Food insecurity and food bank use: who is most at risk of severe food insecurity and who uses food banks?

OBJECTIVES: To identify (1) who experiences food insecurity of differing severity and (2) who uses food banks in England, Wales and Northern Ireland; (3) whether the same groups experience food insecurity and use food banks; and (4) to explore country- and region-level differences in food insecurity and food bank use. DESIGN: This pooled cross-sectional study analysed the characteristics of adults experiencing food insecurity of differing severity using generalised ordinal logistic regression models and the characteristics of adults using food banks using logistic regression models, using data from three waves of the Food and You 2 surveys, 2021-2023. SETTING: England, Wales and Northern Ireland. PARTICIPANTS: 18 557 adults. RESULTS: 20·8 % of respondents experienced food insecurity in the past 12 months, and 3·6 % had used a food bank. Food insecurity was associated with income, working status, respondent age, family type, ethnicity, country, long-term health conditions, food hypersensitivity, urban-rural status and area-level deprivation. Severe food insecurity was concentrated among respondents with long-term health conditions and food hypersensitivities. Food bank use was more prevalent among food insecure respondents and unemployed and low-income respondents. Neither outcome showed clear geographical variation. Certain groups experienced an elevated likelihood of food insecurity but did not report correspondingly greater food bank use. CONCLUSIONS: Food insecurity is unevenly distributed, and its nutrition and health-related consequences demonstrate that food insecurity will intensify health inequalities. The divergence between the scale of food insecurity and food bank use strengthens calls for adequate policy responses.

A multi-dimensional access index: Exploring emergency food assistance in New York City.

Access to resources and services needs to be considered from a multi-dimensional perspective to capture the complex landscape of human experience. The robust body of research exploring food access has multiple limitations that create an incomplete view of food access, like studies limited to only one mode of transit and inconsistent methods across studies which limit generalizability. This study proposes a framework to formulate a multi-dimensional access index that considers travel time, operating hours, and availability of transit infrastructure across space. We use food pantries in New York City as a case study since there are relatively few of them and they have limited opening hours. We propose an index that quantifies spatiotemporal access by different modes of transportation and takes operating hours of food pantries into account during a one week time period. We compare our results to two traditional access measures and demonstrate that our index provides a significantly different measure of access. We utilize this index to highlight areas of high need but low resources, which shows the importance of this tool to policy makers and service providers. We use our experience of developing this index to highlight the challenges with quantitative analysis of human experience. Our tool is reproducible through an open-access software, which allows researchers and policy-makers to utilize it with parameters that reflect their communities.

Effect of using biodegradable film constituting red grape anthocyanins as a novel packaging on the qualitative attributes of emergency food bars during storage.

This study presents a novel packaging film based on whey protein isolate/κ-carrageenan (WC) with red grape pomace anthocyanins (RGA) to investigate its impact on some qualitative attributes of emergency food bars (EFBs) for 6 months at 38°C. Increasing the RGA dose in WC films from 5% (WCA5) to 10% (WCA10) reduced hydrogen bonding between polymers and polymer homogeneity in the matrix according to FTIR and SEM. Tensile strength slightly declined in WCA5 from 7.47 ± 0.26 to 6.97 ± 0.12, while elongation increased from 27.74 ± 1.36 to 32.36 ± 1.25% compared to WC film. The maximum weight loss temperature (TM) increased by incorporating 5 wt% RGA from 182.95°C to 244.36°C, whereas TM declined to 187.19°C in WCA10 film. WVP and OTR slightly changed in WCA5 (from 7.83 ± 0.07 and 2.57 ± 0.18 to 8.41 ± 0.03 g H2O.m/m2.Pa.s × 10-9 and 1.79 ± 0.32 cm3 O2/m2.d.bar, respectively), but significantly impaired in WCA10 compared to WC film. WCA5 and WCA10 films had high AA%, 68.77%, and 79.21%, respectively. WCA10 film presented great antimetrical properties against Staphylococcus aureus with an inhibition zone of 6.00 mm. The light transmission of RGA-contained films in the UV spectrum was below 10%. The WCA5 film effectively restrained moisture loss and hardness increment until the end of the storage period, which were 14.33% and 28.76%, respectively, compared to day 0. Antioxidant films provided acceptable resistance against oxidation to EBF treatment. Sensory panels scored WCA5 and WCA10 higher in overall acceptance with 5.64 and 5.40 values, respectively, while complaining about the hardness of OPP treatment. The results of this investigation demonstrated that incorporating RGA, preferably 5 wt%, into WC-based film effectively improved the qualitative properties of EFB during the 6-month shelf life. This film might be a promising alternative for packaging light and oxygen-sensitive food products.

Special Supplemental Nutrition Program for Women, Infants, and Children Participant Grocery Store Purchases during the COVID-19 Pandemic in North Carolina.

Background: Families participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) experienced barriers to accessing healthy food during the COVID-19 pandemic, but we do not yet understand how WIC participant food purchases shifted during the pandemic. Objectives: We aimed to describe the association between the initial shock of the pandemic in March 2020 and WIC shoppers' food purchases and changes in purchases before and during the pandemic at a top grocery chain and examine differences in these relationships by duration of WIC use. Methods: We used longitudinal food transaction data from WIC shoppers (n = 2,989,116 shopper-month observations from 175,081 unique WIC shoppers) from 496 stores in a top grocery store chain in North Carolina between October 2019 and May 2021. We used an interrupted time series design to describe the following: 1) the relationship between the initial shock of the pandemic and WIC shopper food purchases and 2) differences in purchases before and during the pandemic. To assess differences in purchases between shoppers consistently using WIC electronic benefit transfer (EBT) cards and shoppers starting or stopping WIC EBT use during the pandemic, we used models stratified by WIC group. Primary outcomes were share (%) of total calories purchased from fruits, vegetables, nuts, and legumes (FV), processed foods, and sugar-sweetened beverages (SSBs). Results: We observed small decreases in the share of total calories from FV (-0.4%) and small increases in the share of calories from processed food (1.1%) and SSBs (0.5%) purchased at this retailer when comparing the pre and post March 2020 periods. Compared with shoppers that started or stopped using WIC benefits during the pandemic, shoppers that used WIC benefits consistently had slightly higher FV and lower processed food and SSB purchases at this retailer. Conclusions: Future studies should examine whether additional supports for nutrient-dense food choices may be needed for families with low incomes in public health emergencies.

Longitudinal Associations of Food Security with Health and Dietary Factors among Food FARMacy Participants during COVID-19 in New York City.

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.

Increases in New but Not Returning Families to a Midwestern Food Pantry Network During the COVID-19 Pandemic.

BACKGROUND: Food pantries are a resource for those experiencing food insecurity. OBJECTIVE: The purpose of this study was to evaluate changes in food pantry utilization and volunteerism for a food pantry network during the COVID-19 pandemic. DESIGN: This 36-month longitudinal, observational study is a secondary analysis of data collected from an Ohio food pantry network. PARTICIPANTS/SETTING: Participants were clients of a food pantry network. The data represent visits from 12 months prepandemic (March 2019 through February 2020), during the pandemic (March 2020 through February 2021), and after vaccines were readily available (March 2021 through February 2022). MAIN OUTCOME MEASURES: Each data point represents a visit to the pantry network. The main outcome measures were total, returning, and new visits (ie, households that had not previously used this pantry network). The secondary outcome was volunteer hours by month. STATISTICAL ANALYSIS: In order to account for month-to-month variability in pantry utilization, the data were analyzed using a time-series linear regression analysis with the month as the unit of analysis. RESULTS: A total of 174,397 visits were recorded during the course of 36 months. Sixty-nine percent of reporting household members were female, 48% reported at least 1 senior in the home, and 41% reported at least 1 child at home. There was no significant change in total or returning visits during the pandemic or after vaccines were available compared with prepandemic levels. However, there was a significant increase in new households to the food pantry network during the pandemic compared with prepandemic (P = .05). Volunteer hours decreased significantly during the pandemic compared with prepandemic months and remained low even after vaccines were available (P = .004 and P = .003, respectively). CONCLUSIONS: Although there was an increase in households new to the food pantry, overall utilization did not increase.

Nutrition Environment Gaps and Distribution Challenges in Rural Food Pantries During the COVID-19 Pandemic: A Mixed-Methods Study.

BACKGROUND: Food insecurity disproportionately affects low-income, racially marginalized, and rural communities. The COVID-19 pandemic led to higher demand for emergency food distribution, potentially impacting food pantry operations and services. Limited research exists assessing consumer nutrition environments of pantries in rural regions. OBJECTIVES: To assess the consumer nutrition environment of rural food pantries and report challenges and adaptations encountered during the pandemic. DESIGN: A mixed-methods, cross-sectional survey. PARTICIPANTS/SETTING: Nineteen food pantry representatives from California's San Joaquin Valley were surveyed between August 2020 and June 2021. Representatives were eligible if their pantry served the general population and was open at least once a week. Nine were church-based pantries, and 10 were from other settings. MAIN OUTCOME MEASURES: The Nutrition Environment Food Pantry Assessment Tool (NEFPAT) measured the nutrition food environment and scored pantries as bronze (0-15), silver (16-31), or gold (32-47) categories. Eleven items were developed to explore pandemic-related challenges. STATISTICAL ANALYSES PERFORMED: Independent χ2 tests assessed the relationship between the organization type and NEFPAT scores and food supply sources. Fisher's exact test explored associations between food pantry type, NEFPAT category, and challenges. Nonparametric tests were run on non-normally distributed data. Inductive content analysis was used to examine open-ended pandemic-related questions. RESULTS: The nutrition environment of most pantries was suboptimal, because no pantry scored in the "gold" category based on total NEFPAT scores (median, 18 of 47). No statistically significant differences were found in the NEFPAT scores by organization type. Most pantries did not provide healthy food nudges or culturally diverse foods. Key COVID-19 challenges encountered consisted of supply- and demand-side issues, including reduced personnel, capacity, and resources, and increased client quantity and demand for food. CONCLUSIONS: Assessing the nutrition environment of rural food pantries revealed gaps and strategies for improvement, including the use of healthy nudges and increasing the availability of culturally diverse foods.

Experiences of New Visitors With Low Food Security Seeking Food Assistance During the COVID-19 Pandemic.

OBJECTIVE: To describe the experiences of first-time visitors with low food security seeking food assistance during the coronavirus disease 2019 pandemic. DESIGN: A qualitative study. SETTING: Emergency food distribution sites in West Central Florida. PARTICIPANTS: Adults (aged 18-64 years) seeking food assistance between November, 2020 and July, 2021. PHENOMENON OF INTEREST: Using food security as a multidimensional concept, in-depth interviews explored the impact of emergency food assistance on food availability, access, utilization, and stability. ANALYSIS: Applied thematic analysis was conducted to identify emergent themes. RESULTS: Participants (n = 18) were White (55.6%), female (72.2%), and aged 40-59 years (55.6%). Seven salient themes described participants' experience seeking food assistance (eg, the crisis resulting in seeking food assistance, mixed quality of pantry foods, and gaining firsthand insight on hunger). Although food assistance increased food availability and access, there were barriers to using the pantry foods (eg, foods not preferred, health/allergies). CONCLUSIONS AND IMPLICATIONS: Study findings suggest that first-time visitors seeking emergency food assistance during the coronavirus disease 2019 pandemic may be experiencing temporary cycles of financial instability, which could impact dietary quality. Because pantry foods are often the primary source of household food supply, client-focused emergency food distribution tailored to client needs can increase food availability, access, and utilization.

Assessing lignocellulosic biomass as a source of emergency foods.

Catastrophes such as a nuclear war would generate atmospheric soot and reduce sunlight, making it difficult to grow crops. Under such conditions, people might turn to inedible plant biomass for nutrition, but the convertibility and nutritional content of this biomass have not been rigorously analyzed. We found that if plant biomass were converted into food at 30% efficiency, 6.7 kg of biomass per day would yield adequate carbohydrates, but contain potentially toxic or insufficient levels of other nutrients for a family of four. Therefore, exploiting biomass with low mineral content for carbohydrates and consuming other sources of protein, fat, and vitamins such as edible insects/single-cell proteins and vitamin supplements could provide a balanced diet in a global catastrophic environment.

A Qualitative Examination of the Detroit Community Food Response to COVID-19.

The COVID-19 pandemic increased the need for food assistance due to surging unemployment, the closure of in-person schooling, and other factors. This posed a historic challenge to organizations that address food insecurity: meeting the surging need for food while minimizing COVID-19 transmission. This study aimed to identify how food insecurity program operations changed during the pandemic and to examine the facilitators/successes and barriers/challenges to operations. Semi-structured interviews were conducted with staff at 13 organizations involved in addressing food insecurity in Detroit during the pandemic. Interviews were coded by two coders, summarized, and then used to create matrices and concept map displays for each organization. We found that nearly all programs changed to a contactless food distribution format, and most programs experienced an increase in demand for food. Common successes/facilitators included keeping clients and staff safe from COVID-19 and waivers that eased program rules. Common challenges/barriers included the increased need for labor and food. Lack of funding was a barrier for some organizations, and others that experienced an increase in funding reported that it facilitated their work. This research identified the needs of programs addressing food insecurity during the COVID-19 pandemic, which can inform future disaster planning.

Use of the Emergency Food System among Food Insecure, Low-income Households in the United States 2015 to 2020.

The emergency food system (EFS) is a critical part of the United States' social safety net. Using 2015-2020 Current Population Survey Food Security Supplement data, we identified trends in EFS use among food insecure, low-income households by estimating the probability of EFS use adjusting for demographics using multivariable logistic regression. From 2015-2019, between 31.0% and 34.4% of households received emergency food, while 42.4% did in 2020. EFS use did not increase in 2020 compared to prior years for older adults and non-metropolitan households. Targeted outreach should be used to expand the reach of this resource to underserved and marginalized populations."

Estimating the Number, Distribution, and Predictors of Food Pantries in the US.

OBJECTIVE: To estimate the number, distribution, and predictors of food pantries across counties in the US in 2020. DESIGN: A cross-sectional, secondary data analysis of geocoded food pantry locations and social, demographic, and economic characteristics at the county level. PARTICIPANTS: Publicly disclosed food pantry locations were collected from websites in all counties. Pantry locations were merged with data from the American Community Survey 2015-2019. MAIN OUTCOME MEASURES: The number of food pantries per county. ANALYSIS: A negative binomial regression estimated the association between the number of pantries per county and community characteristics. RESULTS: We found 48,581 food pantries from publicly disclosed websites, covering 98% of counties. The mean and median number of pantries per county were 15.5 and 6, respectively. Selected characteristics positively associated with the number of pantries per county were income inequality, percentage of noncitizens, and percentage of single-parent households. Selected characteristics negatively associated with the number of pantries per county were percent with a high school education or less, percent of households in poverty, and rurality. CONCLUSIONS AND IMPLICATIONS: The US has an extensive network of food pantries. Future work could assess the potential causal pathways between pantry placement and county-level characteristics.

Usefulness of Simple Meal Screening Using Dietary Assessment Sheets for Evacuation Shelters.

To maintain the health of evacuees, meals provided at emergency shelters should be monitored and improvement measures should be taken where necessary. Time and human resources are limited during devastating disasters; thus, the authors have developed the Dietary Assessment Sheets for Evacuation Shelters. This study examines whether the quality of meals can be assessed using simple check items on the Dietary Assessment Sheets.A total of 28 Dietary Assessment Sheets for 98 meals provided 16-19 days after the heavy rains in Kumamoto in July 2020 at 12 shelters were used in the analysis. Dietitians working for shelters were requested to fill the Dietary Assessment Sheets and food record sheets provided by the Prefectural Government. If any subitem was checkmarked, it was considered "checked," and if left blank, it was considered "not checked" and divided into categorical groups. Based on the food record sheets and meal photos, contents of energy, protein, and vitamins B1, B2, and C were calculated for each meal. Energy and nutrient contents were compared between the categorical groups.The study revealed that nutritionally poor meals were characterized as those comprising only "Grain dishes," those that were not "Boxed meals," and those involving "Self-Defense Forces," "Dietitians," or "Others." Their energy, protein, and vitamin B1, B2, and C content was significantly lower than that of meals with marks on other checkboxes in the same category.Shelters that provide these meals should be given priority for nutrition assistance due to their poor diets. The results imply that the Dietary Assessment Sheets could serve as a simple tool to determine the shelters that require nutritional assistance.

Food donation as a strategy to reduce food waste in an emerging Latin American country: a case study in Uruguay.

Abstract: Food donation has expanded globally and has become a common form of food assistance in emerging countries. However, research on food donation experiences in these settings is still scarce. Purpose: In this context, the objectives of the present work were as follows: (i) to explore the views of Uruguayan stakeholders on food donation as a strategy to reduce food waste, (ii) to identify barriers and enablers for food donation in Uruguay, and (iii) to explore the organizational characteristics of Uruguayan food banks. Methods: A qualitative approach based on two data collection strategies was used: documentary content analysis of official governmental documents and in-depth semi-structured interviews with key stakeholders related to food waste and food donations in Uruguay. Results: Food donation emerged as a central strategy for food waste reduction in the view of Uruguayan stakeholders, mainly because it was perceived as an efficient strategy to reduce food insecurity. The complexity of food donation was acknowledged by Uruguayan stakeholders and who identified several barriers for its implementation related to economic considerations, the characteristics of the donated products, legal and commercial considerations, and organizational characteristics of food banks. Conclusion: Although most barriers were aligned with results from previous studies conducted in developed countries, some specificities to the Uruguayan context were also identified. Clear and detailed legal frameworks to ensure that the donated products reach the target population along with nutritional requirements for the foods to be donated were deemed necessary.

Exploring the impacts of a fresh produce market program: a realist economic evaluation.

OBJECTIVE: To determine the contexts under which a fresh food market program is cost-effective in improving dignified access to nutritious food for food-insecure individuals. METHODS: A realist economic evaluation was employed. Purported cost related theories about how the program may function, known as context-mechanism-outcome configurations were developed. In-depth interviews with key stakeholders (program developers, funder, local food relief agencies, volunteers) involved in the program (n=19) as well Photovoice with focus groups with market attendees (n=8) were conducted and coded for contexts, mechanisms and outcomes. A cost-effectiveness analysis of the program was calculated whereby the cost inputs associated with operating the program were compared to the quantity and value of produce distributed. Alternative cost scenarios were evaluated in a sensitivity analysis. The cost-effectiveness analysis was used together with qualitative data to refine theory. RESULTS: Food insecure individuals attending a partnership fresh food market with a small fee, experienced improved, yet infrequent access to nutritious food through community connections and support a more dignified, viable access to fresh nutritious food. CONCLUSIONS: Food relief should consider alternative models. IMPLICATIONS FOR PUBLIC HEALTH: More dignified food relief programs that support local connections may be part of the solution to addressing food insecurity.

Nutrient Content, Organoleptic Quality, and Shelf Life of Sagon Substitute From Lindur (Bruguiera gymnorrhiza L.) and Soybean Flour (Glycine max L.), as an Alternative Emergency Food.

Lindur (Bruguiera gymnorrhiza L.) fruit as a mangrove species has not been widely developed. However, the combination of lindur fruit functional food with soybean flour has high carbohydrates and protein potential to serve as an additional food product in emergency conditions. Therefore, this study aims to evaluate the nutritional content, dietary fiber, organoleptic quality, and sagon shelf-life estimation of lindur and soybean flour, in accordance with emergency food quality requirements. The shelf life was determined using the Accelerated Shelf-life Testing (ASLT) method with the Arrhenius equation, where the sample was stored in an incubator at a temperature of 27, 37, as well as 47°C for 30 days, and the water content, peroxide number, and free fatty acid content were tested every 5 days. In addition, formulation P1 comprising 45% lindur flour and 35% soybean flour was discovered to be the best formulation, with a composition of 251.5 kcal/bar of energy, 6.3 g of fat, 4.4 g of protein, 30 g of carbohydrates, 15.79% dietary fiber, 1.84% ash content, and 4.03% water content. Therefore, the nutritional content of sagon substitution for lindur flour is in accordance with the emergency food quality requirements, except for the protein content. Also, the P2 sagon sample's shelf life was estimated to be 37 days in polypropylene plastic packaging at a room temperature of 27°C.

Establishing a Multidisciplinary Framework for an Emergency Food Supply System Using a Modified Delphi Approach.

A scientific food emergency supply system is helpful for assuring food supplies continuity, improving response efficiency, and reducing disaster losses. However, the framework for a food emergency supply system is currently an understudied area in emergency management post-disaster. In this study, a comprehensive literature review of major databases was performed to identify potential indicators for the emergency food supply system, followed by a two-round modified Delphi with a multidisciplinary expert panel (n = 17) to verify the proposed framework. The effective response rate of questionnaires ranged from 94.4% (17/18) to 100% (17/17) and the authority coefficient of experts was 0.88, indicating high positivity and reliability of the experts. Furthermore, the p-values of Kendall's W were < 0.01 and the Cronbach's α were > 0.7 for all domains and indicators, indicating a high reliability and validity for the proposed framework. Finally, a consensus was reached on all eight domains and 81 indicators. In conclusion, this study introduced and verified a multidisciplinary framework for the food emergency supply system, which could provide a theoretical basis for emergency responders to make corresponding commands and decisions post-disaster.

Ready-to-Use Therapeutic Food (RUTF) Formulations with Functional Food and Nutrient Density for the Treatment of Malnutrition in Crisis.

Background: Ready-to-use therapeutic food (RUTF) spread has been highly effective in the treatment of malnutrition in those affected by disasters since it does not require preparation and baking and has a long shelf life and sufficient energy to improve growth and weight loss. Such features may be crucial during crises such as wars and natural disasters. The present study aimed to design a high-energy and nutrient-dense RUTF formulation. Methods: Soybean flour and milk protein concentrate were used as protein sources, corn flour, and sugar were employed as carbohydrate sources, cacao butter substitute was used as the lipid source, and vitamin/mineral, beta-alanine, arginine, Nigella sativa, and sesame seeds were used as a functional food. The study was performed in accordance with the guidelines of the Institute of Medicine (IOM) and criteria for food products. Results: To design the formulation, we used carbohydrates (45% of total energy), protein (13% of total energy), fat (42% of total energy), vitamins, minerals, beta-alanine, and arginine, and 100 grams of the diet was considered to release 525 kilocalories of energy. The experimental results of food safety at the determined intervals (at the beginning and 45 and 90 days after the production) showed acceptable values. Conclusions: Since nutritional requirements are among essential human needs (especially in the management of malnutrition in crisis), it is of utmost importance to prepare RUTF products in order to meet all human nutritional needs by facilitating the easy use of these products, particularly for the prevention of malnutrition and diseases.

US state variations in food bank donation policy and implications for nutrition.

Food insecurity has increased dramatically in 2020 as a result of the COVID-19 public health and economic crisis. Many more families in the United States are turning to the charitable food system to help meet their needs. However, little is known about the policies that influence food bank donations and whether they promote healthy food donations. The purpose of this study was to explore state variation in food donation policies and secondarily to assess whether policies promoted the donation of healthy foods and beverages. We reviewed donation policies for all states in the United States and Washington, DC (hereafter "states") in fall 2020. Two reviewers independently assessed donation policies using two legal databases; we reconciled discrepancies via team discussion. We then grouped them into 10 distinct categories based on common purpose and theme. We identified 252 state policies from 51 states. Policies fell into all 10 categories. The largest category was "liability protection," with all states having a policy in this category. The second largest category was date labeling; 32 states had requirements or policies restricting the donation of past-dated foods. However, across all categories, we found that only two policies explicitly promoted the donation of healthy foods and beverages. Although all states had some policies governing food donations, few promoted healthier foods and beverages. States could encourage healthy donations through policy to help ensure that all families have access to nutritious foods and beverages.

Evaluating a Food Pantry-Based Intervention to Improve Food Security, Dietary Intake, and Quality in Midwestern Food Pantries.

BACKGROUND: Voices for Food was a longitudinal community, food pantry-based intervention informed by the social ecological model, and designed to improve food security, dietary intake, and quality among clients, which was carried out in 24 rural food pantries across 6 Midwestern states. OBJECTIVE: Our objective was to evaluate changes in adult food security, dietary intake, and quality from baseline (2014) to follow-up (2016), and to assess the role of adult food security on dietary outcomes. DESIGN: A multistate, longitudinal, quasi-experimental intervention with matched treatment and comparison design was used to evaluate treatment vs comparison group changes over time and changes in both groups over time. PARTICIPANTS/SETTING: Adult food pantry clients (n = 617) completed a demographic food security survey, and up to three 24-hour dietary recalls at baseline (n = 590) and follow-up (n = 160). INTERVENTION: Community coaching served as the experimental component, which only "treatment" communities received, and a food council guide and food pantry toolkit were provided to both "treatment" and matched "comparison" communities. MAIN OUTCOME MEASURES: Change in adult food security status, mean usual intakes of nutrients and food groups, and Healthy Eating Index-2010 scores were the main outcome measures. STATISTICAL ANALYSES PERFORMED: Linear mixed models estimated changes in outcomes by intervention group and by adult food security status over time. RESULTS: Improvements in adult food security score (-0.7 ± 0.3; P = .01), Healthy Eating Index-2010 total score (4.2 ± 1.1; P < .0001), and empty calories component score (3.4 ± 0.5; P <.0001) from baseline to follow-up were observed in treatment and comparison groups, but no statistically significant changes were found for adult food security status, dietary quality, and usual intakes of nutrients and food groups between the 2 groups over time. The intervention effect on dietary quality and usual intake changes over time by adult food security status were also not observed. CONCLUSIONS: Food pantry clients in treatment and comparison groups had higher food security and dietary quality at the follow-up evaluation of the Voices for Food intervention trial compared with baseline, despite the lack of difference among the groups as a result of the experimental coaching component.