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2.
Pediatrics ; 149(2)2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35039867

RESUMO

OBJECTIVES: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federal program that improves the health of low-income women (pregnant and postpartum) and children up to 5 years of age in the United States. However, participation is suboptimal. We explored reasons for incomplete redemption of benefits and early dropout from WIC. METHODS: In 2020-2021, we conducted semistructured interviews to explore factors that influenced WIC program utilization among current WIC caregivers (n = 20) and caregivers choosing to leave while still eligible (n = 17) in Massachusetts. By using a deductive analytic approach, we developed a codebook grounded in the Consolidated Framework for Implementation Research. RESULTS: Themes across both current and early-leaving participants included positive feelings about social support from the WIC clinic staff and savings offered through the food package. Participants described reduced satisfaction related to insufficient funds for fruits and vegetables, food benefits inflexibility, concerns about in-clinic health tests, and in-store item mislabeling. Participants described how electronic benefit transfer cards and smartphone apps eased the use of benefits and reduced stigma during shopping. Some participants attributed leaving early to a belief that they were taking benefits from others. CONCLUSIONS: Current and early-leaving participants shared positive WIC experiences, but barriers to full participation exist. Food package modification may lead to improved redemption and retention, including increasing the cash value benefit for fruits and vegetables and diversifying food options. Research is needed regarding the misperception that participation means "taking" benefits away from someone else in need.


Assuntos
Cuidadores/tendências , Assistência Alimentar/normas , Assistência Alimentar/tendências , Pobreza/tendências , Inquéritos e Questionários , Adolescente , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estados Unidos/epidemiologia , Adulto Jovem
3.
J Acad Nutr Diet ; 121(12): 2454-2463, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34215563

RESUMO

BACKGROUND: The federal Child and Adult Care Food Program (CACFP) provides reimbursable meals to 4.6 million children annually and sets nutrition standards for foods served. Licensing regulations in many states extend these rules to nonparticipating programs. OBJECTIVE: To evaluate the quality of meals and snacks served in Connecticut licensed childcare centers in 2019 and assess implementation of a state licensing requirement to adhere to CACFP minimum nutrition standards in all centers. DESIGN: Cross-sectional survey. PARTICIPANTS/SETTING: Two hundred licensed childcare centers in Connecticut in 2019. MAIN OUTCOME MEASURES: Meal/snack quality was assessed based on menus. Foods/beverages listed were compared to the minimum CACFP nutrition standards and optional best practices. Surveys completed by center directors measured center characteristics. STATISTICAL ANALYSIS: Logistic and linear multivariable regression models tested differences in centers' adherence to nutrition standards and best practices by CACFP participation status. RESULTS: CACFP centers complied with more required nutrition standards than non-CACFP centers (an adjusted mean of 4.7 vs 3.4 standards among programs serving meals, P < 0.001), with particularly large mean differences for whole grains and low-fat milk. Implementation of optional best practices, except for beverages, was relatively low among all centers, especially for snacks. Compliance (adjusted mean number of minimum nutrition standards met) was greater among centers accredited by the National Association for the Education of Young Children and those using a registered dietitian or a sponsoring agency to prepare menus and receiving food from a vendor. Recent completion of nutrition training was associated with greater mean implementation of best practices. CONCLUSIONS AND IMPLICATIONS: Better adherence to minimum nutrition standards and best practices among CACFP-participating childcare centers contributed to higher nutritional quality of meals and snacks offered. Snack quality would benefit most from greater compliance with nutrition standards. Providers outside of CACFP need additional supports in the implementation of licensing regulations to improve the food environment for young children.


Assuntos
Creches/normas , Serviços de Alimentação/normas , Fidelidade a Diretrizes/estatística & dados numéricos , Implementação de Plano de Saúde/estatística & dados numéricos , Política Nutricional , Benchmarking , Bebidas , Criança , Pré-Escolar , Connecticut , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Assistência Alimentar/normas , Humanos , Licenciamento , Masculino , Refeições , Necessidades Nutricionais , Valor Nutritivo , Guias de Prática Clínica como Assunto/normas , Lanches
4.
J Acad Nutr Diet ; 121(9): 1679-1694, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34294591

RESUMO

BACKGROUND: A steep rise in food insecurity is among the most pressing US public health problems that has resulted from the COVID-19 pandemic. OBJECTIVE: This study aimed to (1) describe how food-insecure emerging adults are adapting their eating and child-feeding behaviors during COVID-19 and (2) identify barriers and opportunities to improve local food access and access to food assistance. DESIGN: The COVID-19 Eating and Activity Over Time study collected survey data from emerging adults during April to October 2020 and completed interviews with a diverse subset of food-insecure respondents. PARTICIPANTS/SETTING: A total of 720 emerging adults (mean age: 24.7 ± 2.0 years; 62% female; 90% living in Minnesota) completed an online survey, and a predominately female subsample (n = 33) completed an interview by telephone or videoconference. MAIN OUTCOME MEASURES: Survey measures included the short-form of the US Household Food Security Survey Module and 2 items to assess food insufficiency. Interviews assessed eating and feeding behaviors along with barriers to healthy food access. ANALYSES PERFORMED: Descriptive statistics and a hybrid deductive and inductive content analysis. RESULTS: Nearly one-third of survey respondents had experienced food insecurity in the past year. Interviews with food-insecure participants identified 6 themes with regard to changes in eating and feeding behavior (eg, more processed food, sporadic eating), 5 themes regarding local food access barriers (eg, limited enforcement of COVID-19 safety practices, experiencing discrimination), and 4 themes regarding barriers to accessing food assistance (eg, lack of eligibility, difficulty in locating pantries). Identified recommendations include (1) expanding the distribution of information about food pantries and meal distribution sites, and (2) increasing fresh fruit and vegetable offerings at these sites. CONCLUSIONS: Interventions of specific relevance to COVID-19 (eg, stronger implementation of safety practices) and expanded food assistance services are needed to improve the accessibility of healthy food for emerging adults.


Assuntos
COVID-19/epidemiologia , Dieta/normas , Assistência Alimentar/normas , Insegurança Alimentar , Adulto , Etnicidade , Comportamento Alimentar , Feminino , Humanos , Masculino , Minnesota/epidemiologia , Prevalência , Racismo/etnologia , SARS-CoV-2 , Discriminação Social/etnologia , Fatores Socioeconômicos , Adulto Jovem
6.
J Acad Nutr Diet ; 121(4): 678-687.e1, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-32855102

RESUMO

BACKGROUND: Nationally, approximately one-third of early childhood education centers participating in the Child and Adult Care Food Program (CACFP) are independently owned and operated (ie, not owned by a corporation, not affiliated with Head Start, and with no food program sponsor). Independent providers are less likely to meet CACFP standards and best practices and would benefit from additional support and technical assistance. OBJECTIVE: To explore independent early childhood education center key informants' (KIs) (ie, directors or relevant staff) perspectives on implementing the revised CACFP standards. DESIGN: Following qualitative exploratory design, semistructured, in-depth, telephone interviews were conducted with KIs individually. PARTICIPANTS/SETTING: In summer 2018, 30 randomly sampled KIs from independent CACFP-participating early childhood education centers serving children ages 2 to 5 years nationwide were interviewed. Participants were sampled from respondents to a previously completed nationwide survey of providers. MAIN OUTCOMES: KIs' perspectives on the CACFP program and revised meal pattern standard implementation. ANALYSIS PERFORMED: After audio recordings were professionally transcribed and reviewed, constant comparative analysis was conducted using Atlas.ti v8 qualitative software (Atlas.ti. version 8 for Windows, 2018, Scientific Software Development GmbH). RESULTS: KIs indicated that program benefits (eg, health and nutrition benefits, reimbursement, guidelines, and training) outweighed challenges experienced. Challenges associated with revised CACFP standards implementation (eg, availability or acceptability of new, creditable foods) were impacted by enhanced CACFP standards status, reported revised standards, and availability or utilization of outside support. KIs desired more contact with their state representative. KIs found the training and technical assistance on the revised standards useful and suggestions to enhance future training and technical assistance (eg, increasing accessibility, training resources, and audience-specific training). CONCLUSIONS: Overall, KIs desired additional resources, training, and increased communication from CACFP state representatives specific to CACFP-approved and reimbursable products, menu ideas, recipes, and cooking demonstrations. The present study suggests that a more tailored training and technical assistance approach is necessary as reported benefits, challenges, and program needs varied based on state-enhanced CACFP standards, reported familiarity with the revised meal pattern, and reported outside support.


Assuntos
Creches/organização & administração , Assistência Alimentar/normas , Fidelidade a Diretrizes/organização & administração , Refeições , Política Nutricional , Pré-Escolar , Humanos , Pesquisa Qualitativa , Estados Unidos
7.
PLoS One ; 15(10): e0239778, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33085685

RESUMO

PURPOSE: Heightened obesity risk among food-insecure food pantry clients is a health equity issue because the co-occurrence of obesity and hunger is deeply-rooted in systematic social disadvantage and historical oppression. This qualitative study examined key stakeholders' perspectives of the relationship between the U.S. food banking system and obesity disparities among food insecure clients. METHODS: We conducted in-depth, semi-structured interviews with 10 key stakeholders (e.g., food bank director, food bank board member, advocate) who are familiar with food bank operations. Data were transcribed verbatim, coded in NVivo [v11], and analyzed using thematic analysis. RESULTS: Multiple themes emerged drawing linkages between structural characteristics of the food banking system and disparities in the dual burden of food insecurity and obesity: [a] access to unhealthy food from donors; [b] federal emergency food policy and programming; [c] state-level emergency food policy and programming; [d] geography-based risk profiles; and [e] inadequate food supply versus client need. Interviewees also identified social challenges between system leaders and clients that maintain disparities in obesity risk among individuals with very low food security including: [a] media representation and stereotypes about food pantry clients; [b] mistrust in communities of color; [c] lack of inclusion/representation among food bank system leaders; and [d] access to information. CONCLUSION: Future efforts to alleviate obesity inequities among clients chronically burdened by food insecurity, especially among certain subpopulations of clients, should prioritize policy, systems, and environmental strategies to overcome these structural and social challenges within the food banking system.


Assuntos
Assistência Alimentar/normas , Abastecimento de Alimentos/normas , Fome , Obesidade , Pobreza/estatística & dados numéricos , Feminino , Humanos , Masculino , Política Nutricional , Pesquisa Qualitativa , Fatores Socioeconômicos , Estados Unidos
8.
J Acad Nutr Diet ; 120(10): 1722-1729.e1, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32586746

RESUMO

BACKGROUND: The US Department of Agriculture Child and Adult Care Food program (CACFP) recently (October 2017) updated requirements for meal reimbursement and best practice recommendations for serving nutritious meals and beverages, and minimum age-specific serving sizes for five food groups. It is not known whether CACFP-funded child-care centers are meeting the updated meal pattern requirements and best practice recommendations, and whether children are meeting nutrition recommendations based on the current 2015-2020 Dietary Guidelines for Americans (DGA). OBJECTIVE: This study assessed whether the recruited CACFP-funded child-care centers in this study were meeting the updated (2017) CACFP requirements regarding foods served for lunch and whether children attending these child-care centers were meeting age- and sex-specific DGA recommendations regarding foods consumed. DESIGN: This was a cross-sectional study using the Dietary Observation for Child Care method.  PARTICIPANTS AND SETTINGS: Children aged 3 to 5 years (n=108) from 10 classrooms in three CACFP-funded child-care centers in Lincoln, NE, were recruited by convenience sampling during spring 2018. MEASURABLE OUTCOMES: Food served and consumed during observed lunches in comparison with updated CACFP requirements and DGA, respectively. STATISTICAL ANALYSIS: Adjusted mean amounts of foods served from each food group were compared with age specific minimum CACFP serving size requirements. Adjusted mean amounts of foods consumed from each food group were then compared with age- and sex-specific DGA recommendations. RESULTS: The recruited child-care centers were meeting the updated CACFP requirements regarding foods served but showed limited adherence to the best practice recommendations during the observed lunches. However, the overall mean intake for grains, fruits, and vegetables was significantly lower (P<0.01) than DGA recommendations. In addition, approximately 25% of the children did not consume any vegetables during their meal.      CONCLUSIONS: Although child-care centers were meeting the updated CACFP requirements by serving the recommended amounts of foods, children were not meeting DGA-recommended intakes. Future studies are needed to explore ways to improve adherence to best practice recommendations to improve children's consumption of healthy foods in child-care centers.


Assuntos
Creches/normas , Comportamento Alimentar , Assistência Alimentar/estatística & dados numéricos , Assistência Alimentar/normas , Almoço , Necessidades Nutricionais , Comportamento Infantil , Pré-Escolar , Estudos Transversais , Feminino , Assistência Alimentar/economia , Humanos , Masculino , Política Nutricional , Valor Nutritivo , Recomendações Nutricionais , Mecanismo de Reembolso , Estados Unidos , United States Department of Agriculture
9.
BMC Public Health ; 20(1): 678, 2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32404069

RESUMO

BACKGROUND: Food packages provided by the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were revised in 2009 to better align them with the Dietary Guidelines for Americans. This study was conducted to evaluate whether the effect of the food package change on childhood obesity varied by the food environment in the neighborhoods where WIC-participating children live. METHODS: Administrative data from participating children in Los Angeles County, California (2003-2016) were merged with geocoded food vendor information by neighborhood of residence. Obesity risk at age 4 was compared between children receiving old (2003-2009) and new (2010-2016) WIC food packages using sex-stratified Poisson regression models, with interaction terms between WIC package and neighborhood density (number per square mile) of healthy and unhealthy food outlets. RESULTS: The new food package was associated with a significant decrease in obesity risk. Among boys, the new food package was associated with 8 to 18% lower obesity risk at all healthy and unhealthy food outlet densities, and the association was not modified by neighborhood food outlet density. Among girls, the association of the new food package with obesity risk was protective in neighborhoods with high healthy and low unhealthy food outlet densities, and adverse in neighborhoods with high unhealthy and low healthy food outlet densities. The effect of the new food package among girls was modified by unhealthy food outlet density, with significantly smaller (p-value = 0.004) decreases in obesity risk observed in neighborhoods with higher unhealthy food outlet density. CONCLUSIONS: The impact of the food package change was modified by the neighborhood food environment among girls only. Future policy changes should incorporate consideration of ways to mitigate potentially inequitable geographic distribution of the health benefits of policy changes.


Assuntos
Assistência Alimentar/organização & administração , Abastecimento de Alimentos/normas , Obesidade Infantil/epidemiologia , Índice de Massa Corporal , Pré-Escolar , Feminino , Assistência Alimentar/normas , Humanos , Los Angeles , Masculino , Política Nutricional , Características de Residência
10.
J Pak Med Assoc ; 70(5): 796-802, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32400730

RESUMO

OBJECTIVES: To assess spending by beneficiaries of Benazir Income Support Programme on monthly food commodities, and contribution of the cash grant programme on purchase of nutritious foods. METHODS: The descriptive cross-sectional survey of households enrolled in the Benazir Income Support Programme was conducted during July and August, 2013, in Matiari district of the Sindh province of Pakistan. Monthly household food expenditure on food commodities and use of the cash grant on type of food purchased was assessed through structured interviews of the beneficiaries. Results were computed in 2013 Pak rupees and converted to 2018 United States dollar. Women beneficiaries were also interviewed on decision-making regarding the use of the cash grant and on household food expenditure. RESULTS: The survey comprised 421 households. with a mean monthly expenditure on food of Rs 7,577, r 80.73 dollars. Women made decisions on food spending in only 135(32%) households, but in 235(56%) households, women were the primary decision-makers on cash grant spending. CONCLUSIONS: Unconditional cash grant did not meaningfully translate into the purchase of nutritious foods even though it played an important role in increasing women's agency.


Assuntos
Assistência Alimentar , Abastecimento de Alimentos , Papel de Gênero , Zeladoria/economia , Política Nutricional , Adulto , Estudos Transversais , Tomada de Decisões , Economia , Feminino , Declarações Financeiras , Assistência Alimentar/organização & administração , Assistência Alimentar/normas , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/métodos , Abastecimento de Alimentos/estatística & dados numéricos , Produtos Domésticos/economia , Produtos Domésticos/estatística & dados numéricos , Humanos , Masculino , Avaliação das Necessidades , Paquistão
11.
PLoS One ; 15(4): e0231216, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32302329

RESUMO

BACKGROUND: The Brazilian Workers Food Program (WFP) is a public policy program of nutritional assistance to workers, with the main objective of improving nutritional conditions, which was implemented 40 years ago and serves over 21.4 million workers. OBJECTIVES: To compare the long-term change in anthropometric indicators of the nutritional status and dietary intake between workers of manufacturing industries adherent to and non-adherent to the WFP. METHODS: A prospective cohort study, based on a combined stratified and multistage probability sampling, was carried out, with two waves with a 4-year interval. The change in body mass index (BMI), waist circumference (WC) and dietary intake at lunch by the 24-hour recall method were compared between groups with analysis of covariance. RESULTS: A total of 273 workers in 16 industries from an initial cohort of 1069 workers in 26 industries of the State of Rio Grande do Norte in Brazil were evaluated in the two waves. The mean age was 37±10 years and 53.1% were male, with no differences between groups in age and sex distribution. BMI increased in both groups (0.44 kg/m2 in non-WFP, p = 0.003, and 0.56 kg/m2 in WFP, p = 0.0006) and WC increased in the WFP group (1.50 cm, p = 0.0006). BMI change over time did not show statistical differences between groups (p = 0.54) but WC had a greater increase in the WFP group (difference 1.37 cm, p = 0.047). There were no differences between groups in the change over time of the dietary intake. CONCLUSION: BMI and WC increased over time in manufacturing workers of industries both adherent and non-adherent to the WFP, but with a greater increase of WC in the WFP group. In order to achieve the objectives of the WFP, there will be a need for periodic evaluation and monitoring of nutritional indicators in these workers and implementation of monitoring and enforcement actions of the WFP.


Assuntos
Assistência Alimentar/normas , Abastecimento de Alimentos/estatística & dados numéricos , Estado Nutricional , Recursos Humanos , Local de Trabalho , Adulto , Antropometria , Índice de Massa Corporal , Brasil/epidemiologia , Dieta , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Masculino , Indústria Manufatureira , Pessoa de Meia-Idade , Saúde Ocupacional , Serviços de Saúde do Trabalhador/normas , Estudos Prospectivos , Circunferência da Cintura
12.
J Public Health Manag Pract ; 26(1): 71-79, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30969273

RESUMO

OBJECTIVES: (1) To examine patterns of catch-up growth and anemia correction in refugee children younger than 5 years after participation in the Special Supplemental Nutrition for Women, Infants, and Children (WIC) program, and (2) to identify factors associated with recovery from growth abnormalities. DESIGN: Records on 1731 refugee children younger than 5 years who arrived in Massachusetts between 1998-2010 were matched to WIC program records and then restricted to 779 children who had at least 2 WIC visits. Kaplan-Meier curves and Cox proportional hazards models were used to examine how sex affected time to recovery from malnutrition and anemia. Factors associated with recovery were analyzed in SAS using multivariate logistic regression. SETTING: Massachusetts. PARTICIPANTS: Refugee children younger than 5 years on arrival, who visited a WIC program at least twice between 1998 and 2010. MAIN OUTCOME MEASURES: (1) Proportion of children who recovered from low height-for-age (stunting), low weight-for-age, low weight-for-height (wasting), and anemia; (2) odds ratios for factors associated with recovery; and (3) Kaplan-Meier curves showing recovery over time from low height-for-age, low weight-for-age, and low weight-for-height. RESULTS: The number of WIC visits was associated with recovery from stunting, wasting, low weight-for-age, and anemia; results reached statistical significance for stunting (odds ratio [OR] = 8.64; 95% confidence interval [CI], 2.25-33.19), low weight-for-age (OR = 5.28; 95% CI, 1.35-20.73), and anemia (OR = 6.50; 95% CI, 2.69-15.69). Female sex was associated with recovery from stunting, wasting, and low weight-for-age, whereas male sex was associated with recovery from anemia; the associations were statistically significant between female sex and stunting (OR = 9.14; 95% CI, 1.93-43.29), wasting (OR = 14.78; 95% CI, 1.57-138.85), and low weight-for-age (OR = 4.29; 95% CI, 1.09-16.79). CONCLUSIONS: Children who remained engaged in WIC may recover better from malnutrition than children with fewer WIC visits, although there are limitations to the available data.These findings suggest that those working with refugee families should prioritize outreach toward initiating and maintaining WIC program enrollment for eligible refugee children.


Assuntos
Assistência Alimentar/normas , Desnutrição/dietoterapia , Participação do Paciente/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Pré-Escolar , Feminino , Assistência Alimentar/organização & administração , Assistência Alimentar/estatística & dados numéricos , Humanos , Lactente , Modelos Logísticos , Masculino , Desnutrição/epidemiologia , Massachusetts/epidemiologia , Razão de Chances , Participação do Paciente/métodos , Refugiados/psicologia
13.
J Nutr Educ Behav ; 52(5): 512-521, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31679966

RESUMO

OBJECTIVE: To develop and validate decision cases as a capacity-building training tool for implementing policy, systems, and environmental (PSE) change strategies. DESIGN: Study phases were: (1) in-depth interviews conducted repeatedly over a year with Supplemental Nutrition Assistance Program Education (SNAP-Ed) partner sites and once with SNAP-Ed implementers to identify dilemmas when implementing PSE change strategies; (2) decision cases developed to highlight dilemmas; and (3) focus groups with SNAP-Ed implementers to determine decision case utility as a capacity-building training tool. SETTING: A southeastern state. PARTICIPANTS: SNAP-Ed partner sites and implementers; Focus group participants. INTERVENTION: Decision cases. ANALYSIS: To establish content validity, a thematic analysis of interviews identified common dilemmas when implementing PSE change strategies. SNAP-Ed implementers' focus groups provided feedback to determine the utility and validity of decision cases developed from the analysis. RESULTS: Common dilemmas of implementation of PSE change strategies reported by SNAP-Ed partner sites (n = 20) and implementers (n = 8) were lack of site and educator readiness and capacity; communication breakdowns; and prioritization of nutrition education over PSE implementation. Focus group participants (n = 8) reviewed a case and discussion guide and recommended them as a capacity-building tool for training. CONCLUSIONS AND IMPLICATIONS: Using decision cases could help build SNAP-Ed implementers' capacities to implement nutrition PSE change strategies and strengthen partnerships.


Assuntos
Fortalecimento Institucional , Assistência Alimentar/organização & administração , Assistência Alimentar/normas , Implementação de Plano de Saúde , Política Nutricional , Humanos , Entrevistas como Assunto , Estudos Longitudinais
15.
Transl Behav Med ; 9(5): 857-864, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31570924

RESUMO

Low-income communities often lack access to supermarkets and healthy foods. Enhanced stocking requirements for staple foods for Supplemental Nutrition Assistance Program (SNAP)-authorized retailers may increase availability of healthy foods in smaller stores which are prevalent in low-income areas. This study aimed to evaluate the extent that small food stores located in low-income areas met the U.S. Department of Agriculture's 2016 final rule on SNAP-authorized retailer stocking requirements, which increased the minimum number of required staple food varieties from three to seven for each staple food category, required a depth of stock of three units of each variety, and increased the required number of categories with perishables from two to three. A multisite research project was conducted in 2017. Nine research teams located in seven U.S. states audited the availability of perishable and nonperishable staple foods and beverages in 351 small food stores in low-income areas. Analyses determined the extent to which stores met all or part of the stocking requirements and tested differences by store type. 30.2% of stores met all of the 2016 final rule requirements; 86.3% met the requirements for fruits and vegetables, whereas only 30.5% met requirements for dairy. 53.1% of non-chain small grocery stores met all requirements compared to 17.1% of convenience stores (p < .0001). Less than one half of the food stores audited met the U.S. Department of Agriculture's 2016 final rule that would expand SNAP-authorized retailer stocking requirements suggesting that, if implemented, the rule may generate increased offerings of staple foods in small stores in low-income areas.


Assuntos
Bebidas , Comércio/normas , Assistência Alimentar/normas , Abastecimento de Alimentos/normas , Política Nutricional , Feminino , Frutas , Humanos , Política Organizacional , Pobreza , Estados Unidos , Verduras
16.
Am J Public Health ; 109(12): 1659-1663, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31622138

RESUMO

The Supplemental Nutrition Assistance Program (SNAP) provides funding to low-income households to purchase food at participating stores. The goals of the program include reducing hunger, improving nutrition, and strengthening the US food system. These are interrelated, as food access and choice depend on availability.SNAP generates data that could be useful for program evaluation and evidence-based policymaking to reach public health goals. However, the US Department of Agriculture (USDA) does not collect or disclose all SNAP-related data. In particular, the USDA does not systematically collect food expenditure data, and although it does collect transaction (sales) and redemption data (the amount retailers are reimbursed through SNAP), it does not release these data at the store level.In 2018, Congress quietly changed the law to prohibit the USDA from disclosing store-level transaction and redemption data, and in 2019, the US Supreme Court blocked disclosure of these data. These federal proceedings can inform the outcome of additional efforts to disclose SNAP-related data, as well as future research and policy evaluation to support improved public health outcomes for SNAP beneficiaries.


Assuntos
Revelação/normas , Assistência Alimentar/organização & administração , Assistência Alimentar/estatística & dados numéricos , Abastecimento de Alimentos/métodos , Abastecimento de Alimentos/estatística & dados numéricos , Revelação/legislação & jurisprudência , Assistência Alimentar/legislação & jurisprudência , Assistência Alimentar/normas , Abastecimento de Alimentos/legislação & jurisprudência , Fraude/economia , Fraude/estatística & dados numéricos , Humanos , Estados Unidos , United States Department of Agriculture/organização & administração
17.
Syst Rev ; 8(1): 240, 2019 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-31653271

RESUMO

BACKGROUND: Food control is defined as a mandatory regulatory activity of enforcement aimed at ensuring that all foods during production, handling, storage, processing, and distribution are safe, wholesome, and fit for human consumption; conform to safety and quality requirements; and are honestly and accurately labeled as prescribed by law. This applies to food served by the conventional food supply chain as well as the charitable food assistance programs (CFAPs). This review sought to map the available evidence on the food control in the CFAPs globally. METHODS: In order to identify the literature, we developed a series of search terms, as well as parameters for including articles to review the literature using African Index Medicus, PubMed, Google Scholar, and EBSCOhost (MEDLINE with full text, Academic search complete, MEDLINE) search engines. Articles were also searched through the "Cited by" search as well as citations included in the reference lists of included articles. We included studies reported in all languages and published from inception to 2018. We included studies if they presented evidence of the CFAPs, namely food banks, food charitable organizations (FCOs), pantries, community soup kitchens, and emergency shelters. We presented the results of our search using thematic analysis in order to reveal the emerging themes. RESULTS: Beyond inconsistencies with the classification of the CFAPs, our study found significant knowledge gaps in crucial areas, namely food vulnerability, food traceability, vulnerability of beneficiary populations, and lack of food control. Our search yielded a total of 23 articles, which we included in the analysis. Results show that while food is the critical commodity to saving lives, if not controlled properly, it can have an adverse effect, especially on people it is meant to benefit (the vulnerable). CONCLUSION: With no previous comprehensive review to assess what is known about food control in the CFAPs, we undertook a scoping review, focusing on mapping the key concepts, including the main sources and types of evidence available. By drawing conclusions about the overall state of research activity and identifying research gaps and priorities in the existing literature, this study provides a baseline assessment of the CFAP research published in peer-reviewed journals from inception to 2018.


Assuntos
Assistência Alimentar/normas , Inocuidade dos Alimentos , Alimentos/normas , Saúde Pública , Humanos
19.
Public Health Nutr ; 22(17): 3261-3269, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31486351

RESUMO

OBJECTIVE: The purpose of this evaluation study was to identify strengths and opportunities for improvement in programme functioning and common aspects of patients' experiences at a hospital-based food pantry. DESIGN: Semi-structured, in-depth interviews with patients and a cross-sectional survey for providers were used. Interview transcripts were coded using both inductive and deductive approaches and assessed for inter-rater reliability. Descriptive statistics were produced from quantitative data. SETTING: An academic urban safety-net hospital in the Northeastern US offering inpatient and outpatient services. PARTICIPANTS: Thirty patients and 89 providers. RESULTS: Patients expressed feeling comfortable, trusting the food, high satisfaction with food quality, convenience, and lack of stigma at the hospital-based pantry. Patients mentioned the pantry helped them eat more fruits and vegetables, but expressed concerns about the healthfulness of other foods distributed. Providers believed they should discuss food insecurity (FI) with patients (99 %) and that the pantry improves the health of patients (97 %), but faced barriers to consistently screening for FI and referring patients to the pantry, such as insufficient training on FI (53 %) and time constraints (35 %). CONCLUSIONS: Findings suggest hospital-based food pantries may have several advantages. Hospitals with onsite food pantries must work to eliminate barriers to FI screening and pantry referral. To optimize their impact, such pantries should develop nutritional guidelines for food donations and connect patients with nutrition education resources. Future research should examine health outcomes for patients using hospital-based food pantries.


Assuntos
Atitude do Pessoal de Saúde , Assistência Alimentar/normas , Abastecimento de Alimentos/normas , Hospitais Urbanos , Satisfação do Paciente , Adulto , Idoso , Estudos Transversais , Dieta , Feminino , Assistência Alimentar/organização & administração , Frutas , Pessoal de Saúde/psicologia , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Inquéritos e Questionários , Estados Unidos , Verduras
20.
PLoS One ; 14(7): e0219895, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31329629

RESUMO

The Thrifty Food Plan (TFP) is the basis of benefit allocations within the USDA's Supplemental Nutrition Assistance Program (SNAP), which administers nearly $70 billion in benefits to over 42 million people annually. To produce the allocation of food within the TFP, the USDA uses a mathematical optimization model that solves for the daily apportionment across various food groups. The model is constrained by nutritional and consumption requirements to produce an "optimal" allocation. Despite the importance of the TFP, the computational solution developed by the USDA has received insufficient attention, with only a handful of articles written on the TFP optimization model. Here, we run three alternative objective functions that are simpler than the one used by USDA. Our first alternative objective function minimizes the sum of squared errors between the consumed market basket of goods and an allocated market basket of goods, the second alternative objective function minimizes the sum of the absolute value of the difference between the consumed market basket of goods and an allocated market basket of goods, and the third alternative objective function minimizes the weighted absolute deviation of allocations and actual consumption expressed as a proportion of observed consumption. A clear theoretical advantage of either of our methods is that they eliminate the need to arbitrarily set allocated consumption to nonzero values, as is the case for the logarithmic objective function used by USDA. In an operational sense, we find that our model formulations produce an allocation that fits actual consumption better than the objective function employed by the USDA.


Assuntos
Assistência Alimentar/economia , Assistência Alimentar/normas , Humanos , Modelos Estatísticos , Avaliação Nutricional , Recomendações Nutricionais , Estados Unidos , United States Department of Agriculture/economia , United States Department of Agriculture/normas
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