Describe, and assess disparities in, the changes in Supplemental Nutrition Assistance Program Education (SNAP-Ed) that occurred the year before vs. the year when COVID-19 restrictions were ...implemented.
Observational study comparing reach, intensity, and dose of California Local Health Department (LHD) SNAP-Ed interventions in Federal Fiscal years 2019 and 2020 (FFY19, FFY20).
Student t-tests determined significance of differences in the number of Direct Education (DE) programs, Policy, Systems and Environmental change (PSE) sites, people reached, and intervention intensity and dose between FFY19 and FFY20 using data reported online by LHDs. Linear regression assessed associations between census tract-level characteristics (urbanicity; percentages of population with income <185% of federal poverty level, under 18 years of age, and belonging to various racial/ethnic groups; and California Healthy Places Index) and changes in number of DE programs, PSE sites, people reached, and intervention dose between FFY19 and FFY20.
From FFY19 to FFY20, the number of DE programs, PSE sites, people reached, and census tract-level intervention intensity and dose decreased. Higher census tract poverty, higher proportions of Black and Latino residents, and less healthy neighborhood conditions were associated with greater decreases in some intervention characteristics including PSE sites, PSE reach, DE programs, and DE dose.
These reductions in LHD SNAP-Ed interventions indicate reduced access to education and environments that support healthy eating and obesity prevention during a time when this support was especially needed to reduce risk of COVID-19 infection and complications. Disproportionately reduced access, may have worsened health disparities in already-disadvantaged communities. Assuring maintenance of SNAP-Ed interventions, especially in disadvantaged communities, should be a priority during public health emergencies.
•Health department SNAP-Ed intervention reach and dose decreased dramatically during COVID-19.•Reductions in nutrition interventions may have increased susceptibility to COVID-19.•Disadvantaged communities were disproportionately affected by reductions in SNAP-Ed.•Maintenance of SNAP-Ed interventions should be prioritized during public health emergencies.
California’s Department of Public Health (CDPH) distributes Supplemental Nutrition Assistance Program-Education (SNAP-Ed) funding, known as CalFresh Healthy Living (CFHL) in California, to local ...health departments to implement school-based physical activity/nutrition interventions. We determined the association between intervention presence/dose and student cardiorespiratory fitness and BMI.
This cross-sectional, observational study included 5th and 7th grade students with 2016–17 FitnessGram® results who attended SNAP-Ed eligible California schools. Intervention group students attended schools with CDPH-CFHL interventions during October 2015-September 2016 (n = 904 schools; 97,504 students, 49% female); comparison group students attended schools without CDPH-CFHL interventions (n = 3,506 schools; 372,298 students, 49% female). Adjusted multilevel models determined the association between school-level intervention presence/dose and students’ cardiorespiratory fitness (estimated VO2max) and BMI z-score, and tested for effect modification by student grade and sex.
Students attending intervention schools demonstrated greater VO2max (males: 0.18 mL/kg per min, 95% CI: 0.03, 0.34; females = 0.26 mL/kg per min, 95% CI: 0.13, 0.39) and lower BMI z-scores (males: −0.03, 95% CI: −0.05, −0.02; females = -0.02, 95% CI: −0.04, −0.01) than students in comparison schools. Students in schools with the highest intervention levels demonstrated higher VO2max (0.37 (95% CI: 0.06, 0.16) and 0.22 (95% CI: 0.02, 0.42), respectively), than comparison students, with the strongest associations seen for females and 7th graders.
On average, students in schools with CDPH-CFHL physical activity interventions demonstrated better cardiorespiratory fitness and slightly lower BMI z-scores than students in comparable schools without such programing. Investment in these interventions may positively impact students’ cardiorespiratory health, though further causal investigation is warranted.
Abstract Background Despite the resurgence of interest in scratch-cooking as a way to increase the quality and appeal of school meals, many school districts are concerned about the cost implications ...of switching to scratch-cooking. US Department of Agriculture (USDA) Foods are the single largest source of ingredients for school meals, and about half of USDA Foods are diverted for processing before being sent to the school district. Objective We aimed to determine whether school lunch entrées made in a district from basic or raw USDA Foods ingredients can be healthier and less expensive to prepare than those sent to external processors. Design/setting This cross-sectional study examined the relationship between the extent of scratch-cooking and the nutritional content and cost to prepare entrées. Information was gathered by interview with school foodservice personnel and from school foodservice records from a convenience sample of 10 school districts in California that employed varying degrees of scratch-cooking and is diverse in terms of geographic location and the sociodemographics of the student body. The sample included all elementary school lunch entrées that contain USDA Foods offered during October 2010 for a total sample of 146 entrées. Statistical analyses Ordinary least squares regressions were used to test for statistically significant differences in cost and nutrient content of entrées according to the level of scratch-cooking. Results There was no significant relationship between total costs and level of scratch-cooking. Entrées with the highest scratch-cooking scores had significantly lower food costs, higher labor costs, and not significantly different total costs compared with entrées with no scratch-cooking. Nutrient content was not consistently associated with scratch-cooking, but scratch-cooked entrées did include a larger variety of non–fast-food-type entrées. Conclusions The findings suggest that scratch-cooking can be a cost-effective way to expand the variety of healthy school lunches prepared with USDA Foods.
The Healthy Communities Study Nutrition Assessments Ritchie, Lorrene D., PhD, RD; Wakimoto, Patricia, DrPH, RD; Woodward-Lopez, Gail, MPH, RD ...
American journal of preventive medicine,
October 2015, Letnik:
49, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Multifaceted community interventions directed at improving food environments are emerging, but their impact on dietary change and obesity prevalence has not been adequately documented. The Healthy ...Communities Study (HCS) is seeking to identify characteristics and combinations of programs and policies that are associated with children’s diets and obesity-related outcomes in various types of communities across the U.S. The purpose of this paper is to describe the methods used in 2013–2015 in the HCS to assess dietary intake, school nutrition environments, and other nutrition-related behaviors. The conceptual framework of the HCS is based on the socioecological model and behaviors shown in previous studies to be related to obesity in children guided selection of domains. Nine domains were identified as essential measures of nutrition in the HCS: (1) intake of selected foods and beverages; (2) food patterns and behaviors; (3) social support; (4) home environment; (5) school environment; (6) community environment; (7) breastfeeding history; (8) household food insecurity; and (9) dieting behaviors and body image. Children’s dietary intake was assessed using a dietary screener and up to two automated 24-hour recalls. Dietary-related behaviors were assessed by a survey administered to the parent, child, or both, depending on child age. School nutrition measures were obtained from a combination of school staff surveys and researcher observations. Information from these measures is expected to contribute to a better understanding of “what is working” to improve the dietary behaviors that are likely to prevent obesity and improve health in children.
Abstract Purpose To determine extent and factors associated with implementation of California's school nutrition standards 1 year after standards became active. Methods Information on competitive ...foods and beverages available in schools was collected from a representative sample of 56 public high schools in California. Adherence to nutrition standards was calculated for each item and summarized for each school by venue. The association between schools' sociodemographic characteristics and adherence to standards was determined by multivariate analysis. Results The majority of schools were adhering to the required beverage standards. None of the schools selling competitive foods were 100% adherent to the food standards. Adherence to both standards tended to be highest in food service venues. In univariate analyses, percent nonwhite enrollment, population density, percent free/reduced-price (FRP) meal eligibility, and school size were significantly correlated with the beverage adherence rate. Percent nonwhite enrollment and population density remained significant in the multivariate regression model. Percent nonwhite enrollment and percent FRP meal eligibility were significantly correlated with the food adherence rate in univariate analysis, but neither remained significant in the multiple regression model. Conclusions California high schools are making progress toward implementation of the state nutrition standards. Beverage standards appear easier to achieve than nutrient-based food standards. Additional support is needed to provide schools with resources to implement and monitor these policies. Simpler standards and/or a reduction in the foods and beverages sold could better enable schools to achieve and monitor adherence.
Objective A systematic literature review was conducted to determine whether sweetened beverage intake increases the risk for obesity, and the extent to which it has contributed to recent increases in ...energy intake and adiposity in the USA. Design The search included studies published between 1970 and 2010 that examined secular trends, mechanisms, observational associations and intervention outcomes. Observational and intervention studies were abstracted and systematically evaluated for quality. Setting Trends in obesity prevalence in the USA and studies from industrialized (developed) countries were included. Subjects Studies were included for all ages, genders, ethnic and socio-economic groups for which data were available. Results Obesity rates and sweetened beverage intake have increased in tandem in the USA. Studies consistently show that higher intake of sweetened beverages is associated with higher energy intake. Energy in liquid form is not well compensated for by reductions in the intake of other sources of energy. Well-designed observational studies consistently show a significant positive relationship between sweetened beverage intake and adiposity. More importantly, several well-conducted randomized controlled trials have shown statistically significant changes in adiposity as a result of corresponding changes in sweetened beverage intake. Conclusions All lines of evidence consistently support the conclusion that the consumption of sweetened beverages has contributed to the obesity epidemic. It is estimated that sweetened beverages account for at least one-fifth of the weight gained between 1977 and 2007 in the US population. Actions that are successful in reducing sweetened beverage consumption are likely to have a measurable impact on obesity.
Schools are critical partners in California's Supplemental Nutrition Assistance Program Education (SNAP-Ed) efforts to improve nutrition and physical activity (nutrition-PA) opportunities for ...low-income students and families. School nutrition-PA practices were assessed to identify opportunities for SNAP-Ed partnership.
To determine the nature and extent to which SNAP-Ed-eligible schools are supporting nutrition-PA best practices. Examine differences by school sociodemographics to identify inequities.
In school-year 2020-21, cross-sectional, comprehensive, validated site-level assessment questionnaires (SLAQs) were completed among a convenience sample of 91 SNAP-Ed-eligible elementary schools in 25 California counties. Respondents were personnel familiar with their school's nutrition-PA strategies.
SLAQ scores (0-100%) were generated for each of 8 sections, covering various nutrition-PA best practices (eg, wellness policies, meal programs, PE), and in total. Beta regression was used to examine associations between school-level sociodemographics, urbanicity, and SLAQ scores.
On average, schools scored lowest in Gardens (19%) and Nutrition-Education (40%) and highest in Non-Meal Food/Drinks (76%) and PE (74%) practices. Regression analyses found significant (p<0.05) negative associations between schools with greater proportion of students: experiencing homelessness and Wellness Policies and PE scores; identifying as American Indian/Alaska Native and Parent/Family Involvement score; and classified as English learners and Non-Meal Food/Drinks score. Being located in suburban areas was significantly negatively associated with Nutrition-Education, PE, and Other PA scores, and positively associated with Non-Meal Foods/Drinks score. The final presentation will also include 2021-22 results.
With limited SNAP-Ed resources, comprehensive school assessments are an important tool for program planning. Sociodemographic analyses identify opportunities for reducing inequity. These findings demonstrated that the two sections (Non-Meal Foods/Drinks, PE) with the highest average scores were negatively associated with certain school demographics, highlighting the need to improve equity in nutrition-PA practices. At the site-level, SLAQs are designed to help program implementers work with school partners to assess needs and collaboratively craft action plans. One-size-fits-all programming is inadequate; equity-focused planning and evaluation are critical for reducing health disparities in under-resourced communities.
Supplemental Nutrition Assistance Program - Education
University nutrition policies are a useful step toward improving the food environment for students, faculty, and staff, leading to improved health outcomes for the campus community. As 1 of the first ...universities to adopt and implement a campus-wide nutrition policy, the objective of this report is to share the university's experience with policy development, implementation, monitoring and evaluation, challenges, facilitators, and recommendations to inform these processes for future university nutrition policies.
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