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1.
JAMA ; 331(8): 702-705, 2024 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-38300534

RESUMO

This study assesses differences in breastfeeding initiation trends between Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants and WIC-eligible nonparticipants before, during, and after the 2022 infant formula disruption.


Assuntos
Aleitamento Materno , Assistência Alimentar , Fórmulas Infantis , Feminino , Humanos , Lactente , Aleitamento Materno/estatística & dados numéricos , Assistência Alimentar/estatística & dados numéricos , Alimentos Formulados/provisão & distribuição , Fórmulas Infantis/provisão & distribuição , Estados Unidos/epidemiologia
2.
PLoS One ; 19(2): e0295171, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38329953

RESUMO

Food insecurity and inadequate nutrition are two major challenges that contribute to poor health conditions among U.S. households. Ohioans continue to face food insecurity, and rates of food insecurity in rural Southeast Ohio are higher than the state average. The main purpose of this project is to evaluate the associations between Supplemental Nutrition Assistance Program (SNAP) participation and food security in rural Ohio, and to explore the association between SNAP participation and fruit/vegetable consumption. We control for food shopping patterns, such as shopping frequency, because previous research reports a significant relationship between shopping patterns and food security. To achieve our purpose, we use novel household-level data on food insecurity and SNAP participation in rural Southeast Ohio, collected during the COVID-19 pandemic. We find that people who experience higher levels of food insecurity than others are more likely to participate in SNAP, though this is likely a function of selection bias. To correct for the bias, we employ the nearest neighbor matching method to match treated (SNAP participant) and untreated (similar SNAP nonparticipant) groups. We find that participating in SNAP increases the probability of being food secure by around 26 percentage points after controlling for primary food shopping patterns. We do not find any significant association between SNAP participation and estimated intake of fruits and vegetables. This study provides policymakers with suggestive evidence that SNAP is associated with food security in rural Southeast Ohio during the pandemic, and what additional factors may mediate these relationships.


Assuntos
Assistência Alimentar , Verduras , Humanos , Frutas , Ohio , Pandemias , Abastecimento de Alimentos , Pobreza , Estudos Transversais , Insegurança Alimentar
3.
Int J Public Health ; 69: 1605833, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38404502

RESUMO

Objective: To characterize 12-month trends in the use of food donations and other food-related community-based social assistance programs (CB-SAPs) during the first year following the enrollment of new food bank (FB) users in Quebec, Canada. Methods: A cohort of 1,001 newly registered FB-users in Quebec from the Pathways Study were followed-up during 12-month following baseline assessment. Outcomes were monthly use of food donations and other food-related CB-SAPs. Main predictors were alternative food source utilization (AFSU) profiles: 1) exclusive-FB-users; 2) FB+fruit/vegetable-market-users; and 3) Multiple/diverse-AFS-users. Covariates included sociodemographic characteristics, health status, and major life events. We fit Bayesian hierarchical mixed-effect models, accounting for spatial clustering, temporal correlation, and censoring. Results: We observed an overall downward trend of food donation use among study completers (n = 745). Each AFSU profile had a distinctive monthly trend of food donation use, but probabilities of use across the three profiles overlapped, between 44% and 55%. The use of other food-related CB-SAPs was low and not correlated with AFSU profiles. Conclusion: De novo FB-users use food donations in different ways over time according to specific contextual AFSU profiles.


Assuntos
Assistência Alimentar , Humanos , Quebeque , Teorema de Bayes , Canadá , Frutas
4.
Nutrients ; 16(3)2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38337718

RESUMO

In cross-sectional studies, food insecurity is associated with adverse health and dietary outcomes. Whether self-reported health and dietary outcomes change in response to improvements in food security has not been examined. We sought to examine how increases in food security are related to changes in health and dietary factors. In this longitudinal, observational study, we included adult participants in a clinical-community emergency food assistance program in New York City from July 2020 to November 2021. Program staff measured food security with a validated six-item measure at program enrollment and six-month re-enrollment. Participants self-reported health and dietary factors (vegetable, fruit, juice, and sugar-sweetened beverage (SSB) consumption frequency). We used multivariable regression to examine associations between change in food security with change in health and dietary factors over six months. Among 310 participants, the mean food security score improved by 1.7 ± 2.3 points over six months. In unadjusted models, each point improvement in food security was associated with increased vegetable (ß = 0.10 times; 95% CI: 0.05-0.15); fruit (ß = 0.08 times; 95% CI: 0.03-0.14); and juice (ß = 0.10 times; 95% CI: 0.05-0.15) consumption. In adjusted models, results remained significant for vegetable and fruit consumption, but not juice. Change in food security was not associated with change in health or SSB outcomes. In this cohort during COVID-19, improved food security was associated with improved vegetable and fruit consumption. Randomized trials that examine the effectiveness of clinical-community partnerships focused on improving food security and nutrition are warranted.


Assuntos
COVID-19 , Assistência Alimentar , Adulto , Humanos , Estudos Transversais , Cidade de Nova Iorque/epidemiologia , COVID-19/epidemiologia , Dieta , Frutas , Verduras , Abastecimento de Alimentos , Segurança Alimentar
5.
JAMA Netw Open ; 7(2): e2356619, 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38393731

RESUMO

Importance: Nonadherence to antihypertensive medications is associated with uncontrolled blood pressure, higher mortality rates, and increased health care costs, and food insecurity is one of the modifiable medication nonadherence risk factors. The Supplemental Nutrition Assistance Program (SNAP), a social intervention program for addressing food insecurity, may help improve adherence to antihypertensive medications. Objective: To evaluate whether receipt of SNAP benefits can modify the consequences of food insecurity on nonadherence to antihypertensive medications. Design, Setting, and Participants: A retrospective cohort study design was used to assemble a cohort of antihypertensive medication users from the linked Medical Expenditure Panel Survey (MEPS)-National Health Interview Survey (NHIS) dataset for 2016 to 2017. The MEPS is a national longitudinal survey on verified self-reported prescribed medication use and health care access measures, and the NHIS is an annual cross-sectional survey of US households that collects comprehensive health information, health behavior, and sociodemographic data, including receipt of SNAP benefits. Receipt of SNAP benefits in the past 12 months and food insecurity status in the past 30 days were assessed through standard questionnaires during the study period. Data analysis was performed from March to December 2021. Exposure: Status of SNAP benefit receipt. Main Outcomes and Measures: The main outcome, nonadherence to antihypertensive medication refill adherence (MRA), was defined using the MEPS data as the total days' supply divided by 365 days for each antihypertensive medication class. Patients were considered nonadherent if their overall MRA was less than 80%. Food insecurity status in the 30 days prior to the survey was modeled as the effect modifier. Inverse probability of treatment (IPT) weighting was used to control for measured confounding effects of baseline covariates. A probit model was used, weighted by the product of the computed IPT weights and MEPS weights, to estimate the population average treatment effects (PATEs) of SNAP benefit receipt on nonadherence. A stratified analysis approach was used to assess for potential effect modification by food insecurity status. Results: This analysis involved 6692 antihypertensive medication users, of whom 1203 (12.8%) reported receiving SNAP benefits and 1338 (14.8%) were considered as food insecure. The mean (SD) age was 63.0 (13.3) years; 3632 (51.3%) of the participants were women and 3060 (45.7%) were men. Although SNAP was not associated with nonadherence to antihypertensive medications in the overall population, it was associated with a 13.6-percentage point reduction in nonadherence (PATE, -13.6 [95% CI, -25.0 to -2.3]) among the food-insecure subgroup but not among their food-secure counterparts. Conclusions and Relevance: This analysis of a national observational dataset suggests that patients with hypertension who receive SNAP benefits may be less likely to become nonadherent to antihypertensive medication, especially if they are experiencing food insecurity. Further examination of the role of SNAP as a potential intervention for preventing nonadherence to antihypertensive medications through prospectively designed interventional studies or natural experiment study designs is needed.


Assuntos
Assistência Alimentar , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Anti-Hipertensivos/uso terapêutico , Estudos Retrospectivos , Estudos Transversais , Pobreza
6.
Matern Child Health J ; 28(3): 438-469, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38372834

RESUMO

INTRODUCTION/PURPOSE: Poverty-reduction efforts that seek to support households with children and enable healthy family functioning are vital to produce positive economic, health, developmental, and upward mobility outcomes. The Supplemental Nutrition Assistance Program (SNAP) is an effective poverty-reduction policy for individuals and families. This study investigated the non-nutritional effects that families experience when receiving SNAP benefits. METHODS: We conducted a scoping review using the PRISMA Guidelines and strategic search terms across seven databases from 01 January 2008 to 01 February 2023 (n=2456). Data extraction involved two researchers performing title-abstract reviews. Full-text articles were assessed for eligibility (n=103). Forty articles were included for data retrieval. RESULTS: SNAP positively impacts family health across the five categories of the Family Stress Model (Healthcare utilization for children and parents, Familial allocation of resources, Impact on child development and behavior, Mental health, and Abuse or neglect). DISCUSSION/CONCLUSION: SNAP is a highly effective program with growing evidence that it positively impacts family health and alleviates poverty. Four priority policy actions are discussed to overcome the unintentional barriers for SNAP: distributing benefits more than once a month; increasing SNAP benefits for recipients; softening the abrupt end of benefits when wages increase; and coordinating SNAP eligibility and enrollment with other programs.


Assuntos
Assistência Alimentar , Pobreza , Criança , Humanos , Características da Família , Abastecimento de Alimentos , Comportamentos Relacionados com a Saúde , Nível de Saúde
7.
Transl Behav Med ; 14(3): 187-188, 2024 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-38217523

RESUMO

Under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), current federal policy mandates a lifetime ban for individuals with a past felony drug conviction from receiving Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) benefits. Denying nutritional and financial assistance to individuals with a past felony conviction will widen existing structural health inequities, set back individuals' successful re-entry into society, and contribute to recidivism and poorer health outcomes. Therefore, the Society of Behavioral Medicine supports the RESTORE ACT (Re-Entry Support Through Opportunities for Resources and Essentials Act), which would repeal the lifetime ban on receiving SNAP and TANF benefits for individuals convicted of a drug felony.


Current US law bans people who have been convicted of felony drug crime from participating in nutritional and financial assistance programs (i.e. Supplemental Nutrition Assistance Program [SNAP] and Temporary Assistance for Needy Families [TANF]). By not allowing people who have been convicted of a drug felony to access these programs, this law risks worsening health outcomes and perpetuating existing health disparities. The Society of Behavioral Medicine supports the RESTORE Act (Re-Entry Support Through Opportunities for Resources and Essentials Act), which would end the federal ban and allow all income-eligible people to access SNAP and TANF benefits.


Assuntos
Medicina do Comportamento , Assistência Alimentar , Humanos , Estados Unidos , Políticas
8.
Public Health Nurs ; 41(2): 338-345, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38284424

RESUMO

OBJECTIVE: Administrative requirements could disrupt sustained Supplemental Nutrition Assistance Program (SNAP) participation among income-eligible individuals. To meet their food needs, low-income individuals without consistent SNAP benefits may compromise on medication use, posing a risk to their health. The objective of this study is to examine the association of SNAP participation duration in a given year with cost-related medication nonadherence (CRN) and emergency department (ED) use in income-eligible individuals. DESIGN: Cross-sectional. SAMPLE: Non-elderly and elderly adults who used prescription medications and participated in SNAP the previous year in 2016-2018 National Health Interview Survey. Subsamples included individuals with specific chronic conditions. MEASUREMENTS: CRN and ED usage. RESULTS: SNAP participation for <12 months in the previous year was related to increased CRN and ED use in nonelderly adults taking prescription medication, as well as in those with hypertension, cardiovascular disease and asthma. Further, <12-month SNAP participation was associated with greater odds of having at least one ED visit in nonelderly and elderly adults. CONCLUSIONS: Sustained SNAP participation could help income-eligible individuals better adhere to their prescribed medications and reduce health complications requiring ED visits. Findings suggest the importance of addressing SNAP participation gaps among income-eligible individuals in health care settings.


Assuntos
Assistência Alimentar , Pobreza , Adulto , Humanos , Pessoa de Meia-Idade , Idoso , Estudos Transversais , Adesão à Medicação , Inquéritos Nutricionais
9.
Pediatrics ; 153(2)2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38258385

RESUMO

BACKGROUND AND OBJECTIVES: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) prevents food insecurity and supports nutrition for more than 3 million low-income young children. Our objectives were to determine the cost-effectiveness of changes to WIC's nutrition standards in 2009 for preventing obesity and to estimate impacts on socioeconomic and racial/ethnic inequities. METHODS: We conducted a cost-effectiveness analysis to estimate impacts from 2010 through 2019 of the 2009 WIC food package change on obesity risk for children aged 2 to 4 years participating in WIC. Microsimulation models estimated the cases of obesity prevented in 2019 and costs per quality-adjusted-life year gained. RESULTS: An estimated 14.0 million 2- to 4-year old US children (95% uncertainty interval (UI), 13.7-14.2 million) were reached by the updated WIC nutrition standards from 2010 through 2019. In 2019, an estimated 62 700 (95% UI, 53 900-71 100) cases of childhood obesity were prevented, entirely among children from households with low incomes, leading to improved health equity. The update was estimated to cost $10 600 per quality-adjusted-life year gained (95% UI, $9760-$11 700). If WIC had reached all eligible children, more than twice as many cases of childhood obesity would have been prevented. CONCLUSIONS: Updates to WIC's nutrition standards for young children in 2009 were estimated to be highly cost-effective for preventing childhood obesity and contributed to reducing socioeconomic and racial/ethnic inequities in obesity prevalence. Improving nutrition policies for young children can be a sound public health investment; future research should explore how to improve access to them.


Assuntos
Assistência Alimentar , Obesidade Pediátrica , Lactente , Humanos , Criança , Feminino , Pré-Escolar , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/prevenção & controle , Análise Custo-Benefício , Análise de Custo-Efetividade , Alimentos
10.
J Nutr Educ Behav ; 56(3): 133-144, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38206242

RESUMO

OBJECTIVE: To examine the college student Supplemental Nutrition Assistance Program (SNAP) application process from the perspective of county agency workers. DESIGN: A qualitative study that included semistructured individual and group interviews (n = 14) between February and December, 2021. SETTING: Nine California counties with a University of California campus. PARTICIPANTS: A total of 24 county agency workers who regularly process or advise on college student SNAP applications. PHENOMENON OF INTEREST: Facilitators and barriers to processing student SNAP applications. ANALYSIS: Interviews were recorded, transcribed, and coded using thematic analysis. RESULTS: Five themes were identified regarding student applications: (1) a need for more consistency in policy dissemination and program administration, (2) student exemptions and the application process are perceived as challenging for students, (3) facilitators of successfully processing student applications, (4) tracking policy changes is burdensome, and (5) eliminate the student rules. CONCLUSION AND IMPLICATIONS: County agency workers perceived that students experience unnecessary barriers to accessing SNAP benefits and that implementing the student rules was taxing. Expanding SNAP access to low-income college students could be an equitable solution to mitigate the risk of student hunger while they pursue their degrees.


Assuntos
Assistência Alimentar , Humanos , Pobreza , California , Fome , Estudantes , Abastecimento de Alimentos
11.
BMC Public Health ; 24(1): 97, 2024 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-38183068

RESUMO

BACKGROUND: While campus food pantries have been important safety net programs for alleviating food insecurity among college students, factors related to accessing these vital resources have not been fully researched and summarized. This study systematically synthesized peer-reviewed literature on the predictors, barriers to, and facilitators of using campus food pantries among college students. METHODS: A search was conducted on PubMed, CINAHL Complete, PsychInfo, PsycARTICLES, and ScienceDirect in April 2023. Included studies needed to be peer-reviewed, written in English, and focused on college or university students. Three authors independently screened all articles retrieved from the five databases based on titles, titles and abstracts, and a full article review. The Study Quality Assessment Tool from the National Heart, Lung, and Blood Institute was used to assess the risk of bias in the included cross-sectional studies. The risk of bias and quality of mixed methods or qualitative studies were assessed as well. RESULTS: Eight studies were included in the systematic review. Students likely to use a college food pantry were food-insecure, who most often identified as Asian, Hispanic/Latino, Filipino or Pacific Islander; were first-generation to college; international students; sophomores and juniors; had student loans; were living off-campus; and were without stable housing. Stigma was the most frequently mentioned barrier to using a food pantry. Participants mentioned facilitators such as convenient location and hours of operation, access to fresh produce and nutritious and safe foods, availability of a variety of foods, friendly and helpful service, social support, and awareness of a pantry through fellow students and other members of the university such as staff and faculty. CONCLUSIONS: Continued research must address students' systemic barriers to accessing food pantries. Campus food pantry leaders, university administrators, and policymakers need to work together to create cost-effective and sustainable solutions that will alleviate the stigma and burden of food-insecure students and provide them with safe, nutritious, and culturally acceptable foods.


Assuntos
Assistência Alimentar , Estudantes , Humanos , Universidades
12.
Am J Health Promot ; 38(3): 349-354, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37891714

RESUMO

PURPOSE: Examine whether the association between Supplemental Nutrition Assistance Program (SNAP) participation and diet quality is different by gender and household headship. DESIGN: Quantitative, cross-sectional. SETTING: The 2007-2018 waves of the National Health and Nutrition Examination Survey (NHANES). SUBJECTS: 6180 individuals aged 20 to 65 with household annual income below 130% of the poverty level. MEASURES: The outcome of diet quality was measured using the 2015 Healthy Eating Index (HEI) based on dietary intake from 24-hour diet recall. The exposures were self-reported participation in SNAP and socio-demographic variables. ANALYSIS: Ordinary Least Square (OLS) regression models. RESULTS: The study found that female household heads had higher average total HEI scores relative to their male and non-head counterparts (ß = 1.81, 95% CI: -.27, 3.88). However, for SNAP participants, female household heads had lower average total HEI scores (ß = -3.67, 95% CI: -7.36, .11). CONCLUSION: Female household heads are more likely to experience difficulty in maintaining diet quality relative to their counterparts. The study suggests that intra-household effort allocation may play an important role in differentiating and maintaining diet quality.


Assuntos
Assistência Alimentar , Humanos , Masculino , Feminino , Inquéritos Nutricionais , Estudos Transversais , Dieta , Características da Família
13.
Matern Child Health J ; 28(2): 315-323, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37955841

RESUMO

OBJECTIVES: To assess trends in food insecurity between 2005 and 2017-a period including the Great Recession-by participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). METHODS: Data from the California Health Interview Survey (CHIS), 2005-2017, were used, including 7421 households: WIC participants (n = 4184)-those participating in WIC only (n = 2315) and in the Supplemental Nutrition Assistance Program (SNAP) in addition to WIC (n = 1869)-and WIC-eligible non-participants (n = 3237). Multivariable logistic regression models were run with food insecurity as the outcome, WIC participation and survey year as predictors, and adjusted by children's and family's demographic and socioeconomic variables. Interactions between WIC participation and survey year were tested. RESULTS: WIC + SNAP participating households had higher crude food insecurity prevalence across time compared to WIC only and WIC-eligible non-participant households. In fully adjusted models: (1) food insecurity was higher between 2009 and 2017, compared to 2005, for all groups; (2) WIC participating households had higher odds of food insecurity than WIC-eligible non-participants (OR = 1.23, 95%CI = 1.10-1.38); (3) when WIC participants were split into WIC only and WIC + SNAP, WIC + SNAP households had higher odds of food insecurity than WIC-eligible non-participants (OR = 1.45, 95%CI = 1.27-1.66); and (4) the association between food insecurity and WIC participation did not change across time (interaction p-value > 0.10). CONCLUSIONS: Food insecurity increased post-Great Recession among low-income households with children in California, with those participating in WIC, particularly in WIC + SNAP, at higher risk. WIC should consider additional referrals for households who participate in WIC + SNAP.


Assuntos
Assistência Alimentar , Lactente , Criança , Humanos , Feminino , Características da Família , Pobreza , California , Insegurança Alimentar , Abastecimento de Alimentos
14.
J Nutr Educ Behav ; 56(1): 35-42, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38032565

RESUMO

OBJECTIVE: To explore factors influencing the adoption of direct education programs and policy, systems, and environmental (PSE) change initiatives focused on physical activity for Supplemental Nutrition Assistance Program-eligible audiences by Virginia Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education (SNAP-Ed) staff. METHODS: Online survey with Expanded Food and Nutrition Education Program and SNAP-Ed peer (paraprofessional) educators (n = 28) and SNAP-Ed agents (master of science level) (n = 9) in Virginia. Descriptive statistics were computed for sociodemographic characteristics and responses to questions on the basis of Likert-type scales. Exploratory factor analyses were run to identify the underlying structures of the different variables. RESULTS: The main factors for peer educators were related to substituting nutrition programs or content for physical activity programs. Other factors included staff qualifications and expectations about leading vs teaching physical activities. For PSEs, the top factors were the capacity to reach many community members, attract new partners and stakeholders, and personal interest in the PSE. CONCLUSIONS AND IMPLICATIONS: The results provide insight into potential barriers and motivators for adopting physical activity education and PSEs within community-based initiatives and can be used to inform program planning and staff training. Additional research is warranted to examine other factors influencing the adoption and implementation of physical activity programs and PSEs.


Assuntos
Assistência Alimentar , Humanos , Virginia , Educação em Saúde , Políticas , Exercício Físico
15.
Ann Behav Med ; 58(2): 100-110, 2024 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-37857305

RESUMO

BACKGROUND: Interventions in food pantry settings have the potential to improve health among clients at risk of diet-related disease. PURPOSE: This study evaluates whether a cluster-randomized, behavioral intervention in food pantries resulted in improved client outcomes. METHODS: Sixteen Minnesota food pantries were randomized to an intervention (n = 8) or control condition (n = 8). The intervention offered pantries technical assistance to improve healthy food supply and implement behavioral economics strategies to promote healthy food selection. A convenience sample of adult clients were enrolled (paired sample, 158 intervention, 159 control) and followed for 1 year. Additional clients were enrolled at follow-up to assess food selection (follow-up sample, 85 intervention, 102 control). Analysis was limited to data from 11 pantries (5 intervention, 6 control) due to COVID-19. Outcome measures included Healthy Eating Index-2015 (HEI-2015) total and subcomponent scores for 24-hr dietary recalls and client cart selections, and Life's Simple 7 (LS7) total and subcomponent scores. Multilevel mixed-effects models tested whether client outcomes differed by intervention condition. RESULTS: In adjusted models, there were no statistically significant differences by intervention condition in HEI-2015 or LS7 scores. Clients in intervention food pantries had improved Refined Grain subcomponent scores (p = .004); clients in control pantries had worsened Saturated Fat subcomponents scores (p = .019) and improved physical activity scores (p = .007). CONCLUSIONS: The intervention did not result in improved diet quality or cardiovascular health as measured by HEI-2015 or LS7. Coordinated efforts across settings are needed to address health risks facing this population.


Food pantries are an optimal setting to address health and diet quality among clients experiencing food insecurity. This study tests whether a food pantry intervention resulted in improved dietary and cardiovascular outcomes among clients. Sixteen Minnesota food pantries were randomized to either receive an intervention or a delayed intervention. The intervention offered food pantries technical assistance to improve healthy food supply and "nudge" clients toward healthy choices. Due to the COVID-19 pandemic, measures were completed 11 pantries (5 intervention, 6 control). Outcome measures included diet quality of food selected by clients, diet quality of food consumed by clients, and Life's Simple 7 measure of cardiovascular health. The intervention did not result in improved diet quality or cardiovascular health. Coordinated efforts across community settings are needed to address health risks facing this population.


Assuntos
Assistência Alimentar , Adulto , Humanos , Dieta , Abastecimento de Alimentos/métodos , Preferências Alimentares , Projetos de Pesquisa
16.
Matern Child Health J ; 28(1): 135-143, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37924419

RESUMO

OBJECTIVE: To examine the racial, ethnic and cultural differences in postpartum participation of women who participated in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) during pregnancy by completing a retrospective analysis of observational data on 35,903 women who enrolled in Minnesota WIC during pregnancy, from April 2018 to March 2020. METHODS: Descriptive analyses were completed using chi-square tests of association to show differences in postpartum WIC participation by maternal demographics and health risk codes of the WIC participants. Binary logistic regression and multivariate logistic regression were used to obtain odds ratios to compare the likelihood of postpartum WIC participation across different races, ethnicities and cultural groups. RESULTS: Asian/Pacific Islander, East African, Hispanic, Hmong, Multigenerational Black, and Other Black pregnant participants were more likely than White participants to return to WIC postpartum (adjusted odds ratio (AOR) 2.54, 95% confidence interval (CI) 1.87-3.46; AOR 3.35, 95% CI 2.40-4.66; 1.30, 95% CI 1.10-1.54; AOR 6.76, 95% CI 4.39-10.42; AOR 1.40, 95% CI 1.11-1.77, AOR 1.52, 95% CI 1.26-1.83, respectively). American Indian pregnant participants were less likely than White participants to return to WIC postpartum (AOR 0.70, 95% CI 0.54-0.92). CONCLUSIONS FOR PRACTICE: These findings can help the Minnesota WIC program, as well as other WIC programs, better understand which cultural groups may need more specific outreach strategies to keep women participating in the program after giving birth. Further research is needed to understand why postpartum women choose to participate, or choose not to participate, in WIC.


Assuntos
Etnicidade , Assistência Alimentar , Lactente , Criança , Gravidez , Feminino , Humanos , Minnesota , Estudos Retrospectivos , Identificação Social , Período Pós-Parto
17.
Am J Prev Med ; 66(3): 526-533, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37918458

RESUMO

INTRODUCTION: Food insecurity is associated with the development of substance misuse and use disorders (SUD). This study sought to estimate associations between state Supplemental Nutrition Assistance Program (SNAP) eligibility policies and substance-related outcomes. METHODS: 2014-2017 SNAP Policy Database and 2015-2019 National Survey on Drug Use and Health state-level estimates were used to estimate associations between state SNAP eligibility policies and alcohol use disorder (AUD), opioid misuse, illicit drug use disorder (IDUD), SUD, and needing but not receiving SUD treatment. State SNAP policies included those that (1) do not disqualify individuals with a felony drug conviction from SNAP and/or (2) expand SNAP eligibility by increasing the income limit or removing the asset test. Analyses were conducted January-May 2023. RESULTS: States that adopted both SNAP eligibility policies had reduced rates of AUD (adjusted rate ratio (aRR): 0.92; 95% CI 0.86, 0.99), opioid misuse (aRR: 0.94; 95% CI 0.89, 0.98), IDUD (aRR: 0.91; 95% CI 0.85, 0.98), SUD (aRR: 0.91; 95% CI 0.85, 0.97), and needing but not receiving SUD treatment (aRR: 0.92; 95% CI 0.87, 0.98) compared to states with neither policy. Among states that did not adopt increases to the income limit or removal of the asset test, those that removed the felony drug disqualification had lower rates of IDUD, SUD, and needing but not receiving SUD treatment, compared to those that maintained a disqualification. CONCLUSIONS: Expanded SNAP eligibility could help reduce rates of substance misuse and SUD. Opting out of the federal disqualification on SNAP participation for those with felony drug convictions may be particularly beneficial.


Assuntos
Alcoolismo , Assistência Alimentar , Transtornos Relacionados ao Uso de Opioides , Humanos , Estados Unidos/epidemiologia , Pobreza , Renda , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle
18.
J Acad Nutr Diet ; 124(2): 169-180, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37482267

RESUMO

BACKGROUND: The United States Department of Agriculture expanded the Supplemental Nutrition Assistance Program (SNAP)-Ed program to all 50 states in 2004. In 2010, the Healthy, Hunger-Free Kids Act required that agencies implementing SNAP-Ed support policy, systems, and environmental (PSE) strategies, in addition to providing direct education (DE). Research has evaluated the impact of PSEs on health, but few studies have investigated the process of PSE implementation. OBJECTIVE: The objective of this study was to identify facilitators and barriers to PSE implementation at SNAP-Ed partner sites from the perspectives of site contacts and SNAP-Ed implementers. DESIGN: This study employed a qualitative longitudinal design. The PSE planning and implementation process was observed over 1 year at SNAP-Ed partner sites. Semistructured interviews were conducted with site contacts and SNAP-Ed implementers throughout the year. PARTICIPANTS/SETTING: Participants were SNAP-Ed implementers (n = 8) and site contacts (n = 18) from 18 partner sites where both PSE and direct education were occurring. SNAP-Ed implementers were debriefed once, and site contacts were interviewed three times over the course of the study. This study was conducted in a Southern US state with SNAP-Ed partner sites that intended to implement PSEs. The duration of data collection was October 2017 through September 2018. ANALYSIS: A thematic analysis of barriers and facilitators to PSE implementation across sites was conducted. RESULTS: The PSE implementation barriers were lack of site or implementer readiness or capacity; breakdowns in communication; and DE prioritized over PSE. Facilitators were effective communication; site capacity or readiness; and alignment between site and SNAP-Ed goals. CONCLUSIONS: Communication, capacity, and coordination between SNAP-Ed and partner sites were key components over the timeline of PSE planning and potential implementation.


Assuntos
Assistência Alimentar , Estados Unidos , Humanos , Nível de Saúde , Políticas , Comunicação
19.
J Acad Nutr Diet ; 124(1): 65-79, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37717918

RESUMO

BACKGROUND: Women living in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-eligible households may be pregnant or breastfeeding. Stress during pregnancy and breastfeeding may influence women's mental health making them more vulnerable to higher rates of food insecurity (FI). OBJECTIVE: Determine whether or not FI is associated with moderate-to-severe mental distress among women living in WIC-eligible households, and whether or not the strength of the association differs among WIC participants compared with eligible nonparticipants with low income. DESIGN: Cross-sectional data from the 2011-2018 National Health Interview Survey were utilized. PARTICIPANTS/SETTING: A total of 7,700 women living in WIC-eligible households with at least one child were analyzed. MAIN OUTCOME MEASURES: Moderate-to-severe mental distress was measured using the validated K6 nonspecific psychological distress scale. FI was measured using the 10-item, US Adult Food Security Survey Module. STATISTICAL ANALYSES PERFORMED: Multivariate logistic regression was used to examine the association between FI and mental distress. The conditional effects of WIC participation were examined by including interaction terms for FI and WIC participation as well as by stratifying the sample by WIC participation. RESULTS: Among women in WIC-eligible households, FI was associated with moderate-to-severe mental distress in a dose-response fashion: compared with those who were food secure, the adjusted odds of moderate-to-severe mental distress were 1.8 times higher among those with marginal food security (adjusted odds ratio [AOR] 1.83, 95% CI 1.50 to 2.23), 2.1 times higher among those with low food security (AOR 2.14, 95% CI 1.76 to 2.60), and 3.7 times higher among those with very low food security (AOR 3.73, 95% CI 2.95 to 4.71). The interaction between FI and WIC participation was not significant, with similar associations between FI and mental distress among WIC participants and nonparticipants. CONCLUSIONS: Among this nationally representative sample of women in WIC-eligible households, increasing severity of food insecurity was associated with poor mental health among WIC participants and nonparticipants. WIC participation was not observed to moderate the association between FI and mental distress. More research should consider including mental health screening at WIC clinic visits to enable early identification and referral for care.


Assuntos
Assistência Alimentar , Estado Nutricional , Lactente , Adulto , Criança , Gravidez , Humanos , Estados Unidos/epidemiologia , Feminino , Estudos Transversais , Aleitamento Materno , Modelos Logísticos , Insegurança Alimentar , Abastecimento de Alimentos
20.
Am J Prev Med ; 66(1): 18-26, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37709155

RESUMO

INTRODUCTION: The federal Child and Adult Care Food Program (CACFP) improves nutrition and reduces food insecurity among young children by helping cover the food costs for child care providers and families. This nationwide study evaluated the extent and predictors of the CACFP's utilization among licensed child care centers to identify opportunities for expanding CACFP nutrition support. METHODS: Administrative data from the CACFP and child care licensing agencies in 47 states and District of Columbia were compiled and geocoded for 93,227 licensed child care centers. CACFP participation was predicted using a multivariable Bayesian spatial logistic regression model in the sample of low-income areas to target CACFP eligible child care centers. Data were collected in 2020-2021 and analyzed in 2022. RESULTS: Of all licensed child care centers, 36.5% participated in the CACFP, ranging from 15.2% to 65.3% across states; when restricted to low-income areas, 57.5% participated (range, 15.7%-85.7%). Income differences did not explain the large variation in CACFP participation rates across states. Having at least three CACFP sponsoring agencies per state predicted a 38% higher probability of CACFP participation (OR=1.38; 95% Credible Interval=1.08-1.78). CONCLUSIONS: Currently CACFP participation rates among licensed child care centers point to program underutilization and unequal access, particularly in some states and regions. Work at the federal and state levels is warranted to expand participation in the program, above all in low-income areas, so that more young children could eat healthfully with the CACFP.


Assuntos
Assistência Alimentar , Estado Nutricional , Adulto , Criança , Humanos , Pré-Escolar , Teorema de Bayes , Creches , Cuidado da Criança , Alimentos , Política Nutricional
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