A Summer Nutrition Benefit Pilot Program and Low-income Children's Food Security.

BACKGROUND: Federal summer meals programs serve less than one-sixth of children that receive free or reduced-price meals during the school year. To address this gap in food assistance for school-aged children, the Summer Electronic Benefits Transfer for Children (SEBTC) Demonstrations provided summer food assistance in the form of electronic benefits transfer cards to households with school-aged children certified for free or reduced-price meals during the school year. METHODS: Over 2011-2013, the SEBTC demonstrations were evaluated by using a random assignment design. Households were randomly assigned a monthly $60-per-child benefit, a monthly $30-per-child benefit, or no benefit, depending on the study year. Key outcomes included children's food security and consumption of foods and food groups related to a healthful diet (diet quality). At baseline (in the spring) and again in the summer, the evaluation surveyed ∼52 000 households over the course of the 3 years of the impact study. RESULTS: SEBTC reduced the prevalence of very low food security among children by one-third. It also had positive impacts on 6 of the 8 child nutrition outcomes measured (amounts of fruits and vegetables; whole grains; dairy foods; and added sugars). CONCLUSIONS: SEBTC is a promising model to improve food security and the dietary quality of low-income school-aged children in the summer months.

Delivering Summer Electronic Benefit Transfers for Children through the Supplemental Nutrition Assistance Program or the Special Supplemental Nutrition Program for Women, Infants, and Children: Benefit Use and Impacts on Food Security and Foods Consumed.

BACKGROUND: The Summer Electronic Benefit Transfers for Children (SEBTC) demonstration piloted summer food assistance through electronic benefit transfers (EBTs), providing benefits either through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or the Supplemental Nutrition Assistance Program (SNAP) EBT. OBJECTIVE: To inform food assistance policy and describe how demonstrations using WIC and SNAP models differed in benefit take-up and impacts on food security and children's food consumption. DESIGN: Sites chose to deliver SEBTC using the SNAP or WIC EBT system. Within each site, in 2012, households were randomly assigned to a benefit group or a no-benefit control group. PARTICIPANTS: Grantees (eight states and two Indian Tribal Organizations) selected school districts serving many low-income children. Schoolchildren were eligible in cases where they had been certified for free or reduced-price meals during the school year. Before the demonstration, households in the demonstration sample had lower incomes and lower food security, on average, than households with eligible children nationally. INTERVENTION: Grantees provided selected households with benefits worth $60 per child per summer month using SNAP or WIC EBT systems. SNAP-model benefits covered most foods. WIC-model benefits could only be used for a specific package of foods. OUTCOME MEASURES: Key outcomes were children's food security (assessed using the US Department of Agriculture food security scale) and food consumption (assessed using food frequency questions). STATISTICAL ANALYSES: Differences in mean outcomes between the benefit and control groups measured impact, after adjusting for household characteristics. RESULTS: In WIC sites, benefit-group households redeemed a lower percentage of SEBTC benefits than in SNAP sites. Nonetheless, the benefit groups in both sets of sites had similar large reductions in very low food security among children, relative to no-benefit controls. Children receiving benefits consumed more healthful foods, and these impacts were larger in WIC sites. CONCLUSIONS: Results suggest the WIC SEBTC model deserves strong consideration.

The third School Nutrition Dietary Assessment Study: background and study design.

OBJECTIVE: This article describes the background and design of the third School Nutrition Dietary Assessment Study (SNDA-III). DESIGN: SNDA-III is a nationally representative cross-sectional study of the National School Lunch Program and the School Breakfast Program in 2005. The three-stage sample design allowed description of district and school food environments and policies, analysis of foods and nutrients in school lunches and breakfasts, and assessment of the role of school meals and competitive foods in students' diets. Surveys of district and school staff were by telephone or in person; school menu data were collected in a mail survey with telephone assistance; and student and parent interviews were conducted in person and in school, except that parents of secondary-school students were interviewed by telephone. Student interviews included a 24-hour dietary recall, as well as measurement of height and weight. Response rates were 83% for districts, 95% for schools, and 63% for students, whose participation was constrained by consent issues and school schedules. SUBJECTS/SETTING: Data were collected from 130 public school food authorities (districts that offer federally subsidized school meals), 398 schools within those districts, and 2,314 public-school students in grades 1 through 12 in these schools. Of the 2,314 students, a random subset of 666 (29%) completed a second recall to permit estimation of usual nutrient intake distributions. STATISTICAL ANALYSES PERFORMED: Descriptive tabulations were used to summarize the background characteristics of schools and students and most study outcomes. Multivariate regression models and propensity score matching were used to compare the nutrient intakes of school meal participants and nonparticipants. CONCLUSIONS: SNDA-III data provide a rich resource for examining interactions among the school meal programs, the school food environment, students' diets, and child obesity. Subsequent articles in this Supplement present analyses in all these areas.

Meals offered and served in US public schools: do they meet nutrient standards?

BACKGROUND: Concerns about the diets of school-aged children and new nutrition recommendations for the US population have increased interest in the nutritional quality of meals available through the National School Lunch Program and School Breakfast Program. OBJECTIVE: This article updates national estimates of the food energy and nutrient content of school meals and compares these estimates to federal nutrient standards established under the 1995 School Meals Initiative for Healthy Children. DESIGN: Data were collected as part of the third School Nutrition Dietary Assessment Study, a nationally representative cross-sectional study fielded during school year 2004-2005. Menu and recipe data for a typical school week were collected in a mail survey with telephone assistance. Nutrient information for common commercially prepared food items was obtained from manufacturers, to supplement the Food and Nutrient Database for Dietary Studies used to analyze the data. Analyses were conducted for meals offered and meals served to (selected by) children. SUBJECTS/SETTING: Samples of 130 public school districts that offered federally subsidized school meals, and 398 schools within those districts, participated in the study. Foodservice managers in each school completed a menu survey. STATISTICAL ANALYSES PERFORMED: Descriptive tabulations present weighted means, proportions, and standard errors for elementary, middle, and high schools, and for all schools combined. RESULTS: Most schools offered and served meals that met the standards for protein, vitamins, and minerals. Fewer than one third of schools met the standards for energy from fat or saturated fat in the average lunch, whereas three fourths or more met the fat standards in school breakfasts. For both meals, average levels of sodium were high and fiber was low relative to Dietary Guidelines for Americans 2005 recommendations. CONCLUSIONS: For school meals to meet nutrient standards and promote eating behaviors consistent with the Dietary Guidelines, future policy, practice, and research should focus on reducing levels of fat and sodium and increasing fiber.