Comida de rua: perfil dos manipuladores de alimentos e necessidades de conhecimentos sobre a gestão do negócio e boas práticas de manipulação / Street food: food handlers profile and their needs knowledge about business management and good handling practices

Introdução: O consumo de comida de rua tem aumentado nos últimos anos, transformando este segmento em um importante comércio de alimentos, com geração de emprego e renda. Objetivo: Este trabalho teve como objetivo conhecer o perfil socioeconômico e analisar a percepção sobre a gestão do negócio e boas práticas de manipulação dos manipuladores de comida de rua no município de Niterói/RJ, participantes de um curso on-line sobre boas práticas de manipulação no comércio de comida de rua. Método: A metodologia foi aplicada e descritiva, de abordagem qualitativa e quantitativa. Foi utilizado questionário on-line, com 56 perguntas, aplicado a 67 participantes do curso. Resultados: 86,4 % eram mulheres; faixa etária predominante entre 27 e 62 anos; renda média de até 3 salários mínimos; 35,8% relataram possuir ensino superior incompleto. Apenas 29,9% possuem registro MEI; 72,7% atuam nesse comércio por escolha; 46,3% fazem controle de estoque e 62,5% fazem controle de caixa; 67,2% possuem cursos na área de alimentação; e 47,8% afirmaram ter experiências anteriores. Conclusão: À medida que se observa a consolidação desse segmento, com um potencial de risco sanitário associado, assim como a insuficiência de trabalhos científicos na área, faz-se necessário ampliar os estudos sobre a formação dos manipuladores.

Introduction: The Consumption of street food has increased in recent years, transforming this segment into an important food trade, with job and income. Objective: This work aimed to know the socioeconomic profile and analyze the perception about business management and good handling practices of street food handlers in the city of Niterói/RJ, participants of an online course on good handling practices in the food trade. Methods: The methodology was applied and descriptive, with a qualitative and quantitative approach. An online questionnaire was used, with 56 questions, applied to 67 course participants. Results: 86.4 % were women; predominant age group between 27 and 62 years; average income of up to 3 minimum wages; 35.8 % reported having incomplete higher education. Only 29.9 % have a MEI record; 72.7 % work in this trade by choice; 46.3 % carry out inventory control and 62.5% carry out cash control; 67.2 % have courses in the field of food; and 47.8 % claimed to have previous experiences.Conclusions:As the consolidation of this segment is observed, with a potential associated health risk, as well as the lack of scientific work in this area, it is necessary to expand studies on the training of handlers.

Mealtime interventions and their outcomes in care homes for older people considering the five aspects meal model: An integrative review.

Mealtimes are important events in care homes for physical and social well-being. However, residents usually have little input concerning meal timings, what food is offered, and how it is served. This integrative review explored mealtime interventions and their outcomes in care homes related to the Five Aspects Meal Model (FAMM). Research articles published 2010-2021 were searched for in ASSIA, CINAHL, PsycINFO, PubMed, and SveMed+ and resulted in 13 articles focusing on interventions. The analysis was based on the aspects of FAMM: room, meeting, product, management control system, and atmosphere. The result shows that even though interventions specifically focused on one aspect, they often evaluated outcomes related to several aspects. Different aspects can work together to foster effective mealtimes. FAMM eased to visualise the usefulness of mealtime interventions from a broad perspective and can be a useful tool for assessing and improving mealtime situations in clinical practice.

Sustainable waste management solutions for the foodservice industry: A Delphi study.

Foodservice businesses influence the sustainability of their natural environment by producing significant amounts of waste. Yet, research has, thus far, been dominated by studies that limit their scope to food waste alone. Few studies have taken a broader look at sustainable waste initiatives, including innovative waste processing techniques, with a view to constructing management indicators for foodservices. This study combines management innovation practices related to resource management, waste prevention, processing and disposal techniques, and stakeholder involvement to offer sustainable standards. It primarily adopts the Delphi technique to propose specific solutions pertaining to waste management. Experts from government, industry, and academia reveal that potential waste management initiatives comprise three facets - service, process (operational), and organisational practices and innovations, 15 sub-facets and 41 indicators. This study thus establishes a catalogue of solutions for food, packaging and other 'non-food' waste that foodservice establishments can implement. In addition to its practical implications, an important contribution is its focus on management systems to establish waste management standards for hospitality, food and beverage (F&B) services, restaurants, and non-commercial catering.

School feeding in Federal Institutes: characterization and analysis of food acquisitions from family farming / Alimentação escolar nos Institutos Federais: caracterização e análise das aquisições de alimentos da agricultura familiar

ABSTRACT Objective The Federal Institutes of Education, Science, and Technology provide Basic Education and, thus, must execute the National School Feeding Program. The study aimed to characterize school feeding in these institutes, focusing on the purchase of food from family farming. Methods Cross-sectional study with Brazilian Federal Institutes that offer Basic Education courses. The characteristics of purchases from family farming in 2019 were analyzed, as well as the type of management of the school food service, the presence of a nutritionist in the unit acting as technical manager, and the presence of a canteen. Pearson's chi-square test was used to analyze the association between the variables, adopting a statistical significance level of 5%. Results A total of 171 campuses, distributed in the five Brazilian regions, participated in the study. Among the participants in the survey, 35.1% did not offer any type of food to their students. The percentage of Federal Institutes that carried out acquisitions from family farming was 48%. The presence of a nutritionist was verified in 33.9% of the campuses and associated with food purchases from family farming. The type of food service management was shown to be related to the diversity of the purchases and the main categories of purchased foods. Conclusion The results demonstrate the importance of monitoring the school feeding policy at the federal level, being possible to characterize the school feeding in the Federal Institutes, also showing that more than half of the sample did not make purchases from family farming.

RESUMO Objetivo Os Institutos Federais de Educação, Ciência e Tecnologia ofertam Ensino Básico, e, assim, devem executar o Programa Nacional de Alimentação Escolar. O objetivo do estudo foi caracterizar a alimentação escolar nos Institutos Federais, com enfoque na aquisição de alimentos da agricultura familiar. Métodos Estudo transversal com Institutos Federais de todo o Brasil que ofertam cursos do Ensino Básico. Foram analisadas as características das compras realizadas da agricultura familiar, o tipo de gestão do serviço de alimentação escolar, a presença de nutricionista na unidade atuando como responsável técnico e a existência de cantina. Para a análise da associação entre as variáveis, utilizou-se o teste qui-quadrado de Pearson, adotando nível de significância estatística de 5%. Resultados Participaram do estudo 171 campi, distribuídos nas cinco regiões brasileiras. Entre os participantes da pesquisa, 35,1% não ofertavam qualquer tipo de alimentação aos seus estudantes. O percentual de Institutos Federais que realizaram aquisições da agricultura familiar foi de 48%. A presença de nutricionista foi verificada em 33,9% dos campi e mostrou associação com a compra de alimentos da agricultura familiar, enquanto o tipo de gestão do serviço de alimentação mostrou relação com a diversidade da aquisição, bem como com as principais categorias de alimentos adquiridos. Conclusão Os resultados demonstram a importância do acompanhamento da política de alimentação escolar na esfera federal, sendo possível caracterizar a alimentação escolar nos Institutos Federais, além de evidenciar que mais da metade da amostra não realizou aquisições da agricultura familiar.

Academy of Nutrition and Dietetics: Revised 2021 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Management of Food and Nutrition Systems.

Management of food and nutrition systems (MFNS) encompasses the varied roles of registered dietitian nutritionists (RDNs) with administrative responsibilities for food and nutrition services within an organization. RDNs in MFNS are frequently employed in acute care, but also expand into a multitude of other settings in which management of nutrition and foodservice is required, for example, foodservice departments in assisted living and post-acute and long-term care; colleges and universities, kindergarten through grade 12 and pre-kindergarten schools and childcare; retail foodservice operations; correctional facilities; and companies that produce, distribute, and sell food products. RDNs in MFNS aim to create work environments that support high-quality customer-centered care and services, attract and retain talented staff, and foster an atmosphere of collaboration and innovation. The Management in Food and Nutrition Systems Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has revised the Standards of Professional Performance (SOPP) for RDNs in MFNS for 3 levels of practice: competent, proficient, and expert. The SOPP describes 6 domains that focus on professional performance: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Indicators outlined in the SOPP depict how these standards apply to practice. The standards and indicators for RDNs in MFNS are written with the leader in mind-to support an individual in a leadership role or who has leadership aspirations. The SOPP is intended to be used by RDNs for self-evaluation to assure competent professional practice.

Provision and Supervision of Food and Protein Substitute in School for Children with PKU: Parent Experiences.

Children spend a substantial part of their childhood in school, so provision of dietary care and inclusion of children with phenylketonuria (PKU) in this setting is essential. There are no reports describing the dietary support children with PKU receive whilst at school. The aim of this cross-sectional study was to explore the experiences of the dietary management of children with PKU in schools across the UK. Data was collected using an online survey completed by parents/caregivers of children with PKU. Of 159 questionnaire responses, 92% (n = 146) of children attended state school, 6% (n = 10) private school and 2% (n = 3) other. Fourteen per cent (n = 21/154) were at nursery/preschool, 51% (n = 79/154) primary and 35% (n = 54/154) secondary school. Sixty-one per cent (n = 97/159) said their child did not have school meals, with some catering services refusing to provide suitable food and some parents distrusting the school meals service. Sixty-one per cent of children had an individual health care plan (IHCP) (n = 95/155). Children were commonly unsupervised at lunchtime (40%, n = 63/159), with snacks (46%, n = 71/155) and protein substitute (30%, n = 47/157), with significantly less supervision in secondary than primary school (p < 0.001). An IHCP was significantly associated with improved supervision of food and protein substitute administration (p < 0.01), and better communication between parents/caregivers and the school team (p < 0.05). Children commonly accessed non-permitted foods in school. Therefore, parents/caregivers described important issues concerning the school provision of low phenylalanine food and protein substitute. Every child should have an IHCP which details their dietary needs and how these will be met safely and discreetly. It is imperative that children with PKU are supported in school.

Facilitators and Barriers to Implementing Healthy School Canteen Intervention among Malaysian Adolescents: A Qualitative Study.

This study evaluated implementing a school-based intervention to promote healthier dietary habits in the school environment among Malaysian adolescents using qualitative methods. This qualitative study was conducted in four secondary schools in Perak and Selangor (two urban and two rural schools) that received the intervention (either training or training and food subsidy). A total of eight focus groups (68 students aged 15 years old) and 16 in-depth interviews were conducted with canteen operators, school convenience shop operators, school teachers and school principals in each school. Thematic analysis was used to analyse the qualitative data to identify suitable themes. We found several initiatives and changes by the schools' stakeholders to change to a healthy school canteen programme. The stakeholders also noticed the students' food preferences that influence healthy food intake in canteens and convenience shops. The food vendors and school administrators also found that subsidising healthy meals might encourage healthy eating. Among barriers to implementing healthy school initiatives were the student's perception of healthy food and their eating habits, which also affect the food vendors' profit if they want to implement a healthy canteen. The school-based intervention has the potential to promotes healthier eating among school adolescents. Continuous training and monitoring of canteen operators and convenience shops are needed, including building partnerships and educating the students on healthy eating to cultivate healthy eating habits.

Resources Needed for Education and Meal Programs by Urban Schoolteachers and Staff During the 2019 Coronavirus Pandemic.

BACKGROUND: Adjustments in teaching resources and school meal programs are urgently needed during the COVID-19 pandemic. This study examined teaching resources that would have been helpful when schools closed, and how school meal programs should be changed in the 2020-2021 school year. METHODS: In October 2020, a 27-item, cross-sectional, online survey was administered to 99 teachers and staff members in an urban, Midwestern school district. Data were analyzed using frequencies and proportions, and open-ended responses were analyzed using content analysis. RESULTS: Online teaching was difficult for teachers and students, and training for online teaching, improved Internet access, and more time for grading or office hours would have been helpful when schools closed. Meal programs were offered by 86% of schools after closing, and many participants supported continuing meal programs for 2020-2021. Resources needed to continue meal programs included funding for meal reimbursement, transportation to the meal sites, and more staff. Suggested changes to meal programs included offering more variety or more food, and solving transportation issues. CONCLUSION: Addressing these concerns can improve school and community health. Findings will inform efforts to enhance online teaching and improve and continue school meal programs as the world continues to be affected by COVID-19.

Gestión clínica en las unidades de nutrición / Clinical management in nutrition units

INTRODUCCIÓN: la gestión clínica es un elemento de excelencia en la práctica de la nutricion clínica que está menos reconocido que otros, como la formación continuada o la investigación. OBJETIVOS: el objetivo de este artículo es exponer las bases de las herramientas de gestión de calidad, como son los programas de gestión clínica (PGC) o de mejora continua de la calidad; describir los principales logros en este campo en las unidades de nutrición, y plantear los principales retos para el futuro. RESULTADOS: en los últimos años, al menos 9 unidades de nutrición han implantado PGC con certificación de calidad por parte de una agencia externa, en la mayoría de los casos AENOR y conforme a la norma ISO 9001. Esto ha supuesto hacer una reflexión sobre las actividades que realiza la unidad con el objetivo de satisfacer las expectativas de los usuarios, documentar dichas actividades, asegurar un mejor entendimiento de la organización y definir las responsabilidades de todo el personal, evitando errores y actividades redundantes, con el resultado de una mejor gestión del tiempo y los recursos. CONCLUSIONES: los PGC contribuyen a la excelencia en la nutrición clínica porque constituyen una herramienta útil para mejorar la organización y nuestros resultados de un modo eficiente. Aunque se ha avanzado mucho, aún queda mucho trabajo por hacer en cuanto al desarrollo de procesos, indicadores, estándares y, especialmente, la codificación de la desnutrición relacionada con la enfermedad (DRE), por su repercusión importantísima en la atención de los pacientes

INTRODUCTION: total quality management (TQM) is an element of excellence in the practice of clinical nutrition that is less recognized than others such as continuous training or research. OBJECTIVE: to discuss the foundations of quality management tools such as TQM or continuous quality improvement, to describe major achievements in this field in nutrition units, and to define the main challenges for the future. RESULTS: in recent years, at least 9 clinical nutrition units have implemented TQM with quality certification by an external agency, in most cases AENOR and in accordance with the ISO 9001 standard. This has meant reflecting on the activities carried out by the units in order to meet user expectations, to document said activities, to ensure a better understanding of the organization, and to define the responsibilities of all staff, avoiding errors and redundant activities, with the result of improved time management and resources. CONCLUSIONS: TQM contributes to excellence in clinical nutrition because it represents a useful tool to improve organization and results in an efficient way. Although much progress has been made, there still remains a lot of work to be done in terms of developing processes, indicators, standards, and especially the coding of disease related malnutrition (DRM), due to its very important impact on patient care

Effects of Home-Delivered Meals on Older People's Protein Intake, Physical Performance, and Health-Related Quality of Life: The Power Meals Randomized Controlled Trial.

This trial examined the effectiveness of an 8-week home meal service on protein and other nutrient intake, physical performance (PP) and health related quality of life (HRQoL) among older people living at home (≥65 years; home care clients, caregivers and care recipients). Participants were randomized into three groups; (1) protein-rich meal, snack, and bread (INT1), (2) regular meal (INT2) and (3) control group. Nutrient intake was assessed with 3-day food diaries, PP with Short Physical Performance Battery (SBBP) and HRQoL with 15 dimensional Health-related quality of life instrument. Total of 67 (59.7% women, mean age 78.2 years) participants (n = 22 INT1, n = 24 INT2, n = 21 CG) completed the trial. At baseline, mean protein intake was 0.92 (SD 0.32) g/kg adjusted body weight (aBW)/d. At 8 weeks, protein-rich home meal service in INT1 increased protein intake (+ 0.11 (95%CI -0.01 to 0.21) g/kg aBW/d, 9.4 (95%CI 1.0 to 17.8) g/d) compared to other groups. It also increased calcium intake (+169.9 (95%CI 26 to 314) mg/d) and improved results in Sit-to-Stand Test (-4.8 (95%CI -6.8 to -2.7) sec) in INT1 compared to CG. Both home meal services increased saturated fat intake (INT1; 4.6 (95%CI 1.0-8.2) g/d, INT2;7.8 (95%CI 1.9 to 13.7)g/d) and decreased salt intake (INT1;-2330.9 (95%CI -2998 to -1664) mg/d, INT2; -2371.9 (95%CI -3399 to -1345) mg/d) compared to CG. There was no effect on overall HRQoL.

Continued Participation in Congregate Meal Programs: The Role of Geographic Access to Food.

The Nutrition Services Program is the largest program that provides prepared meals to older adults in need. However, little is known about the factors associated with participants' continued receipt of meals. This study uses longitudinal nationally representative survey data and residential location information to examine the factors associated with continuing to receive congregate meals (N = 383). 71.6% of participants in a given month continued to receive program meals in all of the next 12 months. Participants with geographic access to food proximate to their home were significantly more likely to stop receiving meals than those with more limited access (OR = 0.37, CI 0.16, 0.85); this was true among participants who lived alone, were older, had lower income, or lived in an urban area. Understanding the factors associated with continuing to receive congregate meals will ensure that older adults can meet their food needs and have a primary access point for community services.

The impact of COVID-19 on food systems, safety, and security-a symposium report.

Our food systems depend on complex interactions between farmers and food producers, local and federal governments, and consumers. Underlying these interactions are economic, environmental, and societal factors that can impact the types of food available, access to food, affordability, and food safety. The recent SARS-CoV-2 global pandemic has affected multiple aspects of our food systems, from federal governments' decisions to limit food exports, to the ability of government agencies to inspect food and facilities to the ability of consumers to dine at restaurants. It has also provided opportunities for societies to take a close look at the vulnerabilities in our food systems and reinvent them to be more robust and resilient. For the most part, how these changes ultimately affect the safety and accessibility of food around the world remains to be seen.

Inclusion of Nutrition Expertise in Catering Operations at a Major Global Sporting Event: A Qualitative Case Study Using a Foodservice Systems Approach.

BACKGROUND: Major sporting event catering is a significant undertaking for foodservice providers, particularly with an increasing focus on sustainability, global health, and nutrition demands of athletes. Yet, the inclusion of nutrition expertise in catering varies significantly between events. Foodservice systems models are commonly used to evaluate foodservice operations but to date have not been applied to catering and nutrition at major sporting events. OBJECTIVE: The aim of this exploratory case study was to gain in-depth insights of key stakeholders (catering management, chefs, organizers, and dietitians) regarding the integration of nutrition into the catering operation of a major global sporting event, with a focus on future continuity, and map this to the foodservice systems model using a program logic model. SETTING: Semistructured interviews were conducted with 12 stakeholders during and after the 2018 Commonwealth Games, Gold Coast, Australia. RESULTS: The 8 themes that emerged were related to planning and preparation, refining processes, improvement of the menu, better technology, increase in food allergies/intolerances, organization controls, experience of the workforce, and increased client knowledge of nutrition. The logic model demonstrated that the system is driven by policy and budget at the level of control prior to and during the planning phase but modified by the environment during operation. CONCLUSIONS: Despite recognition by stakeholders on the importance of change, there are barriers to the provision of suitable food. Integration of nutrition expertise into tender documents and budgets in major event catering will help ensure nutritionally adequate, culturally suitable, and safe menus for future events.

Feeding Students During COVID-19-Related School Closures: A Nationwide Assessment of Initial Responses.

OBJECTIVE: To conduct a nationwide assessment of child nutrition administrative agencies' responses to meal service provision during coronavirus disease 2019-related school closures. DESIGN: Systematic coding of government websites (February-May 2020) regarding school meal provision in all 50 US states and the District of Columbia, 5 US territories, and the US Department of Interior Bureau of Indian Education. PARTICIPANTS: All US jurisdictions (N = 57). VARIABLES MEASURED: Seven coding criteria were established to assess the strengths and weaknesses of jurisdictions' responses derived from emergency declarations, school closure announcements, and government websites on emergency school meals. ANALYSIS: Descriptive analyses. RESULTS: Most jurisdictions mentioned school meal provisions in school closure announcements (76.4%), provided easily interpretable information and/or maps about meal sites (57.9%), and included detailed information about school meal provisions in their coronavirus disease 2019 landing webpages (n = 26, 51%). Fewer provided updated and comprehensive implementation guidance (39.3%), referenced school closures in emergency declarations (37.5%), had clear communication/outreach to families (21.4%), or partnered with antihunger organizations (11.6%). CONCLUSIONS AND IMPLICATIONS: Understanding initial jurisdictions' approaches are critical to current and future emergency planning during school closures and reopening to help address food insecurity better, limit disease transmission, and prevent health disparities, particularly among at-risk populations.

School Closures During COVID-19: Opportunities for Innovation in Meal Service.

In 2019, the National School Lunch Program and School Breakfast Program served approximately 15 million breakfasts and 30 million lunches daily at low or no cost to students.Access to these meals has been disrupted as a result of long-term school closures related to the COVID-19 pandemic, potentially decreasing both student nutrient intake and household food security. By the week of March 23, 2020, all states had mandated statewide school closures as a result of the pandemic, and the number of weekly missed breakfasts and lunches served at school reached a peak of approximately 169.6 million; this weekly estimate remained steady through the final week of April.We highlight strategies that states and school districts are using to replace these missed meals, including a case study from Maryland and the US Department of Agriculture waivers that, in many cases, have introduced flexibility to allow for innovation. Also, we explore lessons learned from the pandemic with the goal of informing and strengthening future school nutrition policies for out-of-school time, such as over the summer.

Addressing Food Insecurity through a Health Equity Lens: a Case Study of Large Urban School Districts during the COVID-19 Pandemic.

Reduced access to school meals during public health emergencies can accelerate food insecurity and nutritional status, particularly for low-income children in urban areas. To prevent the exacerbation of health disparities, there is a need to understand the implementation of meal distribution among large urban school districts during emergencies and to what degree these strategies provide equitable meal access. Our case study of four large urban school districts during the COVID-19 pandemic aims to address these knowledge gaps. Guided by the Getting to Equity (GTE) framework, we conducted a mixed-methods study evaluating emergency meal distribution and strategy implementation in four large urban school districts (Chicago Public Schools, Houston Independent School District, Los Angeles Unified School District, and New York City Department of Education). We gathered data from school district websites on (1) meal service and delivery sites and (2) district documents, policies, communication, and resources. Using qualitative coding approaches, we identified unique and shared district strategies to address meal distribution and communications during the pandemic according to the four components of the GTE framework: increase healthy options, reduce deterrents, build on community capacity, and increase social and economic resources. We matched district census tract boundaries to demographic data from the 2018 American Community Survey and United States Department of Agriculture food desert data, and used geographic information systems (GIS) software to identify meal site locations relative to student population, areas of high poverty and high minority populations, and food deserts. We found that all districts developed strategies to optimize meal provision, which varied across case site. Strategies to increase healthy options included serving adults and other members of the general public, providing timely information on meal site locations, and promoting consumption of a balanced diet. The quantity and frequency of meals served varied, and the degree to which districts promoted high-quality nutrition was limited. Reducing deterrents related to using inclusive language and images and providing safety information on social distancing practices in multiple languages. Districts built community capacity through partnering with first responder, relief, and other community organizations. Increased social and economic resources were illustrated by providing technology assistance to families, childcare referrals for essential workers, and other wellness resources. Geospatial analysis suggests that service locations across cities varied to some degree by demographics and food environment, with potential gaps in reach. This study identifies strategies that have the potential to increase equitable access to nutrition assistance programs. Our findings can support (1) ongoing efforts to address child food insecurity during the pandemic and (2) future meal provision through programs like the Summer Food Service Program and Seamless Summer Option. Future research should further examine the rationale behind meal site placement and how site availability changed over time.

Expanding and Enhancing Food and Nutrition Education in New York City Public Schools: An Examination of Program Characteristics and Distribution.

To expand their capacity, many schools partner with food and nutrition education programs (FNPs). Public policies and funding can support FNPs, but comprehensive data on the organizations that run FNPs, their program characteristics, or distribution across schools did not exist in NYC. This study aims to help local education and health agencies assess the characteristics of food and nutrition education in schools, as well as to measure progress implementing school policies and practices. A cross-sectional study on NYC FNPs was conducted during the 2016-2017 school year. Survey data on organizations and the FNPs they operate were collected. Data on schools in which FNPs operate were gathered. To determine distribution of FNPs across schools and by school demographics, the database of FNPs in schools was combined with a publicly available database of NYC schools. In 2016-2017, 40 organizations operated 101 FNPs in 56% of NYC public schools. These FNPs varied by goals, content, activities, location, and populations served. Information on these variations can help policymakers, advocates, funders, and schools expand school-based food and nutrition education. To ensure equitable access, more coordination, investment, and collaboration are needed.

Qualitative Research in Phoenix, AZ, Exploring Support for Public-Private Partnerships to Expand the Reach of the Fresh Fruit and Vegetable Program.

BACKGROUND: Fruit and vegetable (F/V) consumption among school-aged children falls short of current recommendations. The development of public-private partnerships (PPPs) has been suggested as an effective approach to address a number of public health concerns, including inadequate F/V consumption. The US Department of Agriculture's Fresh Fruit and Vegetable Program (FFVP) provides F/V as snacks at least twice per week in low-income elementary schools. In addition to increasing F/V consumption behaviors at school, children participating in the FFVP make more requests for F/V in grocery stores and at home, suggesting the impact of the program extends beyond school settings. OBJECTIVE: This study explored the potential for establishing successful PPPs between schools and food retailers to promote the sales of F/V in low-income communities. DESIGN: Semi-structured interviews and focus groups were conducted with participants from 4 groups of stakeholders. PARTICIPANTS/SETTING: Grocery store and produce managers from 10 grocery stores, FFVP personnel from 5 school districts and 12 schools, and parents of children attending 3 different FFVP-participating schools, all in the Phoenix, AZ, metropolitan area participated in interviews and focus groups. STATISTICAL ANALYSES PERFORMED: Data were analyzed using a directed content analysis approach to examine benefits, barriers, and strategies for developing a PPP. RESULTS: Key perceived benefits of creating a PPP included the potential to increase store sales, to enhance public relations with the community, and to extend the impact of the FFVP to settings outside of schools. Barriers included offering expensive produce through the FFVP and the potential lack of communication among partners. Strategies for developing a PPP included using seasonal produce and having clear instructions for teachers and staff. Parents reported their children requesting more F/V as a result of FFVP participation. CONCLUSIONS: Stakeholders support forming PPPs. Partnerships between FFVP schools and retailers can be mutually beneficial and have a positive impact on children and their families.