locate. This study assesses whether and how the distribution of FMS across communities and access to them changed after the waiver. METHODS This study used administrative and survey data on all FMS and census tracts in Texas for July 2019, before the waiver, and July 2020, after the waiver. Changes in the characteristics of tracts hosting an FMS and the share within accessible range of a site were evaluated using t-tests. These were supplemented with multilevel conditional logit models linking tract characteristics to the likelihood of hosting an FMS and estimates for the number of children and adolescents with access to an FMS. FINDINGS More FMS were operating after the waiver, and these were spread across a wider range of census tracts. An estimated 213,158 additional children and adolescents gained access to an FMS, including those at highest risk for food and nutrition insecurity. IMPLICATIONS FOR SCHOOL HEALTH POLICY Relaxing restrictions on the location of FMS can expand children and adolescent's access to meals during expected and unexpected disruptions to school meal programs.
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Affiliation(s)
- Saied Toossi
- Economic Research Service, United States Department of Agriculture, 805 Pennsylvania Ave, Kansas City, MO, 64105
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Lu SV, Harper KM, Ding Y, Everett J, Gross J, Borman R, Medina-Perez K, Pinzini B, Wilson MJ, Gross SM. The Impact of the COVID-19 Pandemic on the Experiences and Operations of Sponsors of the Summer Food Service Program in Maryland, USA: A Multiphase Mixed Methods Study. Nutrients 2023; 15:nu15071628. [PMID: 37049469 PMCID: PMC10097045 DOI: 10.3390/nu15071628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/19/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
During the COVID-19 pandemic, the Summer Food Service Program (SFSP) was allowed to operate in untraditional non-summer months to ensure children did not lose access to free and reduced-priced nutritious meals when schools were mandated to close in the United States. This study assessed the impact of the pandemic on the operations and experiences of Summer Food Service Program (SFSP) sponsors in the state of Maryland during the COVID-19 pandemic in 2020 (Phase I) and 2021 (Phase II). This study used a multiphase explanatory sequential mixed methods design with qualitative prioritization. Maryland SFSP sponsors completed an online survey (Phase I: n = 27, Phase II: n = 30), and semi-structured in-depth interviews were conducted with a subset of sponsors who completed the survey (Phase I: n = 12, Phase II: n = 7). Inductive and deductive analyses were used for qualitative data, and descriptive statistics were used for quantitative data. The COVID-19 pandemic caused SFSP sponsors to change their operations. Sponsors were primarily concerned about staff safety/burnout and decreased participation. Sponsors perceived waivers implemented by the United States Department of Agriculture to be crucial in enabling them to serve meals to children during the pandemic. The findings from our study support advocacy efforts to permanently implement waivers and provide free school meals for all children.
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Serving Summer Meals During the COVID-19 Pandemic: A Case Study of 2 Summer Food Service Program Sponsors in Maryland. THE JOURNAL OF SCHOOL HEALTH 2023; 93:249. [PMID: 36724886 PMCID: PMC10117032 DOI: 10.1111/josh.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
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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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Katz BN, Soldavini J, Grover K, Jilcott Pitts S, Martin SL, Thayer L, Ammerman AS, Lane HG. “Let’s Use This Mess to Our Advantage”: Calls to Action to Optimize School Nutrition Program beyond the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137650. [PMID: 35805309 PMCID: PMC9265650 DOI: 10.3390/ijerph19137650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 01/27/2023]
Abstract
School nutrition programs mitigate food insecurity and promote healthy eating by offering consistent, nutritious meals to school-aged children in communities across the United States; however, stringent policy guidelines and contextual challenges often limit participation. During COVID-19 school closures, most school nutrition programs remained operational, adapting quickly and innovating to maximize reach. This study describes semi-structured interviews with 23 nutrition directors in North Carolina, which aimed to identify multi-level contextual factors that influenced implementation, as well as ways in which the innovations during COVID-19 could translate to permanent policy and practice change and improve program reach. Interviews were conducted during initial school closures (May–August 2020) and were deductively analyzed using the Social Ecological Model (SEM) and Consolidated Framework for Implementation Research (CFIR). Analysis elicited multiple relevant contextual factors: director characteristics (motivation, leadership style, experience), key implementation stakeholders (internal staff and external partners), inner setting (implementation climate, local leadership engagement, available resources, structural characteristics), and outer setting (state leadership engagement, external policies and incentives). Findings confirm the strength and resilience of program directors and staff, the importance of developing strategies to strengthen external partnerships and emergency preparedness, and strong support from directors for policies offering free meals to all children.
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Affiliation(s)
- Beth N. Katz
- Food Insight Group, Berkeley, CA 94707, USA; (B.N.K.); (L.T.)
| | - Jessica Soldavini
- Center for Health Promotion and Disease Prevention, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC 27599, USA;
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC 27599, USA; (S.L.M.); (A.S.A.)
| | - Kiran Grover
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | | | - Stephanie L. Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC 27599, USA; (S.L.M.); (A.S.A.)
| | - Linden Thayer
- Food Insight Group, Berkeley, CA 94707, USA; (B.N.K.); (L.T.)
| | - Alice S. Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC 27599, USA; (S.L.M.); (A.S.A.)
- Department of Public Health, East Carolina University, Greenville, NC 27858, USA;
| | - Hannah G. Lane
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27708, USA
- Correspondence:
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