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Johnson-Motoyama M, Ginther DK, Oslund P, Jorgenson L, Chung Y, Phillips R, Beer OWJ, Davis S, Sattler PL. Association Between State Supplemental Nutrition Assistance Program Policies, Child Protective Services Involvement, and Foster Care in the US, 2004-2016. JAMA Netw Open 2022; 5:e2221509. [PMID: 35816315 PMCID: PMC9280401 DOI: 10.1001/jamanetworkopen.2022.21509] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Public assistance policies may play a role in preventing child maltreatment by improving household resources among families of low incomes. The Supplemental Nutrition Assistance Program (SNAP) is one of the largest public assistance programs in the US. However, the association of state SNAP policy options to Child Protective Services (CPS) outcomes has not been rigorously examined. OBJECTIVE To model the association of state SNAP policies with changes in CPS and foster care outcomes in the US over time. DESIGN, SETTING, AND PARTICIPANTS This cohort study used panel data to examine the association between SNAP policy options and study outcomes from 2004 to 2016 for 50 US states and the District of Columbia in 2-way fixed-effects regression models. The count of SNAP policies was used as an instrument for SNAP caseloads in instrumental variables models. Data analysis was conducted in November 2021. EXPOSURES The adoption of 1 or more state SNAP income generosity policies that improves or stabilizes household resources for SNAP participants. MAIN OUTCOMES AND MEASURES Reports of child maltreatment accepted for CPS investigation, children in substantiated reports, and children receiving foster care services for all forms of maltreatment, and specifically for child neglect per 100 000 child population. RESULTS The mean (SD) number of SNAP income generosity policies increased from 1.47 (0.95) in 2004 to 2.37 (0.94) in 2010, to 2.49 (0.86) in 2016 across states; the median increased from 1 to 3 (range, 0-4) over the same period. A count of state income generosity policies was associated with large reductions in reports accepted for CPS investigation (-352.6 per 100 000 children; 95% CI, -557.1 to -148.2). Income generosity policy was associated with -94.8 (95% CI, -155.6 to -34.0) fewer substantiated reports and -77.0 (95% CI, -125.4 to -28.6) fewer reports substantiated for neglect per 100 000. Each additional income generosity policy adopted by a state was associated with -45.1 (95% CI, -71.6 to -18.5) to -42.3 (95% CI, -64.8 to -19.8) fewer total foster care placements per 100 000 children. CONCLUSIONS AND RELEVANCE State SNAP policies that improve and stabilize household resources appear to be associated with reductions in CPS involvement and use of foster care. The number of policies implemented had cumulative outcomes beyond individual policy outcomes.
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Affiliation(s)
| | - Donna K. Ginther
- The University of Kansas Institute for Policy and Social Research, Lawrence
| | - Patricia Oslund
- The University of Kansas Institute for Policy and Social Research, Lawrence
| | - Lindsay Jorgenson
- The University of Kansas Institute for Policy and Social Research, Lawrence
| | - Yoonzie Chung
- University of Maryland School of Social Work, Baltimore
| | | | | | - Starr Davis
- The Ohio State University College of Social Work, Columbus
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202
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LeBleu G, Landry MJ. Hunting-Based Food Donation Programs: Program Characteristics Across the US. J Nutr Educ Behav 2022; 54:677-683. [PMID: 35595636 DOI: 10.1016/j.jneb.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 03/04/2022] [Accepted: 03/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Hunting-based food donation (HBFD) programs are unique food assistance programs because they provide under-resourced food bank participants with a quality protein source. This study aimed to summarize the characteristics of US HBFD programs and discuss the potential barriers and considerations to use or access these programs. METHODS Data were collected via a web search for HBFD programs within all 50 states and the District of Columbia. RESULTS Most states were found to have an active program (n = 36), whereas 14 states and the District of Columbia do not have programs. Game donation amounts vary greatly between states, and funding for these programs typically comes from a government agency. CONCLUSIONS AND IMPLICATIONS Hunting-based food donation can positively impact the food security and nutritional status of vulnerable populations. Nutrition professionals can aid in promoting awareness of these programs and provide nutrition education around wild game nutrition, safety, and food preparation.
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Affiliation(s)
- Grace LeBleu
- Graduate Group in Nutritional Biology, University of California Davis, Davis, CA
| | - Matthew J Landry
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA.
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203
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de Brito JN, Loth KA, Fertig A, Trofholz AC, Tate A, Berge JM. Participant characteristics and dietary correlates of SNAP and other assistance programs among families with children from racially and ethnically diverse households. Appetite 2022; 174:106015. [PMID: 35364114 PMCID: PMC9058240 DOI: 10.1016/j.appet.2022.106015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/02/2022]
Abstract
The objective of this study was to describe food purchasing behaviors and the home food environment across families simultaneously receiving SNAP (Supplemental Nutrition Assistance Program) and other cash and food assistance benefits, and assess how child dietary intake varied across three distinct categories of assistance (i.e., SNAP and other assistance programs, assistance programs other than SNAP, and not enrolled in any assistance program). This cross-sectional study was conducted with parents of children aged 5-9 years (N = 1033) from low-income and racially and ethnically diverse households, living in Minneapolis and Saint Paul, Minnesota, metropolitan areas. In an online survey, parents reported enrollment in seven assistance programs (SNAP, WIC [Special Supplemental Nutrition Program for Women, Infants and Children Program], free or reduced-cost school breakfast, free or reduced-cost school lunch, SSI [Supplemental Security Income Program], MFIP [Minnesota Family Investment Program], daycare assistance), food purchasing behaviors, the home food environment, and child dietary and fast-food intake. Descriptive statistics were computed to describe food purchasing behaviors and the home food environment. Multivariable linear regressions were used to evaluate the association between assistance categories and child dietary intake factors. Models were adjusted for child age, parent and child sex, race and ethnicity, household income, primary caregiver's educational attainment, employment status, and place of birth. Relative to families participating in assistance programs other than SNAP and not enrolled in any assistance program, families participating in SNAP and other assistance programs had less reliable modes of transportation to go food shopping (use 'my own car or vehicle' 57% vs. 90% and 83%, respectively), shopped less frequently during the month ('1 big trip a month and small trips in between' 35% vs. 19% and 24%, respectively], had a somewhat higher presence of energy-dense (e.g., 'French fries' 60% vs. 35% and 25%, respectively) and high-sodium food items in the home (e.g., 'canned pasta' meals 48% vs. 35% and 20%, respectively), and some aspects of children's dietary intake that were not congruent with current dietary recommendations (e.g., consumption of 'fried vegetables' 3.9 times/week [95% CI 3.4, 4.4] vs. 2.9 [2.3, 3.5] and 2.8 [2.1, 3.6], respectively). Findings could inform targeted strategies to maximize the impact of simultaneous programs' benefits on improving child dietary intake and reaching eligible households not enrolled in assistance programs.
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Affiliation(s)
- Junia N de Brito
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, USA.
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St SE, Suite 400, Minneapolis, MN, 55414, USA
| | - Angela Fertig
- Humphrey School of Public Affairs, University of Minnesota, 130 Humphrey School, 301 19th Avenue South, Minneapolis, MN, 55455, USA
| | - Amanda C Trofholz
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St SE, Suite 400, Minneapolis, MN, 55414, USA
| | - Allan Tate
- Department of Epidemiology and Biostatistics, University of Georgia, 101 Buck Rd, Athens, GA, 30606, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St SE, Suite 400, Minneapolis, MN, 55414, USA
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204
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Borger C, Paolicelli C, Sun B, Zimmerman TP, Dixit-Joshi S. Duration of WIC Participation and Early Feeding Practices Are Associated With Meeting the Added Sugars Recommendation at Age 3 Years. J Nutr Educ Behav 2022; 54:670-676. [PMID: 35568685 DOI: 10.1016/j.jneb.2022.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To examine whether duration of participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and early feeding practices are associated with the likelihood of meeting the Dietary Guidelines for Americans (DGA) recommendation for added sugars (AS) at age 3 years. METHODS Using data from the WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2), logistic regression assessed associations between WIC participation patterns, early feeding practices, and whether 3-year-olds met the AS recommendation. RESULTS Children introduced to sugar-sweetened beverages (SSBs) in their first year were about half (adjusted odds ratio, 0.65; P < 0.01) as likely to meet the recommendation as those not exposed in their first 2 years. First-year-only WIC participation (adjusted odds ratio, 0.61; P < 0.04) also increased the risk of excessive consumption compared with children who participated in their third year. CONCLUSIONS AND IMPLICATIONS Duration of WIC participation is inversely associated with young children's AS intakes. Public health efforts to reduce WIC attrition and enhance education efforts focused on delaying sugar-sweetened beverage introduction are supported.
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Affiliation(s)
| | - Courtney Paolicelli
- Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
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205
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Marcus M, Yewell KG. The Effect of Free School Meals on Household Food Purchases: Evidence from the Community Eligibility Provision. J Health Econ 2022; 84:102646. [PMID: 35792362 DOI: 10.1016/j.jhealeco.2022.102646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
We find access to universal free school meals through the Community Eligibility Provision (CEP) had a meaningful impact on grocery spending for households with children, with monthly food purchases declining by about $11, or 5 percent. For households in zip codes with higher exposure, the decline is as high as $39 per month, or 19 percent. The composition of food purchases also changes after CEP, with low income households experiencing a 3 percent improvement in dietary quality. Finally, CEP exposure is associated with an almost 5 percent decline in households classified as food insecure. Our results on the heterogeneous effects of CEP exposure by prior free/reduced price lunch eligibility reveal benefits in terms of both spending, dietary composition, and food insecurity for previously eligible low-income families, suggesting that the stigma of free school meals may be declining after universal access.
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206
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Kanu FA, Hamner HC, Scanlon KS, Sharma AJ. Anemia Among Pregnant Women Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children - United States, 2008-2018. MMWR Morb Mortal Wkly Rep 2022; 71:813-819. [PMID: 35737575 DOI: 10.15585/mmwr.mm7125a1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Among pregnant women, anemia, a condition of low hemoglobin concentration, can increase risk for maternal and fetal morbidity and mortality, including premature delivery, and other adverse outcomes (1). Iron deficiency is a common cause of anemia, and during pregnancy, iron requirements increase (2). Surveillance of anemia during pregnancy in the United States is limited. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Participant and Program Characteristics (PC) data provide an opportunity to establish national and WIC state agency-level* anemia surveillance for WIC participants. National and state agency anemia prevalences among pregnant WIC participants at enrollment were examined using 2008-2018 WIC-PC data. Across all 90 WIC agencies (50 states, the District of Columbia [DC], five territories, and 34 Indian Tribal Organizations), anemia prevalence among pregnant WIC participants at enrollment increased significantly, from 10.1% in 2008 to 11.4% in 2018 (13% increase). Anemia prevalence increased significantly in 36 (64%) of the 56 agencies in states, DC, and territories, and decreased significantly in 11 (20%). Prevalence of anemia overall and by pregnancy trimester were higher among non-Hispanic Black or African American (Black) women than among other racial or ethnic groups. Anemia prevalence was higher among women assessed during the third trimester of pregnancy than among those assessed during first or second trimesters. Routine anemia surveillance using WIC enrollment anemia data can identify groups at higher risk for iron deficiency. Findings from this report indicate that anemia continues to be a problem among low-income women and reinforces the importance of efforts that ensure these women have access to healthier, iron-rich foods before and during pregnancy. This includes ensuring that eligible women are enrolled in WIC early during pregnancy.
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207
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Capps O. Dynamics of macroeconomic factor effects on food assistance program participation in the United States. PLoS One 2022; 17:e0269442. [PMID: 35696377 PMCID: PMC9191738 DOI: 10.1371/journal.pone.0269442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 05/21/2022] [Indexed: 11/27/2022] Open
Abstract
Using polynomial distributed lag (PDL) models, the impacts of macroeconomic factors relating to economic, financial, and sociological stress and designed to be short-run predictors of U.S. economic performance are identified and assessed concerning participation in key food assistance programs (SNAP, WIC, and NSLP). The econometric analysis covers the period October 1999 to September 2020. The impact of COVID-19 on participation in these programs also is quantified. Based on the parameter estimates obtained from the econometric PDL models, ex-ante forecasts of participation in the SNAP, WIC, and NSLP subsequently are made and evaluated over the period October 2020 to August 2021. The empirical results show that different sets of macroeconomic drivers affect participation levels across the respective food assistance programs. No macroeconomic factor is common across SNAP, WIC, and NSLP participation. Changes in macroeconomic conditions which influence SNAP, WIC and NSLP participation are not just contemporaneous but also affect participation levels anywhere from 1 month to 12 months later. Importantly, this research allows not only the determination of the macroeconomic factors which affect program participation but also allows the determination of the ability of the respective models to forecast program participation. As such, the Food and Nutrition Service will be in better position to assess program needs as well as to forecast program participation levels to minimize errors in the budgetary process.
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Affiliation(s)
- Oral Capps
- Department of Agricultural Economics, Texas A&M University, College Station, Texas, United States of America
- * E-mail:
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208
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Greenwald HP, Tao E, Tilley G. Farmers' Market Incentives for Low-Income Families: Who Uses, How Much, and Why. Am J Prev Med 2022; 62:864-871. [PMID: 35597565 DOI: 10.1016/j.amepre.2021.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/22/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Focusing on participation and utilization, this research helps to assess the potential impact and contributions of farmers' market incentive programs, often seen as means for improving nutrition and preventing disease among low-income families. METHODS Evaluating the largest farmers' market incentive program in the U.S. (California Market Match), this study used (1) 3 administrative databases (n=1,469, 6,799, and 30,506), (2) a participant survey (n=2,723), and (3) longitudinal interviews (n=163) with active and former participants. Quantitative data were analyzed with contingency tables and multiple regression. Qualitative data were coded into analytically significant themes. Data were collected in 2015-2018 and analyzed in 2018-2021. RESULTS Participation was typically low and varied across localities (3.7%-19.8% of eligible families in a sample of ZIP codes). According to administrative records, market visits by participants in 2 California regions averaged 2.18 and 3.12 per season. However, 77.1% of participants in the shopper survey indicated that they were repeat customers, and 51.0% indicated that they were regular utilizers. Deterrents to utilization included perceptions of inconvenience and high prices but not availability of produce in the community or travel time to markets. Utilization was most frequent among Asian shoppers and residents of Southern California outside Los Angeles County. CONCLUSIONS Farmers' market incentive programs such as Market Match appear likely to benefit population health through a core of committed shoppers. Improvement in participation and utilization may be attained through a better understanding of the communities that the markets are intended to serve.
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Affiliation(s)
- Howard P Greenwald
- Sol Price School of Public Policy, University of Southern California, Los Angeles, California.
| | - Ernie Tao
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Gabrielle Tilley
- The Los Angeles Trust for Children's Health, Los Angeles, California
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209
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Gallo S, Gahche J, Kitsantas P, Makwana P, Wang Y, Chen X, Rajbhandari-Thapa J. Vitamin D Intake and Meeting Recommendations Among Infants Participating in WIC Nationally. J Nutr Educ Behav 2022; 54:499-509. [PMID: 35288058 PMCID: PMC9149040 DOI: 10.1016/j.jneb.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To report and examine associations with infant vitamin D intake and meeting recommendations among a national sample participating in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN Secondary analysis from the 2013-2015 WIC Infant Toddler Feeding Practices Study-2. PARTICIPANTS US Infants. VARIABLES MEASURED Total reported vitamin D intake from diet and supplementation at the time of data collection. ANALYSIS Descriptive statistics and generalized estimating equations. RESULTS The median total vitamin D intake ranged from 5.43 (95% confidence interval, 5.40-5.46) mcg/d at month 1 to 8.18 (95% confidence interval, 8.11-8.20) mcg/d at month 13, with 16% to 36% of infants meeting the infant vitamin D recommendation over that time. Overall, 6% to 12% of all participants reported supplementation across all time points. Although most (between 78% to 98%) of supplemented breastfed infants met the recommendation, very few were supplemented as a group. Hence, breastfed infants were less likely to meet the recommendation than those who were formula fed across at time points except month 1 (P < 0.001 for all). Whereas infant age, feeding type, and/or their interaction were significant predictors of both receiving supplementation and meeting the recommendation, mother/caregiver nativity (P = 0.006) and parity (P = 0.01 and P < 0.001) predicted receiving supplementation, and child sex (P < 0.001) and mother/caregiver race/ethnicity (P < 0.001) predicted meeting the recommendation. CONCLUSIONS AND IMPLICATIONS Among a national sample of infants participating in WIC between 2013-2015, a high proportion were not meeting the current vitamin D recommendation. The WIC program is 1 resource for promoting strategies for increasing the number of American infants meeting D recommendations, but a coordinated approach involving other health care providers is likely needed. Future research exploring the reason for lack of supplementation, from both the perspective of parents and providers and the clinical impact of low vitamin D intake, is warranted.
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Affiliation(s)
- Sina Gallo
- Department of Nutritional Sciences, University of Georgia, Athens, GA.
| | - Jaime Gahche
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD
| | - Panagiota Kitsantas
- Department of Health Administration and Policy, George Mason University, Fairfax, VA
| | - Priyal Makwana
- Department of Health Administration and Policy, George Mason University, Fairfax, VA
| | - Yu Wang
- Department of Statistics, University of Georgia, Athens, GA
| | - Xianyan Chen
- Department of Statistics, University of Georgia, Athens, GA
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210
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Dong KR, Chen X, Stopka TJ, Must A, Beckwith CG, Tang AM. Food Access, Dietary Intake, and Nutrition Knowledge of Adults on Probation. J Nutr Educ Behav 2022; 54:510-520. [PMID: 35618404 PMCID: PMC9186298 DOI: 10.1016/j.jneb.2021.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To examine food access, dietary intake, and perceptions about diet and associations with health among adults on probation. DESIGN Using a mixed-methods approach, interviews were used to understand food access, dietary intake, and diet and associations with health. A survey measured self-assessed diet quality and diet and associations with health. SETTING One probation office in Rhode Island. PARTICIPANTS English-speaking adults on probation in 2016 (n = 22 interviews, n = 304 surveys). MAIN OUTCOME MEASURE(S) Food access, dietary intake, knowledge about diet and health, and perceptions about healthy food. ANALYSIS We used a thematic analytic approach to analyze the interviews. Descriptive statistics were performed for the survey. RESULTS Many interviewees had inadequate food access, although most participated in the Supplemental Nutrition Assistance Program, and some received food from food banks. Interviewees primarily shopped at grocery stores and prepared food at home, and dietary intakes did not meet the 2020-2025 Dietary Guidelines for Americans. Almost two-thirds (64.2%) of survey participants reported good or fair diet quality. Based on the survey results, the majority of participants strongly agreed and agreed with the statements, "The types of foods I eat affect my health" and "The types of food I eat affect my weight." CONCLUSIONS AND IMPLICATIONS This study identified low-quality dietary intake and food acquisition strategies, such as shopping sales, buying bulk, and going to multiple stores, by US adults on probation to access food with limited resources. Participants reported interest in eating healthier foods and knew there was a connection between dietary intake and health. These data support addressing ways to improve food access and dietary quality, focusing on future programs and policies for this population.
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Affiliation(s)
- Kimberly R Dong
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
| | - Xuemeng Chen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Thomas J Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
| | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Curt G Beckwith
- Division of Infectious Diseases, Alpert Medical School of Brown University, The Center for AIDS Research, The Miriam Hospital, Providence, RI
| | - Alice M Tang
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
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211
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Ziso D, Chun OK, Puglisi MJ. Increasing Access to Healthy Foods through Improving Food Environment: A Review of Mixed Methods Intervention Studies with Residents of Low-Income Communities. Nutrients 2022; 14:nu14112278. [PMID: 35684077 PMCID: PMC9182982 DOI: 10.3390/nu14112278] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 12/22/2022] Open
Abstract
Food insecurity is a broad and serious public health issue in the United States, where many people are reporting lack of access to healthy foods. The reduced availability of healthy, affordable foods has led to increased consumption of energy-dense and nutrient-poor foods, resulting in increasing the risk for many chronic diseases such as obesity, cardiovascular diseases, and type 2 diabetes mellitus. Thus, identifying promising approaches to increase access to healthy foods through improving the food environment is of importance. The purpose of this review article is to highlight how the food environment affects directly a person’s food choices, and how to increase access to healthy foods through improving environmental approaches. The literature search was focused on finding different approaches to improve food security, primarily those with an impact on food environment. Overall, potential solutions were gathered through multilevel environmental approaches, including nutrition education and peer education, community-based participatory research, and policy changes in supplemental nutrition programs. A recommendation to reduce food insecurity is learning to create meals with a variety of seasonal fruits and vegetables purchased from affordable farmers’ markets.
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Lu V, Zhang J, Chen G. Can nutrition interventions tackle the global insulin affordability via improving diabetes management and reducing insulin demand? Glob Health Res Policy 2022; 7:13. [PMID: 35546683 PMCID: PMC9092701 DOI: 10.1186/s41256-022-00247-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 04/28/2022] [Indexed: 02/07/2023] Open
Abstract
Diabetes, a global health concern, requires insulin therapy. As insulin demand and prices rise dramatically, insulin affordability has increasingly become an issue facing patients with diabetes worldwide. To cut insulin costs, many patients ration their supply, which may have dire health consequences. This particularly affects lower-income populations, who are often forced to choose between purchasing their medications or paying for other necessities. Nutrition might be one solution for this. This commentary aims to provide comprehensive insight with historical context into intersectional components of diabetes in the global arena through analyses of insulin affordability, coupled with the critical role of nutrition intervention after searching the PubMed for relevant articles. More studies in personalized nutrition, supplementations, and dietary behaviors may develop evidence-based nutrition interventions to control diabetes. We argue that alongside price regulation, a greater focus to nutrition to address issues of food insecurity and food assistance programs may help to improve insulin affordability.
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Affiliation(s)
- Victoria Lu
- Yantai Zestern Biotechnique Co. LTD, Yantai, Shandong, 264670, China
| | - Jiandi Zhang
- Yantai Zestern Biotechnique Co. LTD, Yantai, Shandong, 264670, China
| | - Guoxun Chen
- Department of Nutrition, University of Tennessee at Knoxville, 229 Jessie Harris Building, 1215 West Cumberland Avenue, Knoxville, TN, 37909, USA.
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213
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Leng KH, Yaroch AL, Nugent NB, Stotz SA, Krieger J. How Does the Gus Schumacher Nutrition Incentive Program Work? A Theory of Change. Nutrients 2022; 14:nu14102018. [PMID: 35631159 PMCID: PMC9146513 DOI: 10.3390/nu14102018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/30/2022] [Accepted: 05/05/2022] [Indexed: 12/27/2022] Open
Abstract
Increased fruit and vegetable (FV) intake is associated with decreased risk of nutrition-related chronic diseases. Sociodemographic disparities in FV intake indicate the need for strategies that promote equitable access to FVs. The United States Department of Agriculture’s Gus Schumacher Nutrition Incentive Program (GusNIP) supports state and local programs that offer nutrition incentives (NIs) that subsidize purchase of FVs for people participating in the Supplemental Nutrition Assistance Program (SNAP). While a growing body of research indicates NIs are effective, the pathways through which GusNIP achieves its results have not been adequately described. We used an equity-focused, participatory process to develop a retrospective Theory of Change (TOC) to address this gap. We reviewed key program documents; conducted a targeted NI literature review; and engaged GusNIP partners, practitioners, and participants through interviews, workshops, and focus groups in TOC development. The resulting TOC describes how GusNIP achieves its long-term outcomes of increased participant FV purchases and intake and food security and community economic benefits. GusNIP provides NIs and promotes their use, helps local food retailers develop the capacity to sell FVs and accept NIs in accessible and welcoming venues, and supports local farmers to supply FVs to food retailers. The TOC is a framework for understanding how GusNIP works and a tool for improving and expanding the program.
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Affiliation(s)
- Kirsten H. Leng
- Healthy Food America, Seattle, WA 98122, USA;
- Correspondence: ; Tel.: +1-206-412-0997
| | - Amy L. Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, NE 68154, USA; (A.L.Y.); (N.B.N.)
| | - Nadine Budd Nugent
- Gretchen Swanson Center for Nutrition, Omaha, NE 68154, USA; (A.L.Y.); (N.B.N.)
| | - Sarah A. Stotz
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - James Krieger
- Healthy Food America, Seattle, WA 98122, USA;
- School of Public Health, University of Washington, Seattle, WA 98195, USA
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Thorndike AN, Gardner CD, Kendrick KB, Seligman HK, Yaroch AL, Gomes AV, Ivy KN, Scarmo S, Cotwright CJ, Schwartz MB. Strengthening US Food Policies and Programs to Promote Equity in Nutrition Security: A Policy Statement From the American Heart Association. Circulation 2022; 145:e1077-e1093. [PMID: 35535604 DOI: 10.1161/cir.0000000000001072] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nutritionally inadequate dietary intake is a leading contributor to chronic cardiometabolic diseases. Differences in dietary quality contribute to socioeconomic and racial and ethnic health disparities. Food insecurity, a household-level social or economic condition of limited access to sufficient food, is a common cause of inadequate dietary intake. Although US food assistance policies and programs are designed to improve food security, there is growing consensus that they should have a broader focus on nutrition security. In this policy statement, we define nutrition security as an individual or household condition of having equitable and stable availability, access, affordability, and utilization of foods and beverages that promote well-being and prevent and treat disease. Despite existing policies and programs, significant gaps remain for achieving equity in nutrition security across the life span. We provide recommendations for expanding and improving current food assistance policies and programs to achieve nutrition security. These recommendations are guided by several overarching principles: emphasizing nutritional quality, improving reach, ensuring optimal utilization, improving coordination across programs, ensuring stability of access to programs across the life course, and ensuring equity and dignity for access and utilization. We suggest a critical next step will be to develop and implement national measures of nutrition security that can be added to the current US food security measures. Achieving equity in nutrition security will require coordinated and sustained efforts at the federal, state, and local levels. Future advocacy, innovation, and research will be needed to expand existing food assistance policies and programs and to develop and implement new policies and programs that will improve cardiovascular health and reduce disparities in chronic disease.
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215
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Cha P, Escarce JJ. The Affordable Care Act Medicaid expansion: A difference-in-differences study of spillover participation in SNAP. PLoS One 2022; 17:e0267244. [PMID: 35507557 PMCID: PMC9067645 DOI: 10.1371/journal.pone.0267244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 04/05/2022] [Indexed: 11/18/2022] Open
Abstract
The Affordable Care Act’s Medicaid expansion to individuals with adults under 138 percent of the federal poverty level led to insurance coverage for millions of Americans in participating states. This study investigates Medicaid expansion’s potential spillover participation in the Supplemental Nutrition Assistance Program (SNAP; formerly the Food Stamp Program). In addition to providing public insurance, the policy connects individuals to SNAP, affecting social determinants of health such as hunger. We use difference-in-differences regression to estimate the effect of the Medicaid expansion on SNAP participation among approximately 414,000 individuals from across the United States. The Current Population Survey is used to answer the main research question, and the SNAP Quality Control Database allows for supplemental analyses. Medicaid expansion produces a 2.9 percentage point increase (p = 0.002) in SNAP participation among individuals under 138 percent of federal poverty. Subgroup analyses find a larger 5.0 percentage point increase (p = 0.002) in households under 75 percent of federal poverty without children. Able-Bodied Adults Without Dependents (ABAWDs) are a category of individuals with limited access to SNAP. Although they are a subset of adults without children, we found no spillover effect for ABAWDs. We find an increase in SNAP households with $0 income, supporting the finding that spillover was strongest for very-low-income individuals. Joint processing of Medicaid and SNAP applications helps facilitate the connection between Medicaid expansion and SNAP. Our findings contribute to a growing body of evidence that Medicaid expansion does more than improve access to health care by connecting eligible individuals to supports like SNAP. SNAP recipients have increased access to food, an important social determinant of health. Our study supports reducing administrative burdens to help connect individuals to safety net programs. Finally, we note that ABAWDs are a vulnerable group that need targeted program outreach.
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Affiliation(s)
- Paulette Cha
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, United States of America
- Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, United States of America
- UC Berkeley, Institute of Government Studies, Berkeley, CA
- * E-mail:
| | - José J. Escarce
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, United States of America
- Division of General Internal Medicine, UCLA Geffen School of Medicine, Los Angeles, California, United States of America
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216
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Wilking C, Nink E, Cradock AL. Drinking Water and the Supplemental Nutrition Assistance Program: Current Policy and Opportunities for Improvement. J Public Health Manag Pract 2022; 28:218-221. [PMID: 34939606 PMCID: PMC10635565 DOI: 10.1097/phh.0000000000001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Cara Wilking
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts (Ms Nink and Dr Cradock). Dr Wilking is an independent legal consultant, Barnstable, Massachusetts
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217
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Gibson S, Metcalfe JJ, McCaffrey J, Allison T, Prescott MP. Nutrition Environment at Food Pantries Improves After Fresh Produce Donation Program. J Nutr Educ Behav 2022; 54:432-441. [PMID: 35534101 DOI: 10.1016/j.jneb.2021.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 09/11/2021] [Accepted: 09/16/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To evaluate the influence of the Growing Together Illinois fresh produce donation program and understand factors that affect produce distribution at participating food pantries. METHODS In this intervention at 17 Illinois food pantries, Master Gardeners supported food donation gardens, and Supplemental Nutrition Assistance Program Education provided educational and environmental interventions to increase selection and use of fresh produce. This mixed-methods pre-post study assessed pantry characteristics and program impact via Nutrition Environment Food Pantry Assessment Tool evaluations, interview feedback from pantry staff, and structured pantry observations. RESULTS Pantries experienced significant increases from preintervention to postintervention in providing various types of produce, marketing and nudging healthful products, providing additional resources, and total Nutrition Environment Food Pantry Assessment Tool scores. Participants had positive feedback about the program and educational interventions and reported the weekly timing of donations mitigated potential storage and spoilage issues. CONCLUSIONS AND IMPLICATIONS Future research could focus on approaches to increase fresh produce in food pantries while supporting clients via nutrition and cooking education.
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Affiliation(s)
- Starr'Retiece Gibson
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL
| | - Jessica Jarick Metcalfe
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL
| | - Jennifer McCaffrey
- Office of Extension and Outreach, University of Illinois, Urbana-Champaign, Urbana, IL
| | - Trinity Allison
- Office of Extension and Outreach, University of Illinois, Urbana-Champaign, Urbana, IL
| | - Melissa Pflugh Prescott
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL.
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218
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Esaryk EE, Moffat LF, Ritchie LD, Martinez SM. Helping College Students Get Supplemental Nutrition Assistance Program: Facilitators of and Barriers to Students Accessing the Federal Nutrition Assistance Program. J Nutr Educ Behav 2022; 54:422-431. [PMID: 35534100 DOI: 10.1016/j.jneb.2022.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 01/19/2022] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To identify effective practices for assisting college students with Supplemental Nutrition Assistance Program (SNAP) applications and explore challenges in student SNAP enrollment. DESIGN In-depth interviews with key informants on experiences assisting college students with SNAP applications. SETTING University of California campuses. PARTICIPANTS Twenty-one key informants, including staff from the University of California on-campus Basic Needs Centers, campus financial aid offices, county agencies, and food banks. PHENOMENON OF INTEREST Facilitators and barriers of college student SNAP enrollment. ANALYSIS Transcripts were coded to identify emerging themes. RESULTS Two of the most frequently mentioned facilitators were county staff presence on campus for application assistance and a strong relationship between campus staff and the county SNAP agency. A common barrier was inconsistent student SNAP eligibility information and procedures across county offices. CONCLUSION AND IMPLICATIONS Federal coordination with state agencies on student SNAP policy is much needed. This approach could help to eliminate heterogeneous interpretations of student exemptions across counties and between county staff. Future research is warranted to identify policy leverage points at the county, state, and federal levels, such as eliminating the student rule, to ensure equitable access to SNAP among college students.
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Affiliation(s)
- Erin E Esaryk
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Laurel F Moffat
- Youth and Families Program Unit, Clark County Extension, Washington State University, Vancouver, WA
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA
| | - Suzanna M Martinez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
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219
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Blumberg R, Fowler E, Bai Y, Lal P, Smolen A, Dubrovsky I. An Investigation of Social Ecological Barriers to and Facilitators of WIC Farmers Market Nutrition Program Voucher Redemption. Nutrients 2022; 14:nu14091871. [PMID: 35565837 PMCID: PMC9099787 DOI: 10.3390/nu14091871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 02/04/2023] Open
Abstract
In the United States, many communities lack sufficient access to fresh produce. To improve access to fresh fruits and vegetables, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides eligible participants vouchers through the Farmers Market Nutrition Program (FMNP) that can be redeemed directly from farmers at markets or farm stands. However, FMNP voucher redemption rates in New Jersey remain lower than those in neighboring states. This article used the social ecological model to examine differences between FMNP participants who redeem vouchers (Redeemers) and those who do not (non-Redeemers) in the areas of: produce procurement practices and consumption frequency, and barriers to and facilitators of FMNP voucher redemption. This cross-sectional study included WIC FMNP participants (N = 329) in northern New Jersey, USA. Analyses were conducted using descriptive statistics, independent sample t-tests, and one-way ANOVA. Compared to Redeemers, non-Redeemers consumed fewer average daily vegetable servings, were more likely to shop at small grocery/corner stores, and encountered significant barriers to FMNP redemption, e.g., difficulty finding time to redeem vouchers.
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Affiliation(s)
- Renata Blumberg
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA; (E.F.); (Y.B.); (A.S.); (I.D.)
- Correspondence:
| | - Emily Fowler
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA; (E.F.); (Y.B.); (A.S.); (I.D.)
| | - Yeon Bai
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA; (E.F.); (Y.B.); (A.S.); (I.D.)
| | - Pankaj Lal
- Department of Earth and Environmental Studies, Clean Energy and Sustainability Analytics Center, Montclair State University, Montclair, NJ 07043, USA;
| | - Alyssa Smolen
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA; (E.F.); (Y.B.); (A.S.); (I.D.)
| | - Ilana Dubrovsky
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA; (E.F.); (Y.B.); (A.S.); (I.D.)
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220
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Hewawitharana SC, Webb KL, Strochlic R, Gosliner W. Comparison of Fruit and Vegetable Prices between Farmers' Markets and Supermarkets: Implications for Fruit and Vegetable Incentive Programs for Food Assistance Program Participants. Nutrients 2022; 14:nu14091842. [PMID: 35565810 PMCID: PMC9104456 DOI: 10.3390/nu14091842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 11/16/2022] Open
Abstract
This cross-sectional study was part of a larger evaluation of a fruit and vegetable (FV) incentive program for Supplemental Nutrition Assistance Program (SNAP) participants in California. We examined the price differences in FV to explore whether these could help explain a previously observed lack of effect of the incentive program on FV consumption. Differences by type (organic/no-spray or conventional), among a convenience sample of farmers' markets (n = 11) and nearby supermarkets (n = 7), were assessed using Wilcoxon rank-sum tests adjusting for clustering by market. We calculated the cost of market baskets comprising recommended FV servings for a household using median prices to consider the implications of FV price differences for SNAP shoppers who use financial incentives for FV. We found that farmers' markets primarily offered organic FV while supermarkets primarily offered conventionally grown FV. Farmers' market prices tended to be lower than supermarkets for organic FV but higher for conventional FV. Compared to supermarkets, the market basket composed only of organic FV cost USD 16.34 less at farmers' markets, whereas a basket comprised of a mix of conventionally and organically grown FV cost USD 3.68 more. These differences warrant further exploration; FV price and type should be considered in studies aimed at understanding the impact of SNAP financial incentive programs.
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221
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Vargo L, Ciesielski TH, Embaye M, Bird A, Freedman DA. Understanding SNAP Recipient Characteristics to Guide Equitable Expansion of Nutrition Incentive Programs in Diverse Food Retail Settings. Int J Environ Res Public Health 2022; 19:ijerph19094977. [PMID: 35564371 PMCID: PMC9101614 DOI: 10.3390/ijerph19094977] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/06/2022] [Accepted: 04/15/2022] [Indexed: 12/04/2022]
Abstract
Structural barriers, such as food costs, reduce access to healthy foods for populations with limited income, including those benefitting from the Supplemental Nutrition Assistance Program (SNAP). Nutrition incentive programs seek to address this barrier. Evaluations of SNAP-based incentive programming often focus on one setting (i.e., either farmers’ markets or grocery stores). We examined use patterns, characteristics, and preferences among 253 SNAP consumers with access to incentive programming at both a farmers’ market and a grocery store located within five miles of their home. Cross-sectional survey data were collected in 2019 in two Ohio cities. Despite geographic access, 45% of those surveyed were not using the incentive program; most non-users (80.5%) were unaware of the program. Program users compared to non-users had higher household incomes (p < 0.001) and knew more people using the program (p < 0.001). Grocery stores were the most common setting of use (59%); 29% used at farmers’ markets; 11% used in both settings. User characteristics varied by store setting based on demographics, program experience, fruit and vegetable purchasing and consumption patterns, and social dynamics related to use. Our findings support comprehensive awareness-raising efforts and tailored implementation of incentive programming that attends to diverse segments of SNAP consumers to promote equity in program reach.
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Affiliation(s)
- Lauren Vargo
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Timothy H Ciesielski
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Milen Embaye
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Ana Bird
- Produce Perks Midwest, Cincinnati, OH 45241, USA
| | - Darcy A Freedman
- Mary Ann Swetland Center for Environmental Health Research, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
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222
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Wong LY, Francis SL, Hopkins H, Boudreau H. Virtual Delivery of Fresh Conversations, a SNAP-Ed Program: Participant Perceived Impact and Satisfaction. J Nutr Gerontol Geriatr 2022; 41:191-200. [PMID: 35946593 DOI: 10.1080/21551197.2022.2107594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This four-month study evaluated the virtual delivery of Fresh Conversations (FC). Participants were community-residing Iowans ages 60+ years. They were placed in one of four meeting groups based on location and participant preference: Zoom™, Adobe Connect®, group-based Zoom™ meeting, and teleconference. Participants were invited to complete a post-meeting online survey. Data analyses were completed using data from the first survey completed by each participant (n = 115). Descriptive statistics assessed response frequencies for all questions. Chi-Square and Mann-Whitney U tests assessed the differences between groups. Overall, participants were "satisfied/very satisfied" (72.1%), learned something new (85.2%), and intended to make behavior change (79.1%); no differences were detected by the group for satisfaction or reported impacts. Only 24.3% reported technical difficulties; the Adobe Connect® group reported the most difficulties (p = .004). These findings suggest virtual delivery of FC is well-received and perceived to be effective by participants.
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Affiliation(s)
- Loo Yee Wong
- Department of Food Science and Human Nutrition, Iowa State University, Ames, Iowa, USA
| | - Sarah L Francis
- Department of Food Science and Human Nutrition, Iowa State University, Ames, Iowa, USA
| | - Haley Hopkins
- Iowa Department of Public Health, Des Moines, Iowa, USA
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223
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Andreyeva T, Sun X, Cannon M, Kenney EL. The Child and Adult Care Food Program: Barriers to Participation and Financial Implications of Underuse. J Nutr Educ Behav 2022; 54:327-334. [PMID: 34865970 DOI: 10.1016/j.jneb.2021.10.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 09/27/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To assess facilitators and barriers to participation in the Child and Adult Care Food Program (CACFP) and estimate foregone federal funds because of CACFP underuse. METHODS An online survey of food service practices and experiences with CACFP among Connecticut-based licensed child care centers (n = 231). RESULTS Serving meals and the center's nonprofit status predicted CACFP participation. The most common challenge among participants was collecting family income eligibility. Streamlining paperwork (mentioned by 44% of respondents) and funding for nonfood, administrative costs (40%) were recommended facilitators to increase CACFP uptake. Nonparticipating centers had limited knowledge about the program and its eligibility. Foregone federal funding due to CACFP underuse among eligible Connecticut centers was estimated at $30.7 million in 2019, suggesting that 20,300 young children from low-income areas missed out on CACFP-subsidized food. CONCLUSIONS AND IMPLICATIONS Improving knowledge about CACFP and reducing participation burdens through additional funding and technical assistance can help expand the program to support child nutrition.
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Affiliation(s)
- Tatiana Andreyeva
- Department of Agricultural and Resource Economics, Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT.
| | - Xiaohan Sun
- The Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY
| | - Mackenzie Cannon
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT
| | - Erica L Kenney
- Prevention Research Center on Nutrition and Physical Activity, Harvard T.H. Chan School of Public Health, Boston, MA
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224
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Burke MP, Gleason S, Singh A, Wilkin MK. Policy, Systems, and Environmental Change Strategies in the Supplemental Nutrition Assistance Program-Education (SNAP-Ed). J Nutr Educ Behav 2022; 54:320-326. [PMID: 35027308 DOI: 10.1016/j.jneb.2021.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To categorize and quantify how states planned to use policy, systems, and environmental (PSE) change strategies in the Supplemental Nutrition Assistance Program-Education (SNAP-Ed). METHODS Qualitative content analysis of SNAP-Ed annual plans from all 50 states, District of Columbia, Guam, and the US Virgin Islands between fiscal years 2014 and 2016. RESULTS Between 2014 and 2016, the percentage of states that included PSEs as a statewide goal increased from 25% to 47%, and the percentage that planned to implement at least 1 PSE increased from 56% to 98%. Among states that planned to implement PSEs in 2016, the 3 most common settings were places in which people learn (92%), live (90%), and work (83%). CONCLUSIONS AND IMPLICATIONS The increased planned use of PSEs in SNAP-Ed was considerable and encouraging as PSEs are important to use in conjunction with direct education and social marketing to improve nutrition and prevent obesity.
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Affiliation(s)
- Michael P Burke
- Food and Nutrition Service, US Department of Agriculture, Alexandria, VA.
| | | | - Anita Singh
- Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
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225
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Cho SJ. The effect of aging out of Women, Infants, and Children on food insecurity. Health Econ 2022; 31:664-685. [PMID: 35066962 DOI: 10.1002/hec.4470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 09/19/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the National School Lunch Program (NSLP) are designed to increase food security and reduce hunger for children from low-income households. Since the cutoff age for WIC is five, and school enrollment is required for receiving free or reduced-price NSLP, some children from low-income households cannot receive both WIC and free or reduced-price NSLP. Using data from the Current Population Survey, the partial identification method developed in this paper addresses the problems of self-selection into WIC and systematic underreporting of program participation. Due to this loophole in food assistance programs for children, aging out of WIC is found to increase child food insecurity by at least 1.1 percentage points. This result indicates that the prevalence of child food insecurity would decline by 15% if WIC extended its cutoff age until children enroll in kindergarten.
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Affiliation(s)
- Seung Jin Cho
- Korea Institute for International Economic Policy, Sejong, Korea
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226
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Wilson NLW, Calancie L, Adkins J, Folta SC. Understanding Micro-pantries as an Emergency Food Source During the COVID-19 Pandemic. J Nutr Educ Behav 2022; 54:299-310. [PMID: 35039234 PMCID: PMC8758996 DOI: 10.1016/j.jneb.2021.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 11/01/2021] [Accepted: 11/05/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the role of micro-pantries in addressing food insecurity during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN Qualitative interviews with 20 micro-pantry users and 10 stakeholders during April and May, 2020. SETTING Six US states. PARTICIPANTS Users, aged ≥ 18 years, had obtained food from a micro-pantry in the past 2 weeks; stakeholders, aged ≥ 18 years, played a role in organizing micro-pantries at the community, regional, or national levels. PHENOMENA OF INTEREST Impact of COVID-19 on food insecurity and use of micro-pantries to mitigate it; benefits of, suggested improvements to, and adoption and administration of micro-pantries. ANALYSIS We transcribed the data verbatim and performed deductive qualitative content analysis. RESULTS Micro-pantry users had increased their use of both micro-pantries and regular food pantries during the pandemic. Micro-pantries helped stretch resources. Users appreciated the anonymity and choice; the mutual aid aspects reduced stigma. Stakeholders described micro-pantries as providing a direct way for neighbors to help neighbors during the pandemic. They described a decentralized and informal system of administration. CONCLUSIONS AND IMPLICATIONS Findings suggest that micro-pantries provided a supplemental food source that supported the resilience of communities during the COVID-19 pandemic.
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Affiliation(s)
- Norbert L W Wilson
- Duke Divinity School and Sanford School of Public Policy, Duke University, Durham, NC
| | - Larissa Calancie
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Janna Adkins
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
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227
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Short E, Sharma J, Thompson DI, Taren D, Gonzalez R, Hingle M. Food Assistance Use Among Food Bank Clients Affected by Type 2 Diabetes. J Nutr Educ Behav 2022; 54:288-298. [PMID: 35034840 PMCID: PMC9007878 DOI: 10.1016/j.jneb.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/28/2021] [Accepted: 11/08/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To understand the perspectives of food bank clients affected by type 2 diabetes (T2DM). DESIGN Semi-structured in-depth interviews conducted with food bank clients. SETTING Arizona regional food bank. PARTICIPANTS Twenty English- and Spanish-speaking food bank clients with T2DM or living with a person with T2DM, aged 45-83 years, majority female, Hispanic, and food insecure. PHENOMENON OF INTEREST Food bank use and preferences, and how these related to T2DM management. ANALYSIS A hybrid thematic analysis combining inductive and deductive reasoning. RESULTS Three organizing themes emerged from the analysis. First, food assistance was influenced by food preferences and the ability to pair with existing household foods. Second, desired support included fresh fruits and vegetables, meat, oats, oil, and herbs; recipes; cooking demonstrations; and social support. Third, factors influencing T2DM management were lack of financial resources, low motivation, insufficient nutrition knowledge, low medication adherence, and multiple comorbidities. Participants also expressed resilience and interest in improving T2DM management. CONCLUSIONS AND IMPLICATIONS Among a predominantly Hispanic food bank sample, produce and protein-rich foods, nutrition and culinary education, and social support were components of a supportive food bank experience and should be considered when designing food-based interventions for T2DM management for food insecure persons.
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Affiliation(s)
- Eliza Short
- School of Nutritional Sciences and Wellness, College of Agriculture and Life Sciences, The University of Arizona, Tucson, AZ; University of Arizona Collaboratory for Metabolic Disease Prevention and Treatment, Abrams Public Health Center, The University of Arizona, Tucson, AZ.
| | - Jayati Sharma
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Debbe I Thompson
- Department of Pediatrics, US Department of Agriculture/Agricultural Research Service, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Douglas Taren
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
| | | | - Melanie Hingle
- School of Nutritional Sciences and Wellness, College of Agriculture and Life Sciences, The University of Arizona, Tucson, AZ; University of Arizona Collaboratory for Metabolic Disease Prevention and Treatment, Abrams Public Health Center, The University of Arizona, Tucson, AZ
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228
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Brady PJ, Askelson NM, Thompson H, Kersten S, Hopkins H. Meeting Older Adults' Food Needs: Interviews with Area Agency on Aging Staff, Food Bank Staff, and Older Adults. J Nutr Gerontol Geriatr 2022; 41:235-255. [PMID: 36016490 PMCID: PMC9679729 DOI: 10.1080/21551197.2022.2114569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Area Agencies on Aging (AAAs) and food banks provide nutritious food for in-need older adults. The objective of this study was to identify successes, challenges, and opportunities associated with meeting the food needs of older adults. We used semi-structured telephone interviews with AAA nutrition staff (n = 5), food bank program coordinators (n = 5) and executives (n = 6), and older adults (n = 60) in Iowa. AAAs and food banks identified providing healthy food and client satisfaction as successes and funding and staff/volunteer capacity as challenges. Before the pandemic, the relationships between these organizations were limited, but both saw opportunities for collaboration. Older adults described coordination between AAAs and food banks during the COVID-19 crisis. AAAs and food banks play an important role in meeting older adults' food needs, but their effectiveness is limited by challenges related to funding and capacity. There is a need to identify feasible and sustainable strategies for collaboration past this crisis.
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Affiliation(s)
- Patrick J. Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2 Street Suite 300, Minneapolis, MN, 55455
| | - Natoshia M. Askelson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
- University of Iowa Public Policy Center, 310 S Grand Ave, Iowa City, IA 52242
| | - Helaina Thompson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Sarah Kersten
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Drive, Iowa City, IA 52246
| | - Haley Hopkins
- Iowa Department of Public Health, 321 E. 12 Street, Des Moines, IA, 50319
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229
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Abel D, Drucker G, Leander R, Huber C, Nieto A, Hulse E, Kannan N, Rausch JC. Assessment of a Fruit and Vegetable Prescription Program in the Northern Manhattan Community. Am J Health Promot 2022; 36:1014-1018. [PMID: 35325560 DOI: 10.1177/08901171221076778] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This study aimed to assess whether produce prescription redemption was associated with food insecurity (FI), sociodemographics, and nutrition-related health measures, and to identify factors affecting participation. DESIGN Retrospective, cross-sectional study. Patients, equally divided between groups who redeemed and did not redeem prescriptions, completed a follow-up survey. SETTING Northern Manhattan, NY. SUBJECTS 242 patients referred to Nutrition at an academic medical center between June and November 2019. INTERVENTION All patients referred to Nutrition received prescriptions for produce at local Greenmarkets (patients with FI received $20; other patients received $10). MEASURES We assessed patient satisfaction and factors impacting participation. Sociodemographics and nutrition-related health measures were extracted from medical records. ANALYSIS The χ2 test for categorical data and Student's t-test for continuous variables. RESULTS Prescription redeemers were significantly more likely to be very satisfied with the program (P < .001), have FI (P < .01), and have elevated hemoglobin A1C than non-redeemers (6.3 vs 5.5%, P < .001). Distance, time constraints, and forgetting or losing the prescription were common barriers, while convenience and valuing healthy eating facilitated redemption. CONCLUSION Higher FI and worse hemoglobin A1c in patients who redeemed prescriptions suggests that our program reaches the target audience: patients needing food assistance and a healthier diet. Awareness of barriers offers areas for improvement. This provides a feasible model for hospital investment to increase access to produce to improve health and health equity.
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Affiliation(s)
- Dori Abel
- 6567Children's Hospital of Philadelphia, Department of Pediatrics, Division of Rheumatology, Philadelphia, PA, USA
| | - Gabriela Drucker
- 21611Columbia University Irving Medical Center, Institute of Human Nutrition, New York, NY, USA
| | - Rose Leander
- 21611Columbia University Irving Medical Center, Institute of Human Nutrition, New York, NY, USA
| | | | - Andres Nieto
- 25065NewYork-Presbyterian Hospital, Division of Community and Population Health, New York, NY, USA
| | - Emma Hulse
- 25065NewYork-Presbyterian Hospital, Division of Community and Population Health, New York, NY, USA
| | - Nandini Kannan
- 25065NewYork-Presbyterian Hospital, Division of Community and Population Health, New York, NY, USA
| | - John C Rausch
- 25065NewYork-Presbyterian Hospital, Division of Community and Population Health, New York, NY, USA
- 21611Columbia University Irving Medical Center, Department of Pediatrics, New York, NY, USA
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230
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Wei Y, Shannon J, Lee JS. Impact of Grocery Store Proximity on Store Preference Among Atlanta SNAP-Ed Participants. J Nutr Educ Behav 2022; 54:263-268. [PMID: 35277223 DOI: 10.1016/j.jneb.2021.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/29/2020] [Accepted: 01/03/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To assess the association between grocery store proximities and the individual's grocery store preferences among Supplemental Nutrition Assistance Program Education participants in Atlanta. METHODS University of Georgia Supplemental Nutrition Assistance Program Education participants (n = 615, response rate is 36%) in 3 counties provided their preferred grocery store chains. The association between store proximity (both network distance and driving time) and store preference was measured through logistic regression controlling for age, sex, and race. RESULTS Descriptive statistics showed participants had widely varying proximities to grocery stores. Model results were significant for all smaller chains (Aldi, Big Bear, Wayfield, Food Depot, and Save-A-Lot), Kroger (P < 0.01), as well as for Walmart (time only, P = 0.002). CONCLUSIONS AND IMPLICATIONS Future studies might identify whether local groceries are more willing to partner on interventions or are more effective at reaching local residents. Surveys or techniques such as sketch mapping could also show whether individuals shop in neighborhoods close to work or friends and family.
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Affiliation(s)
- Yangjiaxin Wei
- Department of Geography, Franklin College of Arts and Sciences, University of Georgia, Athens, GA.
| | - Jerry Shannon
- Department of Geography, Franklin College of Arts and Sciences, University of Georgia, Athens, GA; Department of Financial Planning, Housing, and Consumer Economics, College of Family and Consumer Sciences, University of Georgia, Athens, GA
| | - Jung Sun Lee
- Department of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia, Athens, GA
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231
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Porter KJ, You W, Kirkpatrick BM, Thatcher EJ, Reid AL, Yuhas M, Zoellner JM. Factors Influencing the Sugar-Sweetened Beverage Intake of Caregivers of Adolescents in Appalachia. J Nutr Educ Behav 2022; 54:230-238. [PMID: 34953641 PMCID: PMC8920759 DOI: 10.1016/j.jneb.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To identify factors that influence the sugar-sweetened beverage (SSB) intake of caregivers of middle school-aged adolescents. DESIGN Cross-sectional. SETTING Southwestern Virginia, US, part of Central Appalachia. PARTICIPANTS Caregivers (n = 362) of adolescents enrolled in the Kids SIPsmartER trial. Participants were mostly female (91%) and non-Hispanic White (96%), and 21% received Supplemental Nutrition Assistance Program (SNAP) benefits. MAIN OUTCOME MEASURES Caregiver daily SSB intake and demographics, personal-level, interpersonal-level, and environmental-level determinants. ANALYSIS Descriptive statistics, 1-way ANOVA, and stepwise regression. RESULTS On average, caregivers consumed 25.7 (SD, 33.2) fluid ounces of SSB per day. In the final model, which included all variables, age (β = -0.41; P < 0.05), receiving SNAP benefits (β = 14.19; P ≤ 0.01), behavioral intentions (β = -5.48; P ≤ 0.001), affective attitudes (β = -2.15, P < 0.05), perceptions of whether their adolescent frequently consumes high amounts of SSB (β = 1.92; P ≤ 0.001), and home availability (β = 7.43; P ≤ 0.01) were significantly associated with SSB intake. CONCLUSIONS AND IMPLICATIONS Caregivers of Appalachian middle school students are high SSB consumers. Findings highlight the importance of implementing behavioral interventions for caregivers of adolescents that target multiple levels of influence, including demographic, personal-level, interpersonal-level, and environmental-level factors. Interventions may be particularly important for communities and groups with higher SSB intakes, such as those in Appalachia and who receive SNAP benefits.
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Affiliation(s)
- Kathleen J Porter
- Department of Public Health Sciences, School of Medicine, University of Virginia, Christiansburg, VA.
| | - Wen You
- Department of Public Health Sciences, School of Medicine, University of Virginia, Christiansburg, VA
| | - Brittany M Kirkpatrick
- Department of Public Health Sciences, School of Medicine, University of Virginia, Christiansburg, VA
| | - Esther J Thatcher
- Department of Population Health, University Hospitals, Cleveland, OH
| | - Annie L Reid
- Department of Public Health Sciences, School of Medicine, University of Virginia, Christiansburg, VA
| | - Maryam Yuhas
- Department of Nutrition and Food Studies, Falk College, Syracuse University, Syracuse, NY
| | - Jamie M Zoellner
- Department of Public Health Sciences, School of Medicine, University of Virginia, Christiansburg, VA
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232
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Collins BN, Lepore SJ, Egleston BL. Multilevel Intervention for Low-Income Maternal Smokers in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Am J Public Health 2022; 112:472-481. [PMID: 35196033 PMCID: PMC8887159 DOI: 10.2105/ajph.2021.306601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 12/30/2022]
Abstract
Objectives. To test the efficacy of Babies Living Safe and Smokefree (BLiSS), a multilevel intervention initiated in a citywide safety net health system to improve low-income maternal smokers' abstinence and reduce child tobacco smoke exposure. Methods. This randomized controlled trial in Philadelphia, Pennsylvania (2015-2020), recruited low-income maternal smokers who received a brief smoking intervention (Ask, Advise, Refer [AAR]) from nutrition professionals in the Special Supplemental Nutrition Program for Women, Infants, and Children before randomization to (1) a multilevel intervention (AAR + multimodal behavioral intervention [MBI]; n = 199) or (2) an attention control intervention (AAR + control; n = 197). Results. AAR + MBI mothers had significantly higher 12-month bioverified abstinence rates than did AAR + control mothers (odds ratio [OR] = 9.55; 95% confidence interval [CI] = 1.54, 59.30; P = .015). There were significant effects of time (b = -0.15; SE = 0.04; P < .001) and condition by time (b = -0.19; SE = 0.06; P < .001) on reported child exposure favoring AAR + MBI, but no group difference in child cotinine. Presence of other residential smokers was related to higher exposure. Higher baseline nicotine dependence was related to higher child exposure and lower abstinence likelihood at follow-up. Conclusions. The multilevel BLiSS intervention was acceptable and efficacious in a population that experiences elevated challenges with cessation. Public Health Implications. BLiSS is a translatable intervention model that can successfully improve efforts to address the persistent tobacco-related burdens in low-income communities. Trial Registration. Clinical Trials.gov identifier: NCT02602288. (Am J Public Health. 2022;112(3):472-481. https://doi.org/10.2105/AJPH.2021.306601).
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Affiliation(s)
- Bradley N Collins
- Bradley N. Collins and Stephen J. Lepore are with the Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA. Brian L. Egleston is with the Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia, PA
| | - Stephen J Lepore
- Bradley N. Collins and Stephen J. Lepore are with the Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA. Brian L. Egleston is with the Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia, PA
| | - Brian L Egleston
- Bradley N. Collins and Stephen J. Lepore are with the Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA. Brian L. Egleston is with the Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia, PA
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233
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Anderson CE, Martinez CE, O’Malley K, Ritchie LD, Whaley SE. Longer Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children Is Not Associated with Reduced Sugar-Sweetened Beverage Intake among Black Participants. Nutrients 2022; 14:nu14051048. [PMID: 35268022 PMCID: PMC8912710 DOI: 10.3390/nu14051048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/11/2022] [Accepted: 02/25/2022] [Indexed: 02/05/2023] Open
Abstract
This study assessed relationships of duration of family Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participation with racial/ethnic disparities in child sugar-sweetened beverage (SSB) and water intake. Child beverage intake and family duration on WIC were collected during three cross-sectional surveys of WIC-participating families in Los Angeles County, California (2014, 2017 and 2020; n = 11,482). The associations of family duration of WIC participation, a proxy for the amount of WIC services received, with daily intake of total SSBs, fruit-flavored SSBs and water were assessed in race/ethnicity strata with multivariable negative binomial and Poisson regression models. Among English-speaking Hispanic children, those of families reporting 10 years of WIC participation consumed 33% and 27% fewer servings of total and fruit-flavored SSBs compared to those of families reporting 1 year on WIC. Among Black children, those from families reporting 5 and 10 years of participation in WIC consumed 33% and 45% more daily servings of fruit-flavored SSBs than those from families reporting 1 year on WIC. Disparities in daily total and fruit-flavored SSB intake between Black and White children increased with longer family duration on WIC. Duration of family WIC participation is associated with healthier beverage choices for infants and children, but does not appear to be equally beneficial across racial/ethnic groups in Los Angeles County.
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Affiliation(s)
- Christopher E. Anderson
- Division of Research and Evaluation, Public Health Foundation Enterprises (PHFE) WIC, Irwindale, CA 91706, USA; (C.E.M.); (S.E.W.)
- Correspondence:
| | - Catherine E. Martinez
- Division of Research and Evaluation, Public Health Foundation Enterprises (PHFE) WIC, Irwindale, CA 91706, USA; (C.E.M.); (S.E.W.)
| | - Keelia O’Malley
- Department of Social, Behavioral and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA;
| | - Lorrene D. Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA;
| | - Shannon E. Whaley
- Division of Research and Evaluation, Public Health Foundation Enterprises (PHFE) WIC, Irwindale, CA 91706, USA; (C.E.M.); (S.E.W.)
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234
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Zhang Q, Park K, Zhang J, Tang C. The Online Ordering Behaviors among Participants in the Oklahoma Women, Infants, and Children Program: A Cross-Sectional Analysis. IJERPH 2022; 19:ijerph19031805. [PMID: 35162828 PMCID: PMC8835125 DOI: 10.3390/ijerph19031805] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/24/2022] [Accepted: 02/01/2022] [Indexed: 11/16/2022]
Abstract
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a nutrition assistance program in the United States (U.S.). Participants in the program redeem their prescribed food benefits in WIC-authorized grocery stores. Online ordering is an innovative method being pilot-tested in some stores to facilitate WIC participants’ food benefit redemption, which has become especially important in the COVID-19 pandemic. The present research aimed to examine the online ordering (OO) behaviors among 726 WIC households who adopted WIC OO in a grocery chain, XYZ (anonymous) store, in Oklahoma (OK). These households represented approximately 5% of WIC households who redeemed WIC benefits in XYZ stores during the study period, which was 1 July to 31 December 2020. This period was during the COVID-19 pandemic but after the temporary lockdown in Oklahoma had been lifted. Descriptive statistics were estimated for WIC OO households’ adoption behaviors and their orders. The Cox proportional hazard model and zero-truncated negative binomial regression were applied to examine the relationship between participants’ socio-demographics and the length of time between 1 July 2020, and their first OO, as well as the number of WIC online orders. About 80% of these online orders were picked up without any changes. Minority households had a significantly longer time before adopting their first OO (hazard ratio (HR) < 1, p < 0.001), while households with a child or a woman participant, or more participants, had a shorter time before adopting OO (HR > 1, p < 0.05). Non-Hispanic black households had a fewer number of OOs than non-Hispanic white households (B = −0.374, p = 0.007). OO adoption varied across socio-demographics. More efforts are needed to ensure equal access and adoption of WIC OO.
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Affiliation(s)
- Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA
- Correspondence: ; Tel.: +1-757-683-6870
| | - Kayoung Park
- Department of Mathematics and Statistics, Old Dominion University, Norfolk, VA 23529, USA;
| | - Junzhou Zhang
- Department of Marketing, Montclair State University, Montclair, NJ 07043, USA;
| | - Chuanyi Tang
- Department of Marketing, Old Dominion University, Norfolk, VA 23529, USA;
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235
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Carpenter A, Kuchera AM, Krall JS. Connecting Families at Risk for Food Insecurity With Nutrition Assistance Through a Clinical-Community Direct Referral Model. J Nutr Educ Behav 2022; 54:181-185. [PMID: 35148872 DOI: 10.1016/j.jneb.2021.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To assess the feasibility of a clinical-community direct referral model to enroll eligible households in the Supplemental Nutrition Assistance Program (SNAP). METHODS Pediatric clinics screening for food insecurity (n = 27) invited families experiencing food insecurity to participate in a direct referral to a local organization that assists with SNAP applications. A food stamp specialist telephoned participants to determine SNAP eligibility, assist with the application, and/or provide other supports. Referrals, eligibility determination, enrollment, and estimated benefits were tracked. RESULTS A total of 486 families were referred to the community partner; 72% (n = 351) were successfully contacted by a food stamp specialist, with 17% (n = 83) applying for SNAP benefits. Another 16% (n = 79) were already enrolled in SNAP but received an additional service. CONCLUSIONS AND IMPLICATIONS This referral model was feasible and increased the number of families who received nutrition assistance. This approach could be adapted for other health-related social needs.
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Affiliation(s)
- Abigail Carpenter
- Division of Community Health, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Anne Marie Kuchera
- Division of Community Health, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Jodi S Krall
- Division of Community Health, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
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236
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Weinfield NS, Anderson CE. Postpartum Symptoms of Depression are Related to Infant Feeding Practices in a National WIC Sample. J Nutr Educ Behav 2022; 54:118-124. [PMID: 34930709 DOI: 10.1016/j.jneb.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To examine the association between elevated maternal postpartum depression symptoms and select targets of nutrition education within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), including infant feeding beliefs, feeding practices, and dietary intake choices. DESIGN Longitudinal analysis of secondary data from the WIC Infant and Toddler Feeding Practices Study-2. SETTING Eighty WIC sites. PARTICIPANTS The WIC Infant and Toddler Feeding Practices Study-2 participants interviewed through 13 months postpartum (n = 1,851). MAIN OUTCOME MEASURES Latent factor variables for infant feeding beliefs, feeding practices, and dietary intake choices. ANALYSIS Confirmatory factor analysis using structural equation modeling; multivariable linear regression models. RESULTS Biological mothers with elevated postpartum depression symptoms engaged in significantly less optimal feeding practices than biological mothers with fewer symptoms of depression, in multivariable analyses controlling for sociodemographic variables (β = -0.26; P = 0.02). Maternal depression symptoms were not significantly associated with infant feeding beliefs or dietary intake choices. CONCLUSIONS AND IMPLICATIONS Maternal depression symptoms are specifically associated with infant feeding practices. The Special Supplemental Nutrition Program for Women, Infants, and Children could consider screening for depressive symptoms and referring mothers for treatment. For mothers with elevated depression symptoms, nutrition education may need greater emphasis on healthy and safe feeding practices.
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Affiliation(s)
- Nancy S Weinfield
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD.
| | - Christopher E Anderson
- Public Health Foundation Enterprises WIC Program, Division of Research and Evaluation, Irwindale, CA
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237
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Grummon AH, Reimold AE, Hall MG. Influence of the San Francisco, CA, Sugar-Sweetened Beverage Health Warning on Consumer Reactions: Implications for Equity from a Randomized Experiment. J Acad Nutr Diet 2022; 122:363-370.e6. [PMID: 34465443 PMCID: PMC9127741 DOI: 10.1016/j.jand.2021.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND In 2020, San Francisco, CA, amended an ordinance requiring warning labels on advertisements for sugary drinks to update the warning message. No studies have evaluated consumer responses to the revised message. OBJECTIVES To evaluate responses to the 2020 San Francisco sugary drink warning label and to assess whether these responses differ by demographic characteristics. DESIGN Randomized experiment. PARTICIPANTS AND SETTING During 2020, a convenience sample of US parents of children aged 6 months to 5 years (N = 2,160 included in primary analyses) was recruited via an online panel to complete a survey. Oversampling was used to achieve a diverse sample (49% Hispanic/Latino[a], 34% non-Hispanic Black, and 9% non-Hispanic White). METHODS Participants were randomly assigned to view a control label ("Always read the Nutrition Facts Panel") or the 2020 San Francisco sugary drink warning label ("SAN FRANCISCO GOVERNMENT WARNING: Drinking beverages with added sugar(s) can cause weight gain, which increases the risk of obesity and type 2 diabetes."). Messages were shown in white text on black rectangular labels. MAIN OUTCOME MEASURES Participants rated the labels on thinking about health harms of sugary drink consumption (primary outcome) and perceived discouragement from wanting to consume sugary drinks. The survey was available in English and Spanish. STATISTICAL ANALYSES PERFORMED Ordinary least squares regression. RESULTS The San Francisco warning label elicited more thinking about health harms (Cohen's d = 0.24; P < 0.001) than the control label. The San Francisco warning label also led to more discouragement from wanting to consume sugary drinks than the control label (d = 0.31; P < 0.001). The warning label's influence on thinking about harms did not differ by any participant characteristics, including age, gender, race/ethnicity, education, income, or language of survey administration (all P values for interactions > 0.12). CONCLUSIONS San Francisco's 2020 sugary drink warning label may be a promising policy for informing consumers and encouraging healthier beverage choices across groups with diverse demographic characteristics.
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Affiliation(s)
- Anna H Grummon
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
| | - Alexandria E Reimold
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill; Carolina Population Center, University of North Carolina, Chapel Hill; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
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238
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Claiborne DM, Chen C, Zhang Q. Disparities in Caregiver-Reported Dental Cavities and Toothaches Among Children in the Special Supplemental Nutrition for Women, Infants, and Children (WIC) Program. J Dent Hyg 2022; 96:43-54. [PMID: 35190493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/02/2021] [Indexed: 06/14/2023]
Abstract
Purpose: Dental caries is prevalent among low-income and minority children despite oral health promotion programs. The purpose of this study was to examine disparities associated with caregiver-reported cavities and toothaches among children in the United States aged 2-4 years by their eligibility for and participation in the Special Supplemental Nutrition for Women, Infants, and Children (WIC) program.Methods: A secondary data analysis was performed using the 2016 National Survey of Children's Health (NSCH) data on children aged 2-4 years (n=7,719) with complete WIC participation information. Three groups were formed based on WIC eligibility and participation status: WIC participants, income-eligible non-participants, and higher-income non-participants. Caregiver-reported cavities and toothaches were compared by WIC eligibility and participation using chi-square tests and multivariate logistic regression analysis.Results: Among all children in the data set, 2,069 were WIC eligible, 49.8% of whom participated in WIC. Participants in WIC had higher reported cavities and toothaches (10.0% and 5.2%) than income-eligible, or higher-income non- WIC participating children (8.9% and 3.2%; 4.4% and 0.1%, respectively; p < 0.001). However, non-Hispanic, white WIC participants, had a higher proportion of reported cavities (14.0%) and toothaches (8.2%) than income-eligible non-participants (6.7% and 1.9%, respectively; p < 0.05). While non-Hispanic, black WIC participating children, had nearly 3.6 times more reported cavities than income-eligible nonparticipants (9.0% vs. 2.5%, p < 0.05).Conclusion: Caregiver-reported cavities and toothaches varied by sociodemographic characteristics within WIC participation and eligibility groups. These findings suggest that more research is warranted to explore factors that are contributing to oral health disparities associated with WIC eligibility and participation.
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Affiliation(s)
- Denise M Claiborne
- Assistant professor and the Graduate Program Director, Gene W. Hirschfeld School of Dental Hygiene, Old Dominion University, Norfolk, VA, USA.
| | - Chun Chen
- Associate professor, School of Public Health and Management, Wenzhou Medical University, Chashan University, Wenzhou, Zheijang, PRC
| | - Qi Zhang
- Professor and the Health Services Research PhD Program Director, School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA
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239
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Martin NM, Barnett DJ, Poirier L, Sundermeir SM, Reznar MM, Gittelsohn J. Moving Food Assistance into the Digital Age: A Scoping Review. Int J Environ Res Public Health 2022; 19:1328. [PMID: 35162351 PMCID: PMC8835246 DOI: 10.3390/ijerph19031328] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/15/2022] [Accepted: 01/21/2022] [Indexed: 02/01/2023]
Abstract
One of the most basic needs globally, food assistance refers to the multitude of programs, both governmental and non-governmental, to improve food access and consumption by food-insecure individuals and families. Despite the importance of digital and mobile Health (mHealth) strategies in food insecurity contexts, little is known about their specific use in food assistance programs. Therefore, the purpose of this study was to address that gap by conducting a scoping review of the literature. Keywords were defined within the concepts of food assistance and digital technology. The search included relevant peer-reviewed and grey literature from 2011 to 2021. Excluded articles related to agriculture and non-digital strategies. PRISMA guidelines were followed to perform a partnered, two-round scoping literature review. The final synthesis included 39 studies of which most (84.6%) were from the last five years and United States-based (93.2%). The top three types of articles or studies included text and opinion, qualitative research, and website, application, or model development (17.9%). The top three types of digital tools were websites (56.4%), smartphone applications (20.5%), and chatbots (5.1%). Nineteen digital features were identified as desirable. Most tools included just one or two features. The most popular feature to include was online shopping (n = 14), followed by inventory management, and client tracking. Digital tools for individual food assistance represent an opportunity for equitable and stable access to programs that can enhance or replace in-person services. While this review identified 39 tools, all are in early development and/or implementation stages. Review findings highlight an overall lack of these tools, an absence of user-centered design in their development, and a critical need for research on their effectiveness globally. Further analysis and testing of current digital tool usage and interventions examining the health and food security impacts of such tools should be explored in future studies, including in the context of pandemics, where digital tools allow for help from a distance.
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Affiliation(s)
- Nina M. Martin
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
| | - Daniel J. Barnett
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Lisa Poirier
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
| | - Samantha M. Sundermeir
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
| | - Melissa M. Reznar
- Department of Interdisciplinary Health Sciences, Oakland University School of Health Sciences, Rochester, MI 48309, USA;
| | - Joel Gittelsohn
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
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240
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Bari MDA, Khan GD, He B, Yoshida Y. The impact of unconditional cash and food assistance on contraceptive expenditure of rural households in Coastal Bangladesh: Evidence from fuzzy RDD. PLoS One 2022; 17:e0262031. [PMID: 35061751 PMCID: PMC8782502 DOI: 10.1371/journal.pone.0262031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022] Open
Abstract
This study investigates the impact of unconditional cash and food (UCF) assistance on the monthly contraceptive expenditure of rural households in coastal Bangladesh using a fuzzy regression discontinuity design (RDD). Eligibility for UCF assistance was based on the running variable of land ownership in acres. We used eligibility as an instrumental variable to estimate the local average treatment effect of UCF assistance on contraceptive expenditures. The results show that UCF assistance results in increases in monthly contraceptive expenditures.
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Affiliation(s)
- MD. Abdul Bari
- Graduate School for International Development and Cooperation, Hiroshima University, Kagamiyama, Higashi-Hiroshima, Japan
| | - Ghulam Dastgir Khan
- Graduate School for International Development and Cooperation, Hiroshima University, Kagamiyama, Higashi-Hiroshima, Japan
- * E-mail:
| | - Bing He
- School of Business, Jiangsu Ocean University, Haizhou District, Lianyungang, Jiangsu, China
| | - Yuichiro Yoshida
- Graduate School of Humanities and Social Sciences, Hiroshima University, Kagamiyama, Higashi-Hiroshima, Japan
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241
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Hanson KL, Meng X, Volpe LC, Jilcott Pitts S, Bravo Y, Tiffany J, Seguin-Fowler RA. Farmers’ Market Nutrition Program Educational Events Are Broadly Accepted and May Increase Knowledge, Self-Efficacy and Behavioral Intentions. Nutrients 2022; 14:nu14030436. [PMID: 35276793 PMCID: PMC8840006 DOI: 10.3390/nu14030436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 02/05/2023] Open
Abstract
The Farmers’ Market Nutrition Program (FMNP) in the U.S. provides coupons for the purchase of fruit and vegetables (FV) to pregnant women and children enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and to income-eligible adults 60+ years of age. The New York State FMNP Education Event Guide was developed to support cooperative extension educators in providing information, food tastings, and cooking demonstrations at farmers’ markets (FM) to encourage consumption of FV. This paper describes implementation at seven FM in New York City, and shopping and eating behaviors in a cross-sectional survey of FM shoppers (n = 377). Three of nine lessons were implemented more than once, typically with food sampling (78.9%). FM shoppers were primarily women (81.5%), racially diverse (30.5% Black, 23.1% White), frequent shoppers (2.4 times/month), and had high FV consumption (2.24 cups fruit; 2.44 cups vegetables daily). Most FM shoppers participated in the FM education event (84%), and participants and non-participants had equivalent shopping and eating behaviors. More than 70% of FM education participants believed that the event positively impacted their knowledge, self-efficacy, and behavioral intentions. FMNP education events at FM were broadly accepted by FM shoppers of all characteristics, and may improve knowledge, self-efficacy, and behavioral intention.
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Affiliation(s)
- Karla L. Hanson
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853, USA; (X.M.); (L.C.V.)
- Correspondence: ; Tel.: +1-607-255-8075
| | - Xiangqi Meng
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853, USA; (X.M.); (L.C.V.)
| | - Leah C. Volpe
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY 14853, USA; (X.M.); (L.C.V.)
| | | | - Yvonne Bravo
- Cornell University Cooperative Extension—New York City Programs, New York, NY 10022, USA; (Y.B.); (J.T.)
| | - Jennifer Tiffany
- Cornell University Cooperative Extension—New York City Programs, New York, NY 10022, USA; (Y.B.); (J.T.)
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242
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Shroba J, Das R, Bilaver L, Vincent E, Brown E, Polk B, Ramos A, Russell AF, Bird JA, Ciaccio CE, Lanser BJ, Mudd K, Sood A, Vickery BP, Gupta R. Food Insecurity in the Food Allergic Population: A Work Group Report of the AAAAI Adverse Reactions to Foods Committee. J Allergy Clin Immunol Pract 2022; 10:81-90. [PMID: 34862158 DOI: 10.1016/j.jaip.2021.10.058] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 12/13/2022]
Abstract
Food allergies affect 32 million Americans. Restricted diets due to food allergies can be difficult to maintain especially when the household is food insecure. Food insecurity is defined as the inability to acquire food for household members due to insufficient money or resources for food. The COVID-19 pandemic has caused many people to face food insecurity for the first time with Latinx, Native American, and Black communities disproportionately affected. Because of the increase in food insecurity, this work group developed a survey regarding food insecurity screening. This survey was sent out to a random sample of American Academy of Allergy Asthma & Immunology members to assess food insecurity knowledge and practices. The majority of survey participants did not routinely screen their patients for food insecurity. The biggest barrier identified to screening was lack of knowledge of how to perform a screen and resources available when a patient screened positive. This work group report provides guidance on how to implement and perform a food insecurity screen, including federal resources and assistance programs.
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Affiliation(s)
- Jodi Shroba
- Division of Allergy and Immunology, Children's Mercy Hospital, Kansas City, Mo.
| | - Rajeshree Das
- Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Lucy Bilaver
- Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Eileen Vincent
- Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | | | - Brooke Polk
- Division of Allergy, Imunology and Pulmonary Medicine, Washington University, St Louis, Mo
| | - Ashley Ramos
- Division of Allergy and Immunology, Children's National Health System, Washington, DC
| | - Anne F Russell
- Spring Arbor University School of Nursing and Health Sciences Spring Arbor, Mich
| | - J Andrew Bird
- Southwestern Medical Center, University of Texas, Dallas, Texas
| | | | - Bruce J Lanser
- National Jewish Health Division of Pediatric Allergy and Clinical Immunology, Denver, Colo
| | - Kim Mudd
- Division of Pediatric Allergy and Immunology, Johns Hopkins, Baltimore, Md
| | - Amika Sood
- Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Ark
| | - Brian P Vickery
- Emory University and Children's Healthcare of Atlanta, Atlanta, Ga
| | - Ruchi Gupta
- Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Ill
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243
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Adeyemi OJ, Stullken JD, Baah EG, Olagbemiro N, Huber LR. An Assessment of the Relationship of SNAP and Anemia Among School-Aged Children and Adolescents Living in Households With Food Insecurity. INQUIRY 2022; 59:469580211067498. [PMID: 35199589 PMCID: PMC8883399 DOI: 10.1177/00469580211067498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children in food-insecure households have an increased risk of anemia. Participation in Supplemental Nutrition Assistance Programs (SNAP) has several benefits. However, it is unknown if it ameliorates anemia among school-aged children and adolescents living in food-insecure households. This study aims to assess the association of SNAP participation and anemia among children and adolescents living in households experiencing food insecurity. The sample population (n = 1635), aged 6 to 18 years, were pooled from the 2003–2014 National Health and Nutrition Examination Survey (NHANES). The exposure of interest was self-reported household SNAP participation. The outcome variable was the presence or absence of anemia, classified using the blood hematocrit concentration values. Survey weighted logistic regression was performed to calculate the odds ratio (OR) and 95% Confidence Interval (CI) of the association between participation in SNAP and anemia in food-insecure children. We found that over 80% of anemic children and adolescents, living in food-insecure households, participated in SNAP, while 63% of non-anemic children and adolescents, living in food-insecure households participated in SNAP (p = .007). Among children living in food-insecure households, SNAP participants had 3-fold increased odds of anemia compared to those who do not participate in SNAP, after adjusting for confounders (OR = 3.33, 95% CI: 1.25–8.88). In this study, SNAP participation was associated with increased odds of anemia in children and adolescents living in food-insecure households. Additional research is needed to assess if these unexpected findings are related to the adequacy of SNAP, affordability, and accessibility to healthy foods, or the household and individual food preferences in food-insecure households.
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Affiliation(s)
- Oluwaseun J. Adeyemi
- University of North Carolina at Charlotte, Charlotte, NC, USA
- University of Edinburgh, Edinburgh, UK
- New York University Grossman School of Medicine, USA
- Oluwaseun J. Adeyemi, MBChB, MWACS, MSurg, PhD, Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine 980-939-9764, USA.
| | - Julia D. Stullken
- University of North Carolina at Charlotte, Charlotte, NC, USA
- Colorado Department of Public Health and Environment, Colorado, USA
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244
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Byker Shanks C, Vanderwood K, Grocke M, Johnson N, Larison L, Wytcherley B, Yaroch AL. The UnProcessed Pantry Project (UP3): A Community-Based Intervention Aimed to Reduce Ultra-Processed Food Intake Among Food Pantry Clients. Fam Community Health 2022; 45:23-33. [PMID: 34783688 PMCID: PMC8604383 DOI: 10.1097/fch.0000000000000310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Low-income populations are more likely to experience food and nutrition insecurity and suffer a greater burden of noncommunicable disease than the general population. The UnProcessed Pantry Project (UP3) is an intervention aimed to reduce ultra-processed food availability and consumption of food pantry clients accessing the emergency food system. The pilot study included nutrition education, food boxes, and social support for 16 weeks at 2 food pantries. Data collection included the ASA24 dietary recall to calculate Healthy Eating Index-2015 (HEI-2015) scores, biomarkers (hemoglobin A1c, total cholesterol, blood pressure, waist circumference, body mass index [BMI]), and a demographic and psychosocial survey. Dietary quality among 43 participants significantly (P < .05) improved as measured by the HEI-2015 for total HEI-2015, whole grains, total protein foods, and added sugars scores. BMI, total cholesterol, and waist circumference also significantly improved across study participants. Findings indicate that the emergency food system may be an effective access point to apply frameworks including UP3 to address ultra-processed food consumption, dietary quality, and noncommunicable chronic disease risk among food-insecure populations. Programs and policies that limit the amount of ultra-processed food in the emergency food system should be further tested and could be efficacious in addressing inequities among vulnerable populations.
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Affiliation(s)
- Carmen Byker Shanks
- Department of Health and Human Development, Montana State University, Bozeman, Montana (Drs Byker Shanks and Grocke, Mr Johnson, and Mss Larison and Wytcherley); Gretchen Swanson Center for Nutrition, Omaha, Nebraska (Drs Byker Shanks and Yarock); and Gallatin County Health Department, Bozeman, Montana (Dr Vanderwood)
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245
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Czarnik M, Hamner HC, Moore LV. Food Preparation Practices for Infants Aged From 7 to 13 Months. J Nutr Educ Behav 2022; 54:28-35. [PMID: 34598893 PMCID: PMC10898497 DOI: 10.1016/j.jneb.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/10/2021] [Accepted: 08/15/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To examine infant food preparation practices at age 7, 9, 11, and 13 months overall and by sociodemographic characteristics. DESIGN Data from a longitudinal study from the US Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2) were used. PARTICIPANTS A sample of 1,904 infants (970 males and 934 females) enrolled in WIC who had been introduced to solid foods and were consuming food prepared at home. MAIN OUTCOME MEASURES Food preparation practices included pureeing, mashing, chopping/dicing, and prechewing. Estimates were provided overall and by sociodemographics. ANALYSIS Prevalence estimates were calculated for each survey month overall and by sociodemographics. Chi-square tests for independence were used to test for differences. RESULTS Food preparation practices changed as infants aged. Pureeing and mashing were common in month 7 (57.8% and 59.6%, respectively), but chopping/dicing were the most prevalent by month 13 (85.4%). Food preparation practices did not vary by education status, but statistical differences were consistently observed by race and ethnicity and inconsistently observed by maternal age at birth. CONCLUSIONS AND IMPLICATIONS Exposing children to a range of food textures at an appropriate age is important for developmental progress. Continued culturally relevant efforts by WIC educators and health care providers can emphasize the importance of early experiences with food textures.
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Affiliation(s)
- Michaila Czarnik
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Latetia V Moore
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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246
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Caldwell JI, Kuo T, Shah-Patel D, Cohen DA. Health Behavior Changes Among Adults in the Supplemental Nutrition Assistance Program Education, Los Angeles County, California. Prev Chronic Dis 2021; 18:E102. [PMID: 34914578 PMCID: PMC8718123 DOI: 10.5888/pcd18.210221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE AND OBJECTIVES The Supplemental Nutrition Assistance Program Education (SNAP-Ed), the educational branch of SNAP, can play an important role in improving dietary outcomes, eliminating food insecurity, and preventing chronic disease among low-income populations. This study examined the effects of local SNAP-Ed efforts on self-reported health behaviors and body mass index (BMI) over a 1-year period, using data collected from intercept surveys of program-eligible adults. INTERVENTION APPROACH From 2016 to 2020, the Los Angeles County Department of Public Health partnered with 24 community-based organizations to provide nutrition education and to implement policy, systems, and environmental changes in the community. EVALUATION METHODS A cross-sectional survey was conducted in 2018 and repeated in 2019 to measure 6 outcomes describing population-level changes in health behaviors and BMI. The study recruited 4 samples: 2 samples from outside selected supermarkets (2018, n = 2,098; 2019, n = 2,323) and 2 samples from participants at SNAP-Ed class sites (2018, n = 651; 2019, n = 569). RESULTS While study results showed an increase in consumption of fruits and vegetables and in vigorous physical activity, they also showed an increase in BMI and high consumption of unhealthy foods. Participating in SNAP-Ed classes was positively associated with several health behaviors but no change in BMI. Participants who experienced food insecurity had worse health behavior outcomes than those who did not experience this condition. IMPLICATIONS FOR PUBLIC HEALTH SNAP-Ed interventions appear to have a favorable effect on fruit and vegetable consumption, but increases in BMI suggest that unhealthy food consumption is abundant and may be counteracting the benefits gained from eating more fruits and vegetables. Future efforts should take these results into consideration and optimize enrollment in nutrition assistance programs. These efforts should include coordinating with local programs to increase healthy food access for at-risk low-income populations in Los Angeles County.
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Affiliation(s)
- Julia I Caldwell
- Nutrition and Physical Activity Program, Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd, Ste 800, Los Angeles, CA 90010.
| | - Tony Kuo
- Los Angeles County Department of Public Health, Los Angeles, California
- University of California, Los Angeles, California
- University of California, Clinical and Translational Science Institute, Los Angeles, California
| | - Dipa Shah-Patel
- Los Angeles County Department of Public Health, Los Angeles, California
| | - Deborah A Cohen
- Kaiser Permanente Research and Evaluation, Pasadena, California
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247
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Quinn EL, Ortiz K, Titzer L, Houston-Shimizu B, Jones-Smith J. Healthy Food Environments in Food Pantries: Lessons Learned from a Sodium Reduction Intervention. Int J Environ Res Public Health 2021; 18:13206. [PMID: 34948815 PMCID: PMC8701667 DOI: 10.3390/ijerph182413206] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/06/2021] [Accepted: 12/11/2021] [Indexed: 11/16/2022]
Abstract
In the United States, food pantries increasingly serve as regular food sources for low income households experiencing high rates of chronic disease, including hypertension. Sodium consumption is a modifiable risk factor for hypertension, so pantry customers would benefit from access to low-sodium foods. Pantry customers often experience difficulty acquiring healthy foods, however; little is known about pantry foods' sodium content specifically. This study assesses the sodium content of pantry foods and lessons learned from an adaptable intervention to support pantries in adopting policies and environmental changes to make healthy, lower-sodium foods appealing and accessible. We conducted sodium assessments of food at 13 food pantries, tracked implementation of intervention strategies, and interviewed 10 pantry directors. More than half of food items in 11 categories met sodium standards for foods to be chosen "often". Pantry directors reported valuing the intervention approach and implemented six of nine behavioral economics strategies, especially those targeting the visibility and convenience of foods, along with layout changes and expanded customer choice. One pantry adopted an agency-specific nutrition policy and 12 adopted a coalition-level policy. Results can inform intervention efforts to make available healthy options appealing and easy to select while also improving the customer experience in food pantries.
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Affiliation(s)
- Emilee L. Quinn
- Department of Health Systems and Population Health, University of Washington, Seattle, WA 98195, USA;
| | - Kate Ortiz
- Chronic Disease & Injury Prevention Division, Public Health Seattle and King County, Seattle, WA 98104, USA;
| | | | | | - Jessica Jones-Smith
- Department of Health Systems and Population Health, University of Washington, Seattle, WA 98195, USA;
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
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248
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Williams BD, Sisson SB, Stinner EL, Hetrick HN, Dunlap M, Graef-Downard J, Eliot K, Finnell K, Salvatore AL. Quality of Nutrition Environments, Menus and Foods Served, and Food Program Achievement in Oklahoma Family Child Care Homes. Nutrients 2021; 13:4483. [PMID: 34960034 PMCID: PMC8704456 DOI: 10.3390/nu13124483] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 02/02/2023] Open
Abstract
Child care environments foster children's healthy eating habits by providing exposure to healthy foods and feeding practices. We assessed the healthfulness of nutrition environments, menu/meal quality, and the achievement of Child and Adult Care Food Program (CACFP) guidelines and best practices in Oklahoma CACFP-enrolled family child care homes (FCCHs) (n = 51). Two-day classroom observations were conducted. Healthfulness of classroom nutrition environments was assessed using the Environment and Policy Assessment and Observation (EPAO). Foods served to and consumed by children were quantified using the Dietary Observations in Child Care (DOCC) tool. Nutrient analysis was performed to determine total energy for foods listed on menus, served to, and consumed by children. Menu and meal food variety and CACFP Guideline Achievement Scores were determined. Average nutrition environment score was 11.7 ± 1.2 (61.5% of maximum possible score). Energy (kcals) from menus and consumed by children was insufficient to meet two-thirds of their daily reference intake. Children were exposed to 1.7 vegetables and 1.3 fruits per meal. CACFP Guideline Achievement Scores were 66.3% ± 7.8 for menus and 59.3% ± 7.6 for mealtimes. Similar to previous research, our findings indicate a need for improved FCCH nutrition practices. Tailored interventions for FCCHs are needed.
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Affiliation(s)
- Bethany D. Williams
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, 1200 N. Stonewall Ave., AHB 3068, Oklahoma City, OK 73117, USA; (B.D.W.); (E.L.S.); (H.N.H.); (J.G.-D.); (K.E.)
- Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University Health Sciences Spokane, 412 E Spokane Falls Blvd, Spokane, WA 99202, USA
| | - Susan B. Sisson
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, 1200 N. Stonewall Ave., AHB 3068, Oklahoma City, OK 73117, USA; (B.D.W.); (E.L.S.); (H.N.H.); (J.G.-D.); (K.E.)
| | - Emily L. Stinner
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, 1200 N. Stonewall Ave., AHB 3068, Oklahoma City, OK 73117, USA; (B.D.W.); (E.L.S.); (H.N.H.); (J.G.-D.); (K.E.)
| | - Hope N. Hetrick
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, 1200 N. Stonewall Ave., AHB 3068, Oklahoma City, OK 73117, USA; (B.D.W.); (E.L.S.); (H.N.H.); (J.G.-D.); (K.E.)
| | - Marny Dunlap
- Department of Pediatrics, Section of General and Community Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, 1200 Children’s Ave., Oklahoma City, OK 73104, USA;
| | - Jennifer Graef-Downard
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, 1200 N. Stonewall Ave., AHB 3068, Oklahoma City, OK 73117, USA; (B.D.W.); (E.L.S.); (H.N.H.); (J.G.-D.); (K.E.)
| | - Kathrin Eliot
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, 1200 N. Stonewall Ave., AHB 3068, Oklahoma City, OK 73117, USA; (B.D.W.); (E.L.S.); (H.N.H.); (J.G.-D.); (K.E.)
| | - Karla Finnell
- Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK 73104, USA; (K.F.); (A.L.S.)
| | - Alicia L. Salvatore
- Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Health Sciences Center, 801 N.E. 13th Street, Oklahoma City, OK 73104, USA; (K.F.); (A.L.S.)
- Institute for Research on Equity and Community Health, ChristianaCare, Wilmington, DE 19803, USA
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE 19706, USA
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249
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Fung GJ, Jefferies LK, Call MAL, Eggett DL, Richards R. Comparison of Emergency Preparedness Practices between Food Assistance Program Participants and Non-Participants in the United States. Int J Environ Res Public Health 2021; 18:ijerph182412937. [PMID: 34948550 PMCID: PMC8702057 DOI: 10.3390/ijerph182412937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 11/24/2022]
Abstract
Background: Previous research has suggested many households are meeting the Federal Emergency Management Agency’s 3-day emergency food and water storage recommendations. The impact of limited economic household resources on emergency preparedness practices related to food and water is uncertain. The purpose of this study was to compare emergency preparedness practices in households participating in United States’ food assistance programs with households not participating in these programs. Methods: A convenience sample of adults (n = 572) completed an online Qualtrics survey. Descriptive statistics, chi-square statistics, and independent t-tests were used to measure differences between households participating in food assistance programs vs. non-participating households. Results: Most households participating in food assistance programs felt prepared to provide household members with food and water during an emergency, which did not significantly differ from non-participating households. Households using food assistance programs had less accessible cash but had similar foods on-hand for an emergency compared to non-participating households. However, they more frequently reported having baby formula/food and less frequently reported having vitamin/mineral supplements compared to non-participating households. Conclusions: Food assistance programs may be effective in providing enough food and water to help low-income families be prepared for an emergency.
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Affiliation(s)
- Gina J. Fung
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT 84602, USA; (G.J.F.); (L.K.J.); (M.A.L.C.)
| | - Laura K. Jefferies
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT 84602, USA; (G.J.F.); (L.K.J.); (M.A.L.C.)
| | - Michelle A. Lloyd Call
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT 84602, USA; (G.J.F.); (L.K.J.); (M.A.L.C.)
| | - Dennis L. Eggett
- Department of Statistics, Brigham Young University, Provo, UT 84602, USA;
| | - Rickelle Richards
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT 84602, USA; (G.J.F.); (L.K.J.); (M.A.L.C.)
- Correspondence: ; Tel.: +1-801-422-6855
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250
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Cardarelli KM, DeWitt E, Gillespie R, Graham RH, Norman-Burgdolf H, Mullins JT. Policy Implications of the COVID-19 Pandemic on Food Insecurity in Rural America: Evidence from Appalachia. Int J Environ Res Public Health 2021; 18:ijerph182312792. [PMID: 34886518 PMCID: PMC8657698 DOI: 10.3390/ijerph182312792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 01/04/2023]
Abstract
Rural communities are disproportionally affected by food insecurity, making them vulnerable to the consequences of supply disruptions caused by the COVID-19 pandemic. While access to food was initially diminished due to food supply disruptions, little is known about the mechanisms through which federal emergency assistance programs impacted food access in rural populations. Through a series of five focus groups in spring 2021, we examined the impact of the COVID-19 pandemic on food access in a rural Appalachian community in Kentucky. Data were analyzed using a Grounded Theory Approach. Findings revealed the following four primary themes: food scarcity in grocery stores; expanded federal food assistance; expanded community food resources; and expanded home gardening. Participants provided details regarding the way increased federal assistance, especially expanded benefits within the Supplemental Nutrition Assistance Program, allowed them to purchase greater quantities of nutritious food. This study unveils the specific impacts of the COVID-19 pandemic on one rural population, including the influence of some social determinants of health on food insecurity. Policymakers and stakeholders should recognize the layered protection of multiple federal emergency assistance programs against food insecurity and the potential for long-term population health promotion in rural areas.
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Affiliation(s)
- Kathryn M. Cardarelli
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY 40506, USA
- Correspondence: ; Tel.: +1-859-323-5357
| | - Emily DeWitt
- Department of Family and Consumer Sciences Extension, College of Agriculture, Food & Environment, University of Kentucky, Lexington, KY 40506, USA; (E.D.); (R.G.)
| | - Rachel Gillespie
- Department of Family and Consumer Sciences Extension, College of Agriculture, Food & Environment, University of Kentucky, Lexington, KY 40506, USA; (E.D.); (R.G.)
| | - Rachel H. Graham
- Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY 40506, USA;
| | - Heather Norman-Burgdolf
- Department of Dietetics and Human Nutrition, College of Agriculture, Food & Environment, University of Kentucky, Lexington, KY 40506, USA; (H.N.-B.); (J.T.M.)
| | - Janet T. Mullins
- Department of Dietetics and Human Nutrition, College of Agriculture, Food & Environment, University of Kentucky, Lexington, KY 40506, USA; (H.N.-B.); (J.T.M.)
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