Food insecurity and patterns of dietary intake in a sample of UK adults.

The aim of this study was to identify the dietary intake correlates of food insecurity (FI) in UK adults. We recruited groups of low-income participants who were classified as food insecure (n 196) or food secure (n 198). Participants completed up to five 24 h dietary recalls. There was no difference in total energy intake by FI status (ßFI = -0·06, 95 % CI - 0·25, 0·13). Food insecure participants consumed a less diverse diet, as evidenced by fewer distinct foods per meal (ßFI = -0·27, 95 % CI - 0·47, -0·07), and had more variable time gaps between meals (ßFI = 0·21, 95 % CI 0·01, 0·41). These associations corresponded closely to those found in a recent US study using similar measures, suggesting that the dietary intake signature of FI generalises across populations. The findings suggest that the consequences of FI for weight gain and health are not due to increased energy intake. We suggest that there may be important health and metabolic effects of temporal irregularity in dietary intake, which appears to be an important component of FI.

The Nutritional Quality of Food Provision at UK Government-Funded Holiday Clubs: A Cross-Sectional Analysis of Energy and Nutrient Content.

A large proportion of children are at risk of food insecurity during school holidays in the UK. The government-funded Holiday Activities and Food (HAF) programme provides free holiday clubs offering at least one healthy meal/day to eligible children and adolescents. This study aims at evaluating the nutritional quality of food provision at HAF holiday clubs, particularly hot/cold and vegetarian/non-vegetarian meals. Menu variants (n = 2759) from 49 HAF holiday clubs were assessed for adherence to School Food Standards (SFS) and their notional compositional quality, which was scored utilising a novel nutrient-based meal quality index. The median adherence to SFS across all available menus was 70% (IQR 59-79%). Overall, hot variants scored statistically higher menu quality scores than cold variants for both 5-11y (92.3 (80.7-102.7) vs. 80.4 (69.3-90.6)) and 11-18y (73.5 (62.5-85.8) vs. 58.9 (50.0-70.7)) criteria. Cold and hot menu variants tended to score differentially for quality sub-components. These findings highlight areas for potential future improvement in HAF holiday club provision with a tendency for food provision to appear less ideal for attendees for those aged 11-18. Ensuring that children from low-income households have access to a healthy diet is crucial to reduce UK health inequalities.

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.

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.

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.

Investigation of Summer Learning Loss in the UK-Implications for Holiday Club Provision.

This study sought to examine whether summer learning loss occurs in spelling and word reading in a population of 77 primary school aged children aged between 5 and 10 years (37 boys, mean age 100 months, SD 18 months, and 40 girls mean age 103 months, SD 16 months) attending three schools in areas of low socioeconomic status in Scotland and the North East of England. Word reading and spelling was measured using the word reading and spelling subtests of the Wide Ranging Achievement Test. Participants were tested on three occassions: immediately before and immediately after a 7-week summer break, and again after 7-weeks of teaching. The results showed a significant main effect of time for spelling scores, F(2,136) = 21.60, p < 0.001, [Formula: see text]. Post-hoc analysis [t(73) = 4.84, p ≤ 0.001] showed that spelling scores were significantly higher at the end of the summer term (M = 26.57) than at the start of the new academic year (M = 25.38). Likewise, spelling scores after 7 weeks post return to school (M = 27.61) were significantly higher than at the start of the Autumn term, t(73) = 7.79, p ≤ 0.001. Performance in spelling declined when children returned to school immediately after the summer holiday (M = 25.38) but 7 weeks later, performance had improved beyond the baseline reported immediately before the summer break (M = 26.57) [t(73) = 4.40, p ≤ 0.001]. There was also a main effect of school in relation to spelling scores, [F(2,68) = 6.49, p < 0.05, [Formula: see text]], with children from school 2 and school 3 outperforming children from school 1. There was no signficant main effect of gender [F(1,68) = 1.47, p > 0.05, [Formula: see text]]. None of the interactions were significant. There was no main effect of time on word reading scores [F(2,136) = 1.12, p ≥ 0.05, [Formula: see text]]. However, there was a main effect of school [F(2,68) = 4.85, p ≤ 0.01, [Formula: see text]] in relation to reading scores, with children from school 2 and school 3 outperforming children from school 1. There was no significant main effect of gender [F(1,68) = 0.37, p ≥ 0.05, [Formula: see text]]. None of the interactions were significant. This is the first such study in the UK to demonstrate that after a summer break of seven weeks, summer learning loss occurred, or at least stagnation in learning, in a population of primary school aged children attending schools in areas of low SES in relation to spelling. However, after seven weeks of teaching, children caught up to and exceeded the level achieved in spelling prior to the summer break. However, the summer holiday period did not result in a loss of word reading skill, reading scores were consistent across the entire study.