The impact of holiday clubs on household food insecurity-A pilot study

Food insecurity in children and young people in Scotland

The aim of this review is to highlight the key issues in relation to food insecurity among children and young people living in Scotland. It provides an overview of the current context of food insecurity more generally within the UK and specifically in Scotland. Food insecurity has risen in Scotland evidenced through responses to national surveys and the dramatic increase in households relying on emergency food provision. Food insecurity is highest among young people, single parent families and single men. The key drivers of food insecurity include insufficient income, welfare reform, food inflation and geo-political events. Evidence suggests that food insecurity is negatively related to sufficient nutritional intake, and the implications for physical and mental health are profound. Policy actions implemented to mitigate the impact of food insecurity on children and young people include the introduction of the Scottish Child Payment, food voucher schemes, free school meals, and holiday food provision. Further evidence is required to evaluate the success of these policies in reducing or mitigating food insecurity. The review concludes by considering the ways in which a rights-based approach to food might benefit children and young people living in Scotland, and argues that wider systemic change is required.

Exploring the feasibility of using evidence-based feeding practices to promote children's healthy eating in holiday clubs

OBJECTIVE

Encouraging healthy eating is a public health priority in the United Kingdom (UK), given the high prevalence of poor diet and overweight/obesity among school-aged children. Holiday clubs are organisations providing childcare and activities during the school holidays and frequently provide food to children at risk of food insecurity, primarily through government-funded programmes like the Holiday Activities and Food programme. However, the research suggests that holiday clubs could do more to maximise opportunities to promote children's healthy eating by using evidence-based feeding practices.

DESIGN

During August-September 2020, video-based interviews were conducted exploring staff perceptions of the feasibility of using four evidence-based feeding practices to promote children's healthy eating: modelling; involvement in food choice; involvement in food preparation and cooking and involvement in meal planning. Feasibility was assessed using four dimensions of a feasibility framework (acceptability, demand, practicality and implementation).

SETTING

UK holiday clubs.

PARTICIPANTS

Twenty-five staff actively involved in delivering UK holiday clubs (project leaders, coordinators, cooks and coaches/youth workers).

RESULTS

Staff generally reported good acceptability (dimension 1) and demand (dimension 2) for the feeding practices. However, the practicality (dimension 3) of using the practices was dependent on various factors (logistics, resources, staff readiness, children, peers and parents). Promisingly, in the fourth feasibility dimension (implementation), staff provided numerous practical solutions to overcome these barriers.

CONCLUSIONS

Evidence-based feeding practices can be implemented in numerous ways and are therefore generally feasible in holiday clubs. Holiday clubs should be empowered to use evidence-based feeding practices through training resources, sharing networks and provision of sustainable funding.

Perspective: Food and Nutrition Insecurity in Europe: Challenges and Opportunities for Dietitians

In recent years, the interest in food and nutrition insecurity in high-income countries has skyrocketed. However, its recognition in Europe is still developing. This perspective summarizes the evidence on food and nutrition insecurity across Europe in terms of prevalence, consequences, and current mitigation strategies, with the aim of outlining the challenges and opportunities for dietitians. Prevalence in the general population ranges between 5% and 20%, with higher rates identified in women, children, older adults, single-parent households, those with low educational attainment, and on low or unstable income and/or employment. In users of food aid, the prevalence of food insecurity is above 70%. Responses to food and nutrition insecurity include welfare policies and food assistance programs at regional and national levels. However, most current strategies are not successful in tackling the structural drivers of food and nutrition insecurity, nor do they guarantee diet quality. Despite limited involvement to-date, dietitians can play an important role in addressing food and nutrition insecurity across Europe. This narrative identifies 4 areas: 1) create awareness of the existence and severity of food and nutrition insecurity, 2) advocate for comprehensive, robust data on the determinants and prevalence, 3) partner with diverse stakeholders, social assistance providers, local authorities, and nongovernmental organizations in a comprehensive, intersectoral, and integrated manner, 4) participate in the development of political instruments and interventions that ensure equitable access to high-quality safe food.

Understanding the implementation of the holiday activities and food programme in the North East of England using normalization process theory

Following several pilot projects, in 2020, the Department for Education (DfE) in England committed funding of £220M p. a to its Holiday Activities and Food (HAF) programme to support all 153 upper-tier local authorities, comprising City Councils, County Councils and Metropolitan Borough Councils, to provide an activity and food programme for children who are in receipt of means-tested free school meals. In this study, qualitative interviews were conducted with representatives from three Local Authorities in the North East of England who were responsible for overseeing the implementation and delivery of HAF programmes in their Local Authority area to examine how the summer HAF programme was implemented during summer 2021. Interviews were conducted with eight participants prior to the implementation of the HAF programme, and four interviews were conducted after the programme had been delivered. Using a directed content analysis approach, an interpretative framework was co-developed, based on the four constructs (and selected sub-constructs) of Normalization Process Theory. This framework guided data coding. The analysis aimed to identify and understand the barriers and opportunities in relation to HAF implementation within local authorities. Participants did not perceive HAF as a totally new initiative as many had either commissioned or delivered holiday clubs in the past. However, the increased scale and scope of HAF was perceived as highly complex, involving multiple local authority departments and stakeholders. Nonetheless, HAF funding enabled local authorities to improve the quality and reach of their holiday programmes. Strong networks and good communication between all stakeholders supported successful delivery, despite tight delivery timescales. However, the rigidity of some of the DfE guidance was a barrier for some providers, particularly the recommended delivery model of 4 h a day, 4 days a week for 4 weeks, with many individual holiday clubs struggling to meet this level of delivery, and local authority leads interpreting the guidance at a club level rather than an individual child access level. Furthermore, participants considered the HAF eligibility criteria too restrictive. Many councils were developing long-term plans for HAF delivery, integrated into planning across several departments, and all local authorities were actively seeking ways to engage with and embed HAF within local communities.

Staff perspectives on the feeding practices used in holiday clubs to promote healthy eating in disadvantaged communities

An increasing number of holiday clubs provide free meals to alleviate children's hunger during the school holidays. Holiday clubs are well-placed to promote healthy eating among children from disadvantaged communities who may be at risk of experiencing food insecurity, but currently little is known about the feeding practices used by staff and whether these are conducive to maximising opportunities to promote healthy eating. Unlike previous research which has predominantly studied feeding practices in parent-child dyads and childcare settings, this qualitative study explored staff perspectives on the feeding practices they use to promote healthy eating within nine UK holiday clubs working with children from disadvantaged communities. Nine individual interviews and four focus groups were completed with 27 holiday club staff during the 2019 summer holidays. Thematic analysis revealed seven feeding practice themes, including teaching about nutrition; encouraging balance and variety; modelling; involvement; non-food rewards; restriction; and reoffering foods. The results revealed that some staff implement various positive feeding practices which align with the existing evidence-base of feeding practices in other contexts, which is a promising finding given the current lack of information and guidance from which to draw on. However, staff also sometimes reported using maladaptive feeding practices, including overt restriction and punishment. These results emphasise the need for guidance on effective ways to implement feeding practices with children in holiday clubs. Indeed, staff demonstrated their receptivity to engaging with training resources to maximise their opportunities to promote healthy eating behaviours among children.

A mixed-method process evaluation of an East Midlands county summer 2021 holiday activities and food programme highlighting the views of programme co-ordinators, providers, and parents

Background

The Holiday Activities and Food (HAF) Programme is a UK Government initiative created to alleviate food insecurity and promote health and well-being among children and their families, who are eligible for Free School Meals (FSM), during the school holidays. This process evaluation investigated factors that facilitated and acted as a barrier to the delivery of the HAF Programme from the perspectives of key stakeholders (Co-ordinators, Providers, and Parents) involved in the HAF Programme across an East Midlands county.

Methods

This evaluation utilized a mixed-methods approach, incorporating focus groups and online surveys to gain rich, multifaceted data. The focus groups were analyzed using a hybrid inductive-deductive thematic analysis and the online surveys were analyzed using mixed-methods approach due to the variation in question type (i.e., quantitative, Likert scale and open response) to align themes to the Government Aims and Standards of the HAF Programme.

Findings

The stakeholders highlighted several factors that facilitated and acted as a barrier to the delivery of the HAF Programme. Facilitating factors included existing and maintaining relationships between Co-ordinators, Providers, and facilities/schools/communities as this improved communication and attendance. Additionally, transport provision for those attending the Programme helped overcome barriers to attendance. The primary barrier of the Programme was the late awarding of the Programme contract as this limited the time available to prepare and organize the Programme. This in turn, had several "knock on" effects that created more barriers and resulted in some of the Government Aims and Standards not being met such as, nutrition education for children and parents. Despite the challenges faced, Co-ordinators and Providers were able to deliver the Programme and positively impact upon the children and their families that attended the Programme.

Conclusion

Following the facilitators and barriers that were highlighted in this evaluation, several recommendations have been made to enhance the delivery of the HAF Programme and ensure Government Aims and Standards, to improve children and family's health and well-being, are attained.

An Exploration of Nutritional Education within the Holiday Activities and Food Programme in England

Nutritional education is a recent, mandatory inclusion within the quality standards framework for the Holiday Activities and Food (HAF) programme in England; funded by the Department for Education (DfE). Whilst research has been conducted regarding nutritional education in other contexts, such as schools and community organisations, to the authors’ knowledge, no published research has yet explored nutritional education within HAF. The current study therefore aimed to explore the implementation, delivery, and perceived facilitators, barriers and impacts of nutritional education across a number of Local Authorities delivering HAF in England. Purposive sampling (n = 11) was used to recruit HAF leads involved in nutritional education, to participate in semi-structured interviews. Thematic analysis showed that nutritional education is currently delivered through a variety of modes including face-to-face, online, and take-home methods, all of which require a range of considerations in terms of implementation, delivery, and associated impacts, with some holiday clubs offering no nutritional education. According to participating HAF leads, nutritional education was used as a mechanism to enhance children’s and parents’ cooking confidence and competence, to improve dietary intake, and to increase understanding of issues such as food sustainability, environmental impacts, and food provenance. Although there are many examples of innovative practice, the findings suggested that COVID guidelines proved challenging for providers to include nutritional education within HAF delivery during 2021. Further, whilst the quality standards framework for nutritional education provides flexibility in terms of implementation and delivery, specific guidance, and monitoring of provision is required to ensure quality assurance and consistency across the HAF programme.

The Diet of Children Attending a Holiday Programme in the UK: Adherence to UK Food-Based Dietary Guidelines and School Food Standards

Child poverty rates are rising, particularly in London, putting more children at risk of experiencing food insecurity. Holiday programmes in the UK provide children who receive free schools meals during term time with access to free/low-cost holiday clubs offering nutritious food and enriching activities during the school holidays. This study aimed to investigate whether children’s dietary intake was more adherent to the UK Eatwell Guide throughout the day and meets School Food Standards (SFS) for the lunchtime meal on a club attendance versus a non-attendance day. A repeated measures design was used to assess data on the food and drink intake of children (n = 57) aged 7–16 years old using a 24 h recall method on two separate occasions: once based on an attending club day and once based on a non-attending club day. The results showed children’s diet quality improved (p = 0.007) on an attending club day (mean: 58.0 ± SD 12.6) versus a non-attending club day (51.8 ± 15.0). Children also more closely adhered to the SFS (p = 0.001) on an attending club day (median = 9, interquartile range = 8–9) versus a non-attending club day (median = 7, interquartile range = 6–8). This suggests that holiday programmes targeting children who receive free school meals during term time have the potential to improve children’s dietary behaviours during the school holidays, underlining the importance of holiday programmes to support food security.

Adaptations to Holiday Club Food Provision to Alleviate Food Insecurity During the Covid-19 Pandemic

Holiday clubs play a pivotal role in providing food and vital enrichment opportunities to alleviate food insecurity among children during the school holidays (holiday hunger). The need for these opportunities increased substantially for families throughout 2020, as food insecurity quadrupled in the UK during the Covid-19 pandemic. In this qualitative study, holiday club staff from England and Wales reflected on the adaptations they implemented in order to maintain food supplies and food-related enrichment activities for families during the first UK national Covid-19 lockdown and subsequently throughout the summer of 2020. Staff also reflected on the opportunities and challenges related to implementing these adaptations during this period. Twenty-five holiday club staff engaged in video-based interviews during August and September 2020. The findings revealed a range of innovative changes to holiday club food provision, and the challenges and opportunities faced varied across holiday clubs. Challenges during the pandemic in some clubs included staff shortages (typically due to furloughing and/or increased working demands) and difficulties sourcing adequate funding. However, staff identified that the opportunities for holiday clubs included enhanced partnership working during the pandemic, increased engagement with digital technology to communicate with families and deliver their online cooking sessions, and their ability to continue providing food and much needed creative opportunities for children unable to attend school and/or the holiday club. The ability of clubs to adapt their models of working when faced with adversity was essential in protecting their organisational resilience and delivering their vital services. The findings emphasise the important role that holiday clubs play in their communities and highlight their willingness to adapt and expand their role in response to the pandemic to continue to tackle food insecurity and provide vital food and food-related enrichment opportunities to families. The findings also identify lessons that can be applied to practise in the future.

Food Insecurity: A Constant Factor in the Lives of Low-Income Families in Scotland and England

During the school summer holidays, pressures on the already tight budgets of low-income families are compounded, particularly when the safety net of free school meals is removed. The main aim of the current study was to investigate how low-income parents and carers feed their families during term time when children receive free school meals and if, and how, strategies differ during the school summer holidays. A secondary aim was to investigate the role of holiday activity and food programmes in supporting parents and carers to feed their children during the school summer holidays. We used purposive sampling to recruit a total of 21 parents (N = 20 Female, N = 1 Male) whose children attended free summer holiday clubs in Scotland and England during summer 2017. Participants were asked about their food and shopping habits during the school term and if, and how they differed during the school summer holidays when free school meals were not available. The findings suggest that food insecurity is a constant factor in the lives of low-income parents in England and Scotland, and that the stages of food insecurity and the strategies employed to mitigate its effects appear to be cyclical, aligning with the Food and Agriculture Organisation's (FAO) food insecurity continuum and the school academic year. During term time, parents and carers worried about food, suggesting they were experiencing mild food insecurity, despite their children being in receipt of free school meals. As the school holidays approached, moderate food insecurity was experienced as parents reported that they began "provisioning," storing food and reducing household expenditure. During the summer holidays, food did not last, and parental food acquisition habits became more intense. Parents downgraded food brands and bought reduced price items of food. Ultimately, parents self-sacrificed their own nutritional intake by only buying food their children would eat and parents often skipped meals or only ate their children's leftovers. However, children's attendance at holiday club helped make the food at home last longer and once school resumed, parents returned to their less intense, but constantly coping approach to food shopping. The findings of this study suggest that food insecurity is a constant factor in the lives of low-income families who simply do not have enough household income to prevent them from experiencing food insecurity, even when initiatives such as free school meals and access to holiday club provision with food and activities are in place.

Holiday Club Programmes in Northern Ireland: The Voices of Children and Young People

In Northern Ireland, nearly 30% of children are thought to be at risk of going hungry in the summer holidays when they are unable to access free school meals. Community groups, voluntary groups, local authorities, and faith groups have responded to this concern by developing and delivering holiday programmes that enable children from low-income families to take part in activities and access food. The current study used purposive sampling to investigate children's and young people's views of holiday provision, from across three holiday clubs, in Northern Ireland. Both primary school children (n = 34; aged 4-11) and secondary school children (n = 31; aged 12-17) showed high levels of awareness of poverty and food insecurity and associated pressures and stresses on households. Importantly, children and young people did not feel stigmatised about attending holiday provision, suggesting a positive and inclusive culture towards holiday club attendance. Children reported that they enjoyed the range of activities provided at holiday clubs and reported that attendance improved their self-confidence, especially for some older children, who acted as peer mentors to younger attendees, helped them to develop new skills, and provided them with opportunities to socialise with peers in a safe environment, out with their normal social groupings in school. Older children showed a high level of shrewdness and knowledge of sectarian divides in communities but spoke positively about how different religious or cultural backgrounds did not matter in terms of meeting and making new friends in holiday club settings. In terms of food provision, the findings of this study suggest that further work needs to be done to support children to access and eat healthy, nutritious food.

Holiday Hunger and Parental Stress: Evidence from North East England

Summer is a stressful time of year for many parents as they struggle to meet household expenses and feed children. The aim of the present study is to determine if there is an association between summertime food insecurity (i.e., holiday hunger) and parental stress among a sample of UK parents with school age children living in North East England. A cross-sectional sample of (n = 252) parents are analyzed using holiday hunger as the independent variable and a subjective measure of stress that treats summer as a ‘stressful event’ as the dependent variable. Of the parents in the sample, 64.8% reported at least some level of holiday hunger. We find parents facing any holiday hunger scored substantively higher on the overall 75-point Impact of Event Scale (mean difference = 30.4, 95% confidence interval ((CI) 24.2–36.6), the 35-point intrusion subscale (13.7, 95% CI 10.8–16.5), and the 40-point avoidance subscale (16.7, 95% CI 13.3–20.2). These findings are replicated in a regression analysis. In addition, we find that holiday hunger partially mediates the association between economic hardship (i.e., unemployment and poverty) and parental stress. We conclude by suggesting that government policies addressing economic hardship are not only likely to reduce holiday hunger, but also improve mental wellbeing.

Food Insecurity in Advanced Capitalist Nations: A Review

Food insecurity is a substantial problem in nearly every advanced capitalist nation, with sizable portions of residents in many affluent countries struggling to eat healthily every day. Over time, a very large literature has developed that documents food insecurity, evaluates programs meant to reduce that insecurity, and proposes solutions to attenuate the problem. The purpose of the current review is to provide a very broad overview of the food insecurity literature, including definitions, measurement, areas of study, and impacts on health. Importantly, this review suggests there are two major causes of food insecurity in the advanced nations: economic inequality and neoliberalism. The food insecurity literature suggests that diminished government responsibility in advanced capitalist nations corresponds to an increase in feeding programs run by non-profit and charitable organizations. This review concludes by suggesting that, while a massive amount of research on food insecurity currently exists, more research is still needed to address gaps in the literature when it comes to significant events, coping strategies and disadvantaged populations.