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Approximately half of consumer food expenditures and one-third of food calories consumed are as food-away-from-home (FAFH) purchases. FAFH often differs from food at home (FAH) in nutritional profile and convenience. The availability and variety of FAFH outlets may significantly affect diets, health, food choice, and food-related time use. Focusing on U.S. nonmetropolitan (nonmetro) counties over the course of 30 years from 1990 to 2019, the authors examined the rural FAFH landscape across the United States—i.e., the availability of restaurants, cafeterias, food trucks, and the like outside of the home. The authors focused on trends and differentiating features of FAFH access across the metropolitan divide and across the rural-urban continuum using annual establishment-level data from the National Establishment Time Series (NETS) dataset. The authors found that FAFH is generally less available in nonmetro counties and that there is a prevalence of national chain restaurants among the FAFH options in the most rural, nonmetro counties. However, this finding is not uniform across county types. Broad local economic conditions, captured by primary industry, are correlated with differences in the food landscape. Counties with recreation as their primary industry tended to offer more FAFH options than rural counties with other leading industries, including nonmetro counties. Furthermore, there has been an expansion of FAFH in nonmetro counties, including the most rural, nonmetro counties, led by growth in limited-service restaurants. These results could have implications for food access, overall health, and other consumer food metrics because FAFH generally offers a different nutritional profile than food at home and may provide additional convenience.

The Center for Policy Research (CPR) has been retained by the Colorado Evaluation and Action Lab to design and conduct a study of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). The purpose of this evaluation is to rigorously evaluate TF-CBT with the goal of building evidence for the practice towards a “well-supported” rating in the Title IV-E Prevention Services Clearinghouse. In doing so, the capacity will be in place to include TF-CBT as an eligible service in Colorado’s Prevention Services Plan and expand access to TF-CBT as part of Colorado’s strategy for the Family First Prevention Services Act. TF-CBT is a widely practiced therapy intervention for children and adolescents, ages 3-18, who have symptoms associated with trauma exposure. The model is designed to be a short-term course of treatment that typically spans 12-16 sessions and includes both individual and combined therapy sessions with the child and the nonoffending adult caregiver. The intervention itself is comprised of 10 major components that are typically completed in chronological order. These components are summarized by the acronym PRACTICE: Psychoeducation, Parenting skills, Relaxation skills, Affective modulation skills, Cognitive coping skills, Trauma narrative and cognitive processing of the traumatic event(s), In vivo mastery of trauma reminders, Conjoint child-parent sessions, and Enhancing safety and future developmental trajectory. TF-CBT is intended for implementation in clinical settings, as well as in residential treatment facilities, schools, and homes (Cohen et al., 2006; 2012; 2017; 2022). A review of the literature suggests that TF-CBT has yet to be rigorously studied in a school-based setting, where clinical services are rapidly expanding, and a large population of children and youth are now receiving therapy. This research will evaluate the effectiveness of TF-CBT in a school-based setting while simultaneously building the evidence base for TF-CBT as a PTS reducing intervention for children with trauma histories. This study is intended to determine if school-based TF-CBT decreases post-traumatic stress (PTS), depressive, and general mental health symptoms and improves prosocial behavior among youth who have experienced trauma. As an outcome evaluation, it will test specific and measurable hypotheses regarding the short-term and longer-term effects of youth receiving TF-CBT in a school-based setting, compared to youth receiving treatment as usual (TAU) in a school-based setting. TAU refers to the usual or typical services available for the population in the study. In this case, this refers to the usual or typical therapy services available in the school-based setting for students who have experienced trauma and have resultant PTS symptoms. While students in the comparison group will be offered the usual therapy that is available at their school, they will not receive TF-CBT. The four primary research questions contribute to the outcome evaluation: 1. What are the initial end of treatment effects and the six and 12 months beyond the end of treatment effects of youth receiving TF-CBT in a school-based setting on PTS symptoms compared to receiving TAU in a school-based setting? 2. What are the initial end of treatment effects and the six and 12 months beyond the end of treatment effects of youth receiving TF-CBT in a school-based setting on depressive symptoms compared to receiving TAU in a school-based setting? 3. What are the initial end of treatment effects and the six and 12 months beyond the end of treatment effects of youth receiving TF-CBT in a school-based setting on general mental health symptoms compared to receiving TAU in a school-based setting? 4. What are the initial end of treatment effects and the six and 12 months beyond the end of treatment effects of youth receiving TF-CBT in a school-based setting on prosocial behavior compared to receiving TAU in a school-based setting? There are also two secondary research questions that examine the delivery of TF-CBT in a school-based setting and contribute to broader research on school-based delivery of TF-CBT: 4. Are the initial end of treatment effects and the six and 12 months beyond the end of treatment effects of youth receiving TF-CBT in a school-based setting compared to receiving TAU in a school-based setting mediated by parental engagement? 5. To what extent was fidelity of implementation of TF-CBT in a school-based setting achieved?

This study examines the difference in perception of food from a food pantry and food from a grocery store.