Food Insecurity and Health-Related Concerns Among Elementary Schoolteachers During the COVID-19 Pandemic.

INTRODUCTION: US school systems underwent major upheaval, including closures, implementation of virtual and/or hybrid learning, and stringent infection mitigation protocols, during the initial phase of the COVID-19 pandemic. We aimed to examine the association between food insecurity and perceived health, perceived stress, and social determinants of health concerns among elementary schoolteachers serving predominantly low-income children during the COVID-19 pandemic. METHODS: Brighter Bites, a nonprofit organization that weekly distributes fresh fruits and vegetables and nutrition education materials to more than 300 schools serving racial and ethnic minority populations with low income, conducts annual surveys of participating teachers to help determine subsequent efforts to support schools and families during the school year. We analyzed self-reported data collected electronically by the Brighter Bites teachers survey in 76 elementary schools during summer 2020. We used generalized linear mixed models to measure the association between food insecurity and health-related concerns. RESULTS: Of 862 teachers who responded to the survey, 685 answered the 2 questions about food insecurity status; of these, 199 (29.1%) reported experiencing food insecurity. Food insecurity was positively associated with poor perceived general health, greater perceived stress, concerns about various social determinants of health, and changes in fruit and vegetable consumption during the COVID-19 pandemic. CONCLUSION: Our study demonstrated the high prevalence of food insecurity and highlights its associated factors among elementary schoolteachers during the COVID-19 pandemic. It calls attention to the high correlation of various concerns among elementary schoolteachers during the COVID-19 pandemic. Further intervention and policy efforts are needed to relieve food insecurity-related concerns and enhance well-being among teachers.

Changes in unhealthy food consumption among vulnerable elementary-aged children in the United States during the COVID-19 pandemic: a serial cross-sectional analysis.

Objective: Several studies suggest that during the early pandemic, amidst socioeconomic instability, children from underserved families were more likely to resort to consuming cheaper, lower-quality foods with longer shelf lives. This study investigated the change in unhealthy food consumption across different phases (pre, early, mid) of the COVID-19 pandemic, and whether the strength of association between unhealthy food consumption and household socioeconomic disadvantage (HSED) varied across phases of the pandemic. Methods: This study utilized serial cross-sectional data collected from low-income families enrolled in a school-based food co-op, Brighter Bites. Secondary data analysis included 5,384 surveys from families who had complete data: 3422 pre-pandemic, 944 from the early pandemic, and 1,018 mid-pandemic. Outcome measures included sugary food intake and convenience/fast food intake, each of which was operationalized as a scale using pre-validated items from the surveys. HSED was operationalized as a composite of parent employment, parent education, food insecurity, and participation in government programs; responses were categorized into low, medium, and high HSED groups for analysis. We examined the interaction between HSED and time period to explore how HSED and its association with dietary measures changed over the course of the pandemic. Results: A significant linear negative trend, i.e., a decrease in consumption from pre-to-mid-pandemic period was seen in sugary food intake (p < 0.001), but not in convenience food intake. In data pooled across time-periods, both sugary food and convenience/fast food consumption were inversely associated with HSED, and low unhealthy food consumption was observed among high-disadvantage groups. No significant interaction between time period and HSED was observed on either scale. However, the post-regression estimates from the adjusted interaction model showed a significant association between convenience/fast food consumption and HSED in pre- and mid-pandemic periods. Conclusion: The study highlights the nuances of socioeconomic dynamics on the diet behaviors of children from low-income families during a natural disaster.

A Cross-Sectional Study Analyzing Predictors of Perceived Stress Among Elementary School Teachers During the COVID-19 Pandemic.

INTRODUCTION: Teaching is a stressful occupation due to high-stake job demands and limited resources, which were exacerbated during the initial phase of the COVID-19 pandemic. Our study assessed the prevalence of perceived stress and explored its predictors among elementary school teachers employed at schools serving predominantly low-income populations in five cities in the United States. METHOD: Our study analyzed the data among selected schools that were collected through the Brighter Bites teacher survey which comprised items measuring sociodemographic characteristics, perceived stress, perceived general health, food insecurity, and concerns regarding social determinants of health needs. The predictors of perceived stress were examined using generalized linear mixed models (GLMMs) with schools as the random variable. FINDINGS: A total of 685 teachers were included in the analysis (84.9% female, 38.1% Hispanic, 57.6% <5 years of teaching experience). Most (85.4%) of the teachers stated they were stressed "sometimes"/"often." Results from adjusted GLMM showed that teachers who were food insecure (adjusted odds ratio [AOR]: 2.33, confidence interval [CI]: [1.63, 3.35]), those who had concerns regarding financial stability (2.68 [1.91, 3.75]), food availability (1.69 [1.15, 2.48]), food affordability (2.27 [1.57, 3.28]), availability/affordability of housing (2.21 [1.33, 3.67]), access to childcare (1.76 [1.06, 2.92]), and access to a clinic/doctor (1.60 [1.10, 2.33]) were at significantly greater odds of reporting perceived stress. CONCLUSION/APPLICATION FOR PRACTICE: Our study demonstrates the heightened impact of COVID-19 on the mental well-being of teachers across a wide range of social needs. Stress management and additional social service programs are suggested to support teachers to mitigate pandemic impact.

Community-Academic Partnerships to Promote Health Literacy and Address Social Needs Among Low-Income Families During COVID-19.

Brighter Bites is a school-based health promotion program that delivers fresh produce and nutrition education to low-income children and their families across 6 locations in the US. This article provides a perspective on how, despite coronavirus disease 2019-related school closures, Brighter Bites pivoted rapidly to collaborate with medical and public health institutions to improve health and food literacy among their families. Through these partnerships, Brighter Bites was able to rapidly provide accurate, evidence-based information related to coronavirus disease 2019 and other social needs, including food, housing, transportation, and access to health care, to help fill a needed gap in vulnerable communities.

Using a rapid assessment methodology to identify and address immediate needs among low-income households with children during COVID-19.

OBJECTIVE: Brighter Bites is a school-based health promotion program that delivers fresh produce and nutrition education to low-income children and families. Due to COVID-19-related school closures, states were under "shelter in place" orders, and Brighter Bites administered a rapid assessment survey to identify social needs among their families. The purpose of this study is to demonstrate the methodology used to identify those with greatest social needs during this time ("high risk"), and to describe the response of Brighter Bites to these "high risk" families. METHODS: The rapid assessment survey was collected in April 2020 across Houston, Dallas, Washington DC, and Southwest Florida. The survey consisted of items on disruption of employment status, financial hardship, food insecurity, perceived health status and sociodemographics. The open-ended question "Please share your greatest concern at this time, or any other thoughts you would like to share with us." was asked at the end of each survey to triage "high risk" families. Responses were then used to articulate a response to meet the needs of these high risk families. RESULTS: A total of 1048 families completed the COVID-19 rapid response survey, of which 71 families were triaged and classified as "high risk" (6.8% of survey respondents). During this time, 100% of the "high risk" participants reported being food insecure, 85% were concerned about their financial stability, 82% concerned about the availability of food, and 65% concerned about the affordability of food. A qualitative analysis of the high-risk group revealed four major themes: fear of contracting COVID19, disruption of employment status, financial hardship, and exacerbated food insecurity. In response, Brighter Bites pivoted, created, and deployed a framework to immediately address a variety of social needs among those in the "high risk" category. Administering a rapid response survey to identify the immediate needs of their families can help social service providers tailor their services to meet the needs of the most vulnerable.