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Collaborating with the United Nations High Commissioner for Refugees (UNHCR), World Food Program (WFP), and NGOs, the Bangladesh Government implemented cash assistance programs for Rohingya refugee households facing exacerbated food insecurity because of the COVID-19 pandemic. This study investigates the impact of a cash assistance program on alleviating the food insecurity experienced by Rohingya migrants during the pandemic. Additionally, this study explores potential variations of the impact of cash assistance with reference to vulnerability levels based on gender and income inequality. These findings indicate a significant reduction in food insecurity among Rohingya migrants who received cash assistance. However, further analysis reveals that cash assistance is not effective in ensuring the food security of comparatively more vulnerable households headed by women and households with no earning members. This policy implication underscores the need to restructure, redesign, and reconsider the features of cash assistance programs to enhance the welfare of refugee households across all levels of vulnerability. [ABSTRACT FROM AUTHOR]

The rate of usage of community elderly care services in China is low, and past studies about the effects of these services on caregiver burden domestically are few. This study used a large sample of Beijing census data (n = 55,634) to examine the impact of these services on caregiver burden. Logistic regression and propensity score matching were used to estimate the effects. The results showed that meal assistance, respite care, and spiritual comfort are all significantly associated with a lower likelihood of perceived emotional burden among caregivers, while only respite care is very significantly associated with a lower likelihood of feeling physically burdened. However, the effects of these services on caregiver burden also depend on the activities of daily living performance and location of residence of the care recipients. The practical implications for policy makers are discussed. [ABSTRACT FROM AUTHOR]

Context Nutritional interventions substantially improve tuberculosis (TB) treatment outcomes and prevent complications. However, there is limited evidence about the connections between having nutritional support and TB treatment adherence. Objective The aim of this study was to determine the effectiveness of nutritional support in improving treatment adherence among patients with TB. Data Sources Databases, including PubMed, Embase (Ovid), Web of Science, and Scopus, were comprehensively reviewed to identify relevant studies reporting the impacts of nutritional support on TB treatment adherence. Data Extraction Two authors independently screened the title, abstracts, and full article texts to identify eligible studies and assess the risk of bias. Observational and interventional studies were included. Data Analysis A narrative synthesis approach was used to summarize the findings qualitatively. Results From the search, 3059 publications were identified; of these, 8 studies were included in this systematic review. Three types of nutritional interventions were identified: food baskets (eg, energy, micronutrient- or macronutrient-enriched food support), nutritional advice and guidance, and incentives for buying foods. Although 5 studies reported that nutritional support significantly improved treatment adherence in patients with TB, 3 studies showed that nutritional support had no effect on TB treatment adherence. Conclusions Providing nutritional support may improve adherence to TB treatment. However, more well-powered, high-quality trials are warranted to demonstrate the effect of nutrition support on cost-effectively improving adherence to TB treatment. Systematic Review Registration PROSPERO registration no. CRD42023392162. [ABSTRACT FROM AUTHOR]

MyPlate is a tool designed to educate the general US population on how to eat in alignment with the Dietary Guidelines for Americans; yet, there is a lack of data on who has heard of MyPlate over time. The objective of this analysis was to examine the prevalence of awareness of MyPlate within the US population and if awareness changes differentially over time. This study was a serial, cross-sectional survey. Three survey waves of data (2013-2018) were used from the National Health and Nutrition Examination Survey of adults aged 20 years or older (n = 17,023). Percentage of the US adult population who had heard of MyPlate was measured and stratified by sex, age, citizenship status, education, household food security status, income, receipt of Supplemental Nutrition Assistance Program (SNAP) benefits, and receipt of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits. Global Wald tests were used to assess whether prevalence of awareness of MyPlate differed by sociodemographic characteristics. Tests of homogeneity using likelihood ratio tests of nested logistic regression models were used to assess whether differences in awareness of MyPlate by various sociodemographic characteristics changed over time from 2013 to 2018. Twenty percent (19.5%) (n = 875) of the analytic sample of participants aged 20 years and older had heard of MyPlate in 2013-2014, 24.5% (n = 1,020) in 2015-2016, and 24.6% (n = 1,086) in 2017-2018. Awareness of MyPlate changed differentially over time (P value <.1) from 2013 to 2018 by income, household food security status, and receipt of SNAP benefits, with slower increases in awareness for households with lowest income over time, narrowing of differences in awareness by household food security status over time, and persistent differences in awareness by receipt of SNAP benefits over time. These results highlight the current low awareness of MyPlate, disparities in awareness of MyPlate immediately after implementation by sociodemographic characteristics, and increases in awareness over time at differential rates within levels of income, food security status, and ever receipt of SNAP benefits. Given that the Dietary Guidelines for Americans 2025-2030 are currently in development, new strategies should be considered to disseminate tools that translate the updated Dietary Guidelines in such a way that reach the general population equitably upon implementation within the United States. [ABSTRACT FROM AUTHOR]

Food FARMacy is a clinical-community emergency food assistance program developed in response to food insecurity during the COVID-19 pandemic. Few qualitative studies have examined participant, and clinical and community stakeholder experiences with these food assistance programs. To examine the motivations, experiences, and perceptions of Food FARMacy participants and program stakeholders. A qualitative study using in-depth interviews between March 2021 and July 2021. Twenty-four Food FARMacy participants and 10 program stakeholders in New York, NY (Manhattan, Brooklyn, and Queens) older than age 18 years were interviewed. Interviews were recorded, transcribed, translated, and analyzed using thematic analysis. Participant and program stakeholder interviews were analyzed separately. Themes that were salient in both groups were combined for reporting. Both program participants and stakeholders perceived: pandemic-related demands combined with reduced resources motivated participation; convenience, safety, and ease of access facilitated program retention; participants valued fresh produce and diversity of foods; the program improved diet and health; minimizing food waste was a priority; and social cohesion was an unexpected program benefit. Two additional themes among only program stakeholders also were identified: aligned values, flexibility, and communication were key to successful partnerships; and trust between community partners and community members drove programmatic success. Results suggest that a multisite clinical-community partnership to provide emergency food assistance in New York City can be leveraged to reduce barriers to healthy food access and address food insecurity during crises. [ABSTRACT FROM AUTHOR]

Background: Rural U.S. residents experience a disproportionate burden of diet and physical activity (PA) related chronic disease compared to urban residents, due to resource and economic challenges. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating, and PA. Therefore, the purpose of this paper is to describe policy supports for breastfeeding, healthy eating, and/or PA occurring in rural U.S. areas. Methods: A scoping review was conducted March-June 2020 to identify policy, systems, and environment change approaches occurring in the rural U.S. for breastfeeding, healthy eating, and PA. Search procedures were guided by the PRISMA-ScR, Arksey and O'Malley's work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research. ProQuest Dissertations and Theses A&I were used to identify dissertation research. Grey literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Policy results are reported and inclusion criteria were: (1) breastfeeding, healthy eating, and/or PA focus; (2) about policy factors; (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/measurement, setting, population characteristics, behavioral focus, policy-specific results) were extracted into a standardized Excel document. Results: Results include 122 total sources: original research, with some sources referencing multiple behaviors, (n = 74 sources: 8 breastfeeding, 41 healthy eating, 42 PA), grey literature (n = 45 sources: 16 breastfeeding, 15 healthy eating, 27 PA), and graduate research (n = 3 sources: 1 breastfeeding, 2 healthy eating, 1 PA). Breastfeeding policy initiatives included policies or programs at hospitals, increasing access to resources, and improving culture or norms at workplaces. Healthy eating policy initiatives included increasing access to healthy foods, reducing financial burden, implementing programs, food assistance programs, and healthy food prescriptions at healthcare facilities. PA policy initiatives focused on Complete Streets, joint or shared use efforts, Safe Routes to Schools, master plans for greenways, trails, and/or transportation, school health plans, and childcare/school standards. Conclusions: Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, healthy eating, and/or PA in the rural U.S. [ABSTRACT FROM AUTHOR]

Background: Rates of non-communicable diseases are disproportionately high among Native Hawaiian (NH) people, and the proportion of NH infants being fed human milk (HM) is the lowest among all ethnicities within the state of Hawaiʻi. The aim of this study was to explore biological, socio-economic, and psychosocial determinants of the initiation and duration of human milk feeding (HMF) among a study of NH mothers and infants. Methods: A sample of 85 NH mother-infant dyads who were participating in a larger prospective study were involved in this research. Recruitment for the parent was delayed due to the COVID-19 pandemic. Recruitment started in November 2020 and continued until April 2022. Questionnaires were distributed at birth, two-months, four-months, and six-months postpartum. Questionnaires addressed topics relating to maternal and infant characteristics and infant feeding practices. Descriptive statistics, comparative analysis, and multivariate logistic regression tests were conducted. Results: The majority of participating mothers were aged between 31 and 35 years, had some college education or more, were employed, and multiparous. The majority of infants were receiving HM at each timepoint (94% at birth, 78% at two-months postpartum, and 76% at four and six-months postpartum). Factors found to be significantly associated with HMF initiation and duration were prenatal intention to HMF, maternal educational attainment, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, and Supplemental Nutrition Assistance Program (SNAP) recipiency. A prenatal intention to HMF was found to be a strong predictor of HMF at birth (aOR = 64.18, 95% CI 2.94, 1400.28) and at two-months postpartum (aOR = 231.55, 95% CI 2.18, 2418.3). Participants not involved with WIC were more likely to be HMF at four-months postpartum (aOR = 6.83, 95% CI 1.01, 46.23). Conclusion: This research supports existing evidence that prenatal intention to HMF and higher maternal educational attainment are positive predictors of HMF. WIC participation and being a SNAP recipient were found to be negatively associated with HMF which suggests a need for more culturally tailored support. Further research is required to reduce the gap in knowledge related to the determinants of HMF in NH. [ABSTRACT FROM AUTHOR]

This paper describes the 30-year evolution of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) to provide evidence to support our perspective that SNAP-Ed has earned its position as a pillar of the public health infrastructure in the US. Legislatively designated as a nutrition education and obesity prevention program, its focus is the nearly 90 million Americans with limited income. This audience experiences ongoing health disparities and is disproportionately affected by public health crises. The SNAP-Ed program works to reduce nutrition-related health disparities at all levels of the Social-Ecological Model, follows a robust evaluation framework, and leverages strong partnerships between state-based practitioners, state agencies, and the US Department of Agriculture. The expansion of SNAP-Ed would enable the program to reach more Americans so that our nation can end hunger and reduce diet-related health disparities. [ABSTRACT FROM AUTHOR]

To determine the prevalence and characteristics of food insecurity among female collegiate athletes. NCAA Division I female athletes attending a public university located in East Texas in 2018. A prospective cross-sectional online survey was employed to gather quantitative and qualitative data regarding food security status. Participants were instructed to complete the 26-item questionnaire, including the six-item USFSSM. Participants (N = 78) were 18–22 years of age, largely white (75%). Despite most (89.74%) receiving some form of scholarship and 80% reporting provision of some meals, 32.10% were classified as food insecure. Barriers to food intake were two-fold higher among the food insecure (88% vs 43%, p <.001); limited time (43.6%) and finances (23.1%) were the most frequently reported barriers. Despite university support, food insecurity exists in female collegiate athletes. Outcomes warrant screening for food insecurity, referral to support resources throughout matriculation, and tailored intervention programs. [ABSTRACT FROM AUTHOR]

To examine the components of successful food assistance programs for college students. Focus groups conducted during the fall 2019 semester included undergraduate students who accessed a food assistance program on campus (n = 26). Key informant interviews were conducted with professionals working with campus-based food assistance programs (n = 5). Student insight regarding experiences on campus-based food assistance programs was gathered. Key informant interviews were conducted to gain an understanding of strategies put in place to alleviate food insecurity among college students. Emerging focus group themes included financial stressors, eating strategies, struggling to feed dependents, utilization of university-based food assistance programs, and SNAP enrollment. Key informant interviews revealed six strategies of effective food assistance programs: increasing access, securing funding, procurement/distribution of healthy foods, partnerships, outreach, and decreasing stigmatization. A "mission driven" approach has the potential to meet the complex needs of food insecure college students. [ABSTRACT FROM AUTHOR]

Objective: To test the association between food insecurity and educational disruptions from the COVID-19 pandemic and the role of anxiety or depression in mediating this association. Participants: Representative sample of 2,282 City University of New York students. Methods: Using an April 2020 online survey, we estimated adjusted prevalence ratios (aPR) for educational outcomes based on food insecurity status, adjusting for age, sex, race/ethnicity, and degree level with weighted Poisson regressions with robust standard errors. Results: Prevalence of decreased ability to do schoolwork was greater in those with moderate (aPR = 1.12, 95% CIs 1.02, 1.23) and high (aPR = 1.18, 95% CIs 1.08, 1.2) levels of food insecurity compared to food-secure students. Results were similar for dropping/withdrawing from classes and expecting delays or uncertainty around graduation. Anxiety and depression mediated the relationship between food insecurity and educational outcomes. Conclusion: Findings emphasize the urgency of expanded food assistance and mental health services for college students. [ABSTRACT FROM AUTHOR]

This study aims to investigate the association between food insecurity, eating behaviour and relative weight change among Malaysian young adults in the aftermath of the pandemic-led lockdown. Socio-demographics, body height, and body weight were self-reported by the young adults. Food security was assessed using the 8-item validated Food Insecurity Experience Scale (FIES), while the Three-Factor Eating Questionnaire-Revised 18-item (TFEQ-R18) was adopted to evaluate the eating behaviour of young adults. Of the 447, 45.9% maintained the same body weight as before the pandemic-led lockdown. While almost half of the young adults (47.2%) were food secure, about one-fourth (24.8%) suffered moderate-to-severe food insecurity. Meanwhile, the standardised raw scores for all the eating behaviour subscales were in the ascending order of cognitive restraint (49.37 ± 18.60) < uncontrolled eating (50.61 ± 20.37) < emotional eating (50.68 ± 24.50). The findings of the Sobel test indicated that the mediation effects of eating behaviour were not statistically significant (p > 0.05), suggesting that eating behaviour (cognitive restraint, uncontrolled eating and emotional eating) did not mediate the relationship between moderate-to-severe food insecurity and relative weight change. Health promotion interventions such as introducing food assistance programs, offering incentives for nutritious food purchases, and re-emphasising healthy eating are essential to rectify food insecurity and disordered eating among Malaysians. [ABSTRACT FROM AUTHOR]

Among US presidents, Herbert Hoover and Lyndon Johnson had the strongest ties to Australia. Hoover spent over a year in Australia as a mining engineer before launching a career in international business, food relief, and politics. In 1942, LBJ passed part of his pre-presidential career in Australia. Yet Johnson's presidential tour in 1966, coupled with his return in 1967, generated massive enthusiasm and modest protests against the Vietnam War. President Johnson's visits helped to solidify and celebrate US-Australian ties while encouraging Australian independence, even if during a war directed from Washington. While Hoover left his mark on Australia's landscape in the mines he promoted and the sites that still stand, Australians found little appealing in the dour, Depression-era president who had come and gone without regarding their country as a friend or ally. Johnson thus became a consequential figure in Australia's national history in ways Hoover never did. [ABSTRACT FROM AUTHOR]

The Food is Medicine (FIM) movement posits that food access and knowledge are key parts of disease prevention and treatment, but little research has explored how FIM programs fit into the organizational context of federally qualified health centers (FQHC). The purpose of this study was to explore the organizational climate and clinic staff perspectives on a FIM program being implemented in an FQHC. We conducted a cross-sectional survey study with clinic staff during the early implementation of a clinicbased FIM program. Clinic staff (n=40) perceived that patient nutrition was a high priority for the clinic, but that support for providing nutrition resources was more limited. We found high willingness and likelihood of using the FIM program services among staff, but some expressed concern regarding staffing and cultural appropriateness of programming. Optimal adoption and use of FIM investments in FQHCs may be supported by integration with existing clinical workflows. [ABSTRACT FROM AUTHOR]

Background and Aim: The Democratic Republic of Congo (DRC) is facing a humanitarian crisis due to prolonged conflicts, human rights abuses, and gender‐based violence. This perspective article aims to discuss the challenges faced by vulnerable populations in the DRC, including the impact of interventions and broader humanitarian strategies. Methods: A search on Google Scholar was carried out to identify relevant journal articles. Additionally, relevant reports and data on the DR Congo crisis were sourced from the websites of international and humanitarian organizations including the United Nations High Commissioner for Refugees, World Health Organization, United Nations Office for the Coordination of Humanitarian Affairs, and the Norwegian Refugee Council. Results: The crisis has led to 6.1 million displaced individuals and 1 million seeking asylum in neighboring countries. Insecurity and displacement further exacerbate the crisis, exacerbating health issues and malnutrition, particularly among women and children. The deterioration of water, sanitation, and hygiene infrastructure in the region facilitates the spread of infectious diseases. The UN has appealed for $8.3 billion in humanitarian assistance in West and Central Africa, including DRC. However, more attention and efforts are needed to curb the menace of the conflict. Conclusions: Addressing root causes like political volatility, economic disparity, and social unrest is crucial for sustained health protection. Tailoring humanitarian assistance to the context of conflict is essential, prioritizing mental health support and psychosocial services. Improving access to healthcare is crucial. Addressing food insecurity is essential, involving targeted food assistance programs, improving agricultural practices, and establishing income‐generating activities. Sustaining international assistance and investments are needed to address the health needs of the most vulnerable populations. [ABSTRACT FROM AUTHOR]

This study aims to 1) examine food insecurity (FI) among students during and after Hurricane Ian and Nicole in a public university in Florida; 2) understand the association between students’ utilization of food assistance programs (FAPs) and FI, and 3) illustrate perceived barriers stopping students from using FAPs. Our survey of the convenience sample (n = 261) showed that 30.7% experienced FI, with much higher rates observed among socially vulnerable groups. Limited utilization of FAPs resulted in minimal impact on students’ FI. The significant barriers to FAPs include ethical concerns about taking from those in need, lack of information, and eligibility. [ABSTRACT FROM AUTHOR]

Background. Postpartum weight retention is a risk factor for obesity and is particularly important among Hispanic women who have an increased rate of obesity. Given its broad reach, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program provides an ideal setting to implement community-based interventions for low-income postpartum women. Purpose. To examine the feasibility, acceptability, and preliminary efficacy of a multicomponent intervention delivered by staff within the WIC program designed to promote behavior changes in urban, postpartum women with overweight/obesity. Method. This was a 12-week pilot trial randomizing participants to a health behavior change (Intervention) or control (Observation) group. The Intervention included monthly visits with trained WIC staff providing patient-centered behavior change counseling, with multiple touchpoints between visits promoting self-monitoring and offering health behavior change support. Results. Participants (n = 41), who were mainly Hispanic (n = 37, 90%) and Spanish-speaking (n = 33, 81%), were randomized to the Intervention (n = 19) or Observation (n = 22) group. In the Intervention group, 79% (n = 15) of eligible participants were retained for the study duration. All Intervention participants endorsed that they would participate again. Regarding physical activity, participant readiness to change and self-efficacy improved for Intervention participants. About one-quarter of women in the Intervention group (27%, n = 4) had a 5% weight loss compared with one woman (5%) in the Observation group; this difference was not statistically significant (p =.10). Conclusions. This pilot demonstrated the feasibility and acceptability of delivering a low-intensity behavior change intervention within the WIC setting for postpartum women with overweight/obesity. Findings support the role of WIC in addressing postpartum obesity. [ABSTRACT FROM AUTHOR]

BACKGROUND: The US Department of Agriculture's (USDA) summer meal programs are designed to provide meals at no cost while school is out of session. In response to the COVID‐19 pandemic, several regulatory waivers were enacted to facilitate meal distribution. The aim of this study was to assess the rates of meal distribution before and after these waivers were in effect. METHODS: Meal distribution patterns for 2019, 2020, and 2021 were examined through (1) a descriptive comparison of the number of participating districts, sponsors, meal sites, and meals distributed statewide, and (2) repeated measures ANOVAs to examine changes among districts in operation all years. RESULTS: The waivers were associated with an increase in the total number of participating districts, sponsors, and meal sites; an increase in the total number of meals distributed to children during the summer months; and an increase in meal distribution among sponsors that had been in place since 2019. Conclusion: Expanding the area eligibility criteria and enabling flexibility in meal distribution methods increased the number of meals provided. This study provides important preliminary evidence to suggest that the USDA should consider permanent regulatory changes to this program to maximize its reach. [ABSTRACT FROM AUTHOR]

Small food retailers often stock energy-dense convenience foods, and they are ubiquitous in low-income urban settings. With the rise in e-commerce, little is known about the acceptability of online grocery shopping from small food retailers. To explore perceptions of the role of small food retailers (bodegas) in food access and the acceptability of online grocery shopping from bodegas among customers and owners in a diverse New York City urban neighborhood with low incomes. In-depth interviews were conducted with bodega owners and adult customers between May and July 2022. Bodega owners who either had (n = 4) or had not (n = 2) implemented a locally designed online grocery system. Customers (n = 25) were recruited through purposive sampling and were eligible if they purchased at bodegas (>once per month), had low income (household income ≤130% of the federal poverty level or Supplemental Nutrition Assistance Program [SNAP] participants), and owned smartphones. All interviews were transcribed and analyzed in MAXQDA (Verbi Software, Berlin, Germany), using grounded theory. To owners and customers, bodegas were seen as good neighbors providing culturally appropriate foods and an informal financial safety net. Their perceptions concerning food cost and availability of healthy foods in bodegas diverged. Although most perceived online grocery from bodegas as a positive community resource, they also believed it was not suited to their own community because of the bodega's proximity to customers' homes and the low digital literacy of some community members. Customers reported social norms of pride in not using online grocery shopping. Owners and customers believed the service would more likely be used if government benefits such as SNAP allowed payment for online orders. Both suggested improved outreach to increase program awareness and uptake. Online grocery shopping from small food retailers may be acceptable in urban communities with low income and was perceived as a community resource. However, important barriers need to be addressed, such as social norms related to pride in not using online grocery services, digital literacy, program awareness, and allowing SNAP payment for online orders from bodegas. [ABSTRACT FROM AUTHOR]

In recent decades, disappointing poverty trends and welfare state limitations in many European countries – including constraints on minimum income benefits – have paved the way for a larger role of the third sector. An interesting but controversial form of third-sector in-kind support is food aid provision. In Europe, food aid is, so far, a non-rights-based practice displaying worrisome discretionary and stigmatizing characteristics. Yet, the phenomenon of food aid in Europe has spread, professionalized, and penetrated the institutions of the welfare state. This raises the question if, how and to what extent food aid plays a role in bypassing structural constraints on minimum income protection. This article applies an exploratory case study approach to estimate the monetary value of food aid in relation to statutory minimum incomes in four EU-countries. We use cross-nationally comparable food reference budgets to price food aid packages in Belgium, Finland, Hungary and Spain. The results show that food aid, although not sufficient to close the at-risk-of-poverty gap, is non-trivial for some European households. In Spain and Belgium food aid packages can reach up to €100 a month (expressing 7% to 11% of respective minimum income benefit levels). Importantly, we perceive (formalized) cooperation and interaction between local welfare agencies and food charities in all countries, suggesting that welfare state actors use non-rights-based food aid for filling gaps in the social safety net. The large between- and within-country variation of the monetary values of food aid packages points, however, to food aid as a problematic discretionary practice. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has exacerbated the food insecurity issue across the nation, especially for vulnerable population groups. As an important way to access food, online grocery shopping has gained substantial popularity during COVID-19. However, it is not clear how COVID-19 impacted both the in-store and online grocery shopping simultaneously and how the impacts varied among different population groups. To gain a comprehensive understanding of the impacts of COVID-19 on food access, we conducted two rounds of online survey during the initial and middle stages of COVID-19 in Maricopa County, Arizona, United States. In addition to the factors that have been examined in the literature, we examined how travel behavior, food environment, and lifestyle change affected both in-store and online shopping during COVID-19 when compared with before COVID-19. Analysis results suggest that the methods people used for grocery shopping varied with different stages of COVID-19 and among different population groups. Changes of people's daily life and travel behavior during COVID-19 are found to be associated with people's grocery shopping method selection. While people with better food environment were more likely to keep in-store grocery shopping, as the pandemic progressed, food environment became less important as a factor influencing the adoption of online grocery shopping. Food assistance program participants had a higher demand for the online grocery shopping service. However, the barriers associated with redeeming their benefits online prohibited them from becoming new online grocery shoppers during COVID-19. The study provides important insights into planning of food provision and formulating effective intervention strategies during future shocks. [ABSTRACT FROM AUTHOR]

Healthcare-based food assistance programs have the potential to improve patients' food security, but are underutilized. We conducted a qualitative study of user and staff perceptions of an on-site mobile market at a federally-qualified health center (FQHC). Five themes were identified: 1) financial need drives the decision to use the market, 2) people attend specifically to receive healthy food, 3) users feel a connection to the FQHC, which increases participation, 4) social networks increase usage of the program, and 5) long lines, inclement weather, inaccessibility, and inconsistent marketing and communication are attendance barriers. Findings should inform implementation of future healthcare-based food assistance programs. [ABSTRACT FROM AUTHOR]

We explored the association between the use of a hospital-based food pantry and subsequent emergency department (ED) utilization among Medicaid patients with diabetes in a large safety-net health system. Leveraging 2015-2019 electronic health record data, we used a staggered difference-in-differences approach to measure changes in ED use before vs after food pantry use. Food pantry use was associated with a 7.3 percentage point decrease per patient per quarter (95% confidence interval, -13.8 to -0.8) in the probability of subsequent ED utilization (P = .03). Addressing food insecurity through hospital-based food pantries may be one mechanism for reducing ED use among low-income patients with diabetes. [ABSTRACT FROM AUTHOR]

To examine the impact of developmental monitoring on child referrals, a retrospective data review, comparing seven pilot programs with seven matched controls in Special Supplemental Nutrition Programs for Women, Infants, and Children (WIC) was completed. Pilot programs were trained on developmental monitoring and how to refer families to their local Early Intervention (EI) program, Special Education, or Family TIES (Together in Enhancing Support), services when there is a developmental concern. The "Learn the Signs. Act Early" developmental monitoring program was implemented, and the outcomes included the number of referrals made over a 6-month period. The results indicated a statistically significant difference (p = <.001) in referrals made preimplementation compared to postimplementation with a large effect size (d = 0.96) for pilot programs. Additionally, when analyzing between-groups there were significantly more referrals (p = .001) made at the pilot programs compared to the control programs, again with a large effect size (d = 2.10). This study shows that the implementation of developmental monitoring within WIC programs was effective in increasing referrals to intervention services designed to support families with early identification of developmental delay. [ABSTRACT FROM AUTHOR]

This paper investigates how Supplemental Nutrition Assistance Program (SNAP) eligibility affects food expenditures. A 2019 policy change in California granted SNAP eligibility to previously ineligible Supplemental Security Income (SSI) recipients. Using the Consumer Expenditure Survey, we find that after the policy change, affected SSI recipients increased their "food at home" budget share between 2.5 and 4.3 percentage points ($120 to $206 per quarter). The SNAP effect on total food expenditures is dampened by a decrease in "food away from home" which SNAP benefits cannot be spent on. [ABSTRACT FROM AUTHOR]

Noting the importance of food assistance programs to low income families in New York City (NYC), the research questions for the present study were: (1) What are the facilitators and barriers to social service utilization for food pantry clients in the South Bronx?, and (2) Does receiving food pantry services serve as a point of entry for social service utilization? We surveyed 218 food pantry clients at a community-based, social service organization based in the South Bronx. Our findings indicate that being aware of local social services was the strongest predictor for utilizing social services. Social service utilization was also predicted by high use of the food pantry (weekly or more); high levels of food insecurity, depressive symptoms; and the ability to communicate effectively in English. Given rising inflation costs and the continued higher expenses associated with food consumption in the United States generally and in NYC specifically, our findings suggest that food pantry sites in the South Bronx bear the potential to be vital entry points for social service referral and utilization, particularly for the screening and assessment of depressive symptoms. Given these findings, nonprofit leaders and social service funders should prioritize capacity building of food pantries as sites for the delivery of health promotion interventions and social services. [ABSTRACT FROM AUTHOR]

The text discusses the Patriotic Food Show that took place in St. Louis during World War I. The show aimed to promote food conservation and educate the public on responsible consumption. It featured demonstrations, exhibits, and performances, and was organized by the Women's Central Committee on Food Conservation. The show successfully raised funds and awareness for the cause. [Extracted from the article]

Amid national efforts to align priorities for nutrition and food assistance programs, little is known about the implementation of community-led efforts for children. This study aimed to estimate U.S. public school participation in weekend backpack programs (WBPs), to document program structure, and to consider characteristics of programs with more nutritious food offerings. The prevalence of WBP participation in 2022 was estimated using a state-stratified, random sample of n =413 public schools. Administrators from WBPs at 49 schools completed measures of implementation characteristics and nutritional quality of foods offered. In 2022–2023, using a multivariable-adjusted linear regression model, the authors explored the association between hypothesized implementation characteristics and Healthy Eating Index-2015 scores of foods provided. Half of public schools (53.7%, 95% CI: 46.8%, 60.7%) in the national sample reported participating in WBPs. Many WBPs in the subsample were affiliated with anti-hunger organizations (41%), led by school counselors and volunteers (55%), and funded by grants (51%). WBPs spent an average of $0.56 (sd=$0.36) per item. Foods provided averaged a Healthy Eating Index-2015 score of 58.4 (sd=12.3), similar to children's average diets. About half of WBPs (41%) reported accessing nutrition resources. Despite the decentralized structure and absence of dedicated funding mechanisms, WBPs were common in our national sample of schools, suggesting widespread perceptions of unmet food needs and extensive efforts from community members to mitigate weekend hunger. Further research on food procurement methods and program impacts on child nutrition outcomes is needed to advance national priorities for nutrition and food security. [ABSTRACT FROM AUTHOR]

The community sector performs an important function in providing emergency food relief, yet food insecurity is often a chronic issue due to poverty and social exclusion. Progressive food provision models present opportunities to improve voluntary food relief services that are dominant in many countries. Informed by research with clients indicating a preference for blended service models that go beyond food provision, two government agencies partnered with a social enterprise and academics to pilot a social supermarket model. This research article (a) briefly summarizes international evidence on social supermarkets' characteristics and offerings, (b) describes a process used to collaboratively develop a social supermarket incorporating universal access and social supports, and (c) presents a rubric defining elements of a social supermarket. Applicable to other community sector settings, the rubric emphasizes dignified access and service, plus opportunities for social support and connection, which are important elements in pathways out of food insecurity. [ABSTRACT FROM AUTHOR]

Participation in school meals is associated with many benefits. However, participation in school meals served in the summer through the Summer Food Service Program (SFSP) is low due to many barriers, including program requirements such as congregate feeding. During COVID-19, these requirements were waived, allowing grab-and-go meals. The purpose of this study is to compare the number of SFSP breakfast and lunch meals served during the summers of grab-and-go meals (2020 and 2021) to prior summers of congregate feeding (2014–2019) in New York City (NYC). This study is an ecological study of NYC public school geographic districts (n = 32). The primary outcome is the total number of SFSP meals served per student. Using the repeated-measures ANOVA, the results show a significant increase in the number of SFSP meals served per student during the first summer (2020) of grab-and-go meals compared to summers 2016–2019 (p ≤ 0.01) but no significant differences during the second summer (2021) of grab-and-go meals compared to summers 2014–2019. However, there was a significant increase in the number of breakfast meals served in August per student during both the first and second summer of grab-and-go meals compared to summers 2014–2019 (p < 0.05). Among NYC public schools, the waivers may increase the reach of breakfast meals served in August, when there are fewer summer school activities. While there is a need for more research, policymakers may consider making waivers that allow grab-and-go meals permanent flexibilities for the SFSP to increase access to summer meals. [ABSTRACT FROM AUTHOR]

Humanitarian aid in Central Europe after World War I repositioned both food and food research on a global scale. This essay follows the British scientific delegation that worked in Vienna as part of the food aid program and shows how the city became a "lab" for international nutrition. Assuming a political role, British nutrition experts were motivated to collaborate with local experts. To examine what internationalism looked like in the lab, the essay reconstructs the forgotten Viennese NEM system, a scientific theory in which food was measured in milk units instead of calories, and demonstrates the unlikely ways the British researchers adopted it. The exchange of scientific standards between experts resulted in a series of milk experiments in which human and animal milks were exchanged and compared. Bearing on historiographic discussions of standards and internationalism, this case study offers an intervention into how we connect the history of measurement, international politics, and living creatures. [ABSTRACT FROM AUTHOR]

This study uses an embodied political ecology framework to evaluate the structural, discursive, and visceral effects of government food assistance policy in an agrarian community in southern Mexico. During the administration of President Enrique Peña Nieto (2012-2018), the government's efforts to resolve the growing double-burden of under- and over-nutrition included the expansion of food assistance programs alongside cash transfers conditioned on health and nutritional education. A parastatal company sourced and distributed foodstuffs to community and school kitchens, where mothers prepared them into meals. This research explores how women participating in government food assistance in the agricultural community of Santa Inés del Monte, Oaxaca, evaluated the foods they received and conceptualized broader changes in their food system and community health. Qualitative research methods, including interviews, focus groups and a community survey of 87 households, were conducted in the community in 2015, 2017 and 2018. Through attention to visceral experience, this study demonstrates how sensations of taste, embodied knowledge, nutrition discourses, gendered development programs, and structural marginalization combined to produce an outcome in which mothers accepted and prepared foods in the community kitchens that did not meet their standards of food quality. However, this study also finds that participating mothers and other residents continue to conceive of direct food production—especially organic production of local heirloom crop and animal varieties—as the best way to access good nutrition. These findings suggest the need for attention to knowledge politics in the design and evaluation of culturally appropriate food security policy. [ABSTRACT FROM AUTHOR]

Food insecurity is an economic and social condition that involves individuals having limited or uncertain access to healthy food. Despite the well-intentioned efforts of both governmental and not-for-profit organizations in addressing food insecurity, well over one-in-ten households in the U.S., the wealthiest nation in the world, experience food insecurity every year. The objective of this literature review was to identify and explicate the methods and outcomes of food insecurity interventions that have been conducted among U.S. adults. This literature review identified 38 studies detailing several government programs and research interventions designed to address food insecurity. Results from the review highlight how the Supplemental Nutrition Assistance Program (SNAP), The Emergency Food Assistance Program (TEFAP), and not-for-profit food banks have demonstrated success in improving food insecurity. However, the prevalence of food insecurity among U.S. households has fluctuated without any sustained decreases that achieve a food insecurity rate that remains below 10 percent of the population. Food waste, which refers to food that is edible yet discarded at the retail or consumption phases, is rampant in the U.S., as approximately 30 percent (66.5 million tons) of edible food is wasted after leaving the farm every year. Food waste prevention efforts that involve rescuing edible, nutritious food and redistributing it to individuals who are food insecure can promote both environmental wellbeing and public health through simultaneous reductions in food waste and food insecurity. [ABSTRACT FROM AUTHOR]

This document is a compilation of various sources discussing national initiatives to enhance food security and safety in different countries. It includes information on global efforts by organizations such as the World Health Organization and the United Nations, as well as specific initiatives in countries like Argentina, Myanmar, the Philippines, South Africa, the Caribbean, and Uruguay. The sources cover a range of topics including food safety regulations, nutrition programs, agricultural development, and strategies to address food insecurity. The document provides valuable insights into the diverse approaches taken by different countries to ensure food security and safety for their populations. [Extracted from the article]

Background: Meals on Wheels (MoWs) could help adults with care and support needs continue living independently. However, many people are not aware that the service still exists in England, or that it could provide benefits beyond nutrition. Objective: Working with an existing advisory group of six people with lived experience of MoWs (an adult who uses MoWs and people who have referred a family member to MoWs), this work aimed to co‐produce knowledge translation resources (two infographics and a film) to raise awareness of MoWs and their benefits. Methods: Four participatory online workshops were held in May–July 2023, to establish perceived high‐priority themes from recent qualitative research that should be included in the resources, and preferences about message content, language, design, and how the resources should be disseminated. Findings: The most important perceived MoWs benefits that the group agreed should be included in the resources were: the importance of a nutritious meal that requires no preparation; the service's reliability/consistency; the importance of interactions in reducing social isolation, and; the ease to commence the service. The group highlighted the need for language to be nontechnical and invitational, and for images to relate to respective messages, and be inclusive of anyone who could benefit from MoWs. Several routes for dissemination were proposed, highlighting the need to disseminate to the NHS, social care organisations and community groups. Conclusion: These co‐produced resources could enhance adult social care delivery in England, as raising awareness of MoWs and their benefits could increase referral rates, so that more adults with care and support needs can benefit from the service. Patient or Public Contribution: An advisory group of people with lived experience of MoWs (users of the service and family referrers) participated in the workshops, extensively discussed the findings of earlier research, co‐produced the knowledge translation resources, and advised on the implications and future dissemination steps. The group also provided informal feedback on a draft of this manuscript. [ABSTRACT FROM AUTHOR]

College students at the City University of New York are highly mobile as they traverse the city from home to school to work and back again. Their mobility has implications for food security. This paper traces the daily food journeys of students at risk of food insecurity at the City University of New York to understand why so many of them are regularly skipping meals on campus. Their everyday food journeys highlight the limitations and insufficiencies of both public programs and campus-based efforts designed to address food security. Students' attempts and failures to procure a decent meal for themselves expose the sedentary bias embedded within food assistance programs like SNAP and the politics of profit-making, charity, and insufficiency at work in campus food environments. Looking at college student food insecurity through the lens of urban mobility demonstrates the need to enact a "politics of adequacy" on campus and raises new questions about the impact of the sedentary bias embedded in policies and programs designed to address food insecurity in the U.S. more broadly. [ABSTRACT FROM AUTHOR]

Background Food insecurity and obesity are increasing both globally and in the UK. In this review we systematically assess the lived experiences of people with obesity who are food insecure and often turn to food banks. Methods We systematically searched electronic databases from January 2007 until October 2022. Data from eligible studies were extracted and the studies assessed for quality. Thematic analysis and narrative synthesis approach was used to analyse the extracted data. Results Six themes were identified among 25 included studies, including: the financial cost of food; psychological aspects related to food insecurity; geographical access and the food environment; food practices in the home; experience of food assistance; and parental-child relationships. The cost of healthy food and psychological factors were identified as key driving factors of the relationship between food insecurity and obesity. Psychological factors such as depression, low self-esteem and stress played an important part in the lived experience of people with obesity and food insecurity. Conclusion The food environment provides context in which food decisions are made, therefore, systems change is necessary to ensure families can afford the food that enables a healthy diet. For clinicians, identification, and attention to the impact of food insecurity on people with obesity are important. [ABSTRACT FROM AUTHOR]

We study the impact of providing consulting services and major capital infusions to small‐ and medium‐sized enterprises (SMEs) in the food sector in Kenya. We exploit a quasi‐experimental design that matches treated firms with comparable firms that applied for the same support but were just short of scoring sufficient points to receive this support. Using mixed methods, this quantitative analysis is supplemented by in‐depth qualitative interviews, which provide further insights into the workings of the program. The program helped SMEs launch new products and increased numbers of employees. Interviewees described higher sales resulting from the major capital infusions they received. [ABSTRACT FROM AUTHOR]

The COVID-19 restrictions have caused economic losses that affected food availability and accessibility, thereby compromising people’s lifestyles and putting the already existing poor households into severe food insecurity. As such, national government agencies and local government units in the Philippines provided emergency cash assistance and food aid as safety nets during the pandemic to help vulnerable households cope with the impending economic crisis and to improve food security in the country. This cross-sectional study assesses the association of social safety net programs with household food security (i.e., food secure, consistently food insecure, and newly food insecure) in Cavite province, Philippines. Findings show that being beneficiaries of the Pantawid Pamilyang Pilipino Program and the Social Amelioration Program are associated with being consistently and newly food insecure. Furthermore, households that obtained food from the community pantry, a volunteer-led movement during the height of the COVID-19 pandemic are also associated with food insecurity. On the other hand, the households that were provided with food packs, across different socioeconomic conditions, are not significantly associated with food insecurity. The study also affirms that households most vulnerable to food crises in the context of COVID-19 are those who are consistently food insecure and were already exposed to critical food and dietary deprivations before the onset of the pandemic. There is much to be done to improve the safety net programs in the country. The study results can add information and policy recommendations toward strengthening the services for vulnerable population groups to withstand short- and long-term food system disruptions and eventually build food-resilient households and communities. [ABSTRACT FROM AUTHOR]

Introduction: Food prescription programs are part of the broader social prescribing movement as an approach to address food insecurity and suboptimal diet in health care settings. These programs exist amid other social services, including income-based supports and food assistance programs; however, evaluations of the interactions between these programs and pre-existing services and supports are limited. This study was embedded within a larger evaluation of the 52-week Fresh Food Prescription (FFRx) program (April 2021-October 2022); the objective of this study was to examine how program participation influenced individuals' interactions with existing income-based supports and food assistance programs. Methods: This study was conducted in Guelph, Ontario, Canada. One-to-one (n = 23) and follow-up (n = 10) interviews were conducted to explore participants' experiences with the program. Qualitative data were analyzed thematically using a constant comparative analysis. Results: Participants described their experience with FFRx in relation to existing income-based supports and food assistance programs. FFRx reportedly extended income support further to cover living expenses, allowed participants to divert income to other necessities, and reduced the sacrifices required to meet basic needs. FFRx lessened the frequency of accessing other food assistance programs. Aspects of FFRx's design (e.g. food delivery) shaped participant preferences in favour of FFRx over other food supports. Conclusion: As food prescribing and other social prescribing programs continue to expand, there is a need to evaluate how these initiatives interact with pre-existing services and supports and shape the broader social service landscape. [ABSTRACT FROM AUTHOR]

Housing, the single largest expense for low-income individuals, is inherently tied to economic security. During the COVID-19 pandemic, Hispanic/Latinx and Black communities experienced the highest rates of income loss, basic needs insecurity, and COVID-19 hospitalization and mortality. As part of an ethnographic case study, I conducted serial interviews over two years with 35 predominantly low-income Hispanic/Latinx immigrant families in one Denver, Colorado neighborhood during the COVID-19 pandemic. These interviews revealed that very few of these individuals were able to access governmental financial support as a result of limited dissemination despite facing unemployment, underemployment and rising rents. Although governmental financial support forestalled poor outcomes for many US families, these financial interventions were inaccessible for low-income Hispanic/Latinx immigrant families because of their documentation status and/or language barriers. Given no other options, families coped with their increasing economic insecurity by cutting back on non-essential items, doubling-up housing with other families, and relying on nonprofit emergency food assistance in order to maintain stable housing. These experiences highlight the need for further dissemination of information about supportive interventions, which can increase economic security among low-income immigrant families and non-English speaking communities. In tandem, policy efforts related to economic security are needed to mitigate the burden of wealth inequities through poverty-reduction programs, pathways to citizenship, and access to basic needs security – including safe and affordable housing, food security, health-promoting resources, and living wage work. [ABSTRACT FROM AUTHOR]

Although patients experiencing food insecurity commonly screen positive for a myriad of social determinants of health (SDOH) needs and chronic medical conditions influenced by diet, few studies have investigated associations within both uninsured and food insecure populations. We screened patients for food insecurity using the USDA six-item short form between October 2021 and April 2022. We then evaluated associations of food security status with nine separate SDOH needs and eight chronic medical conditions. In this cross-sectional study, of the 190 patients seen at a student-run free clinic serving patients without health insurance, 135 (71%) completed the SDOH survey. We identified chronic medical conditions via retrospective chart review and analyzed associations using multivariable logistic regressions adjusted for age and sex. Uninsured participants experiencing food insecurity (n = 22,16.3%) requested more support for: medications (adjusted odds ratio [AOR] = 7.28; 95% Confidence Interval [95% CI] = 2.33–23.2); p-value [P] = < 0.001, housing (AOR = 9.99; 95% CI = 2.29–48.7; P = 0.002), utilities (AOR = 3.94; 95% CI = 1.07–13.5; P = 0.03), mental health resources (AOR = 4.54; 95% CI = 1.66–12.5; P = 0.003), health insurance (AOR = 2.86; 95% CI = 1.09–8.22; P = 0.04), and dental care (AOR = 3.65; 95% CI = 1.26–13.3; P = 0.03). These participants were more likely to have anxiety (AOR = 3.26; 95% CI = 1.23–8.38; P = 0.02) and depression (AOR = 2.88; 95% CI = 1.01–7.80; P = 0.04) diagnoses or symptoms. We also discovered that individuals aged 18–50 experiencing food insecurity had a higher number of health conditions (AOR = 6.3455; 95% CI = 1.49–26.99; P = 0.01), underscoring the profound impact of SDOH in younger populations. Understanding the interplay between food insecurity, SDOH needs, and medical conditions informs interventions, including food distribution programs and enhanced mental health resources. [ABSTRACT FROM AUTHOR]

Background: Food insecurity (FI) is associated with negative health outcomes and increased healthcare utilization. Rural populations face increased rates of FI and encounter additional barriers to achieving food security. We sought to identify barriers and facilitators to screening and interventions for FI in rural primary care practices. Methods: We conducted a mixed-methods study using surveys and semi-structured interviews of providers and staff members from rural primary care practices in northern New England. Survey data were analyzed descriptively, and thematic analysis was used to identify salient interview themes. Results: Participants from 24 rural practices completed the survey, and 13 subsequently completed an interview. Most survey respondents (54%) reported their practices systematically screen for FI and 71% reported food needs were "very important" for their patients and communities. Time and resource constraints were the most frequently cited barriers to screening for and addressing FI in practices based on survey results. Interview themes were categorized by screening and intervention procedures, community factors, patient factors, external factors, practice factors, process and implementation factors, and impact of FI screening and interventions. Time and resource constraints were a major theme in interviews, and factors attributed to rural practice settings included geographically large service areas, stigma from loss of privacy in small communities, and availability of food resources through farming. Conclusions: Rural primary care practices placed a high value on addressing food needs but faced a variety of barriers to implementing and sustaining FI screening and interventions. Strategies that utilize practice strengths and address time and resource constraints, stigma, and large service areas could promote the adoption of novel interventions to address FI. [ABSTRACT FROM AUTHOR]

This study investigated the feasibility of in-store signage promoting sparkling water and the impact of this signage on sparkling water sales in convenience stores. We conducted a randomized control trial. Convenience stores in North Carolina. Twenty-four convenience stores in neighborhoods with a higher proportion of Supplemental Nutrition Assistance Program -eligible households. The 24 eligible stores were randomized to receive the in-store signage promoting sparkling water or to the control condition of no change. One poster was hung on the beverage cooler doors in front of the sparkling water selections at each of the 12 participating stores. Weekly sales data and fidelity checks were collected. The primary outcome measure was sales of total water, and the subanalysis was sales of sparkling water. T tests were conducted to assess changes in total water and sparkling water sales between intervention and control stores. In-store signage did not significantly increase sales of sparkling water, or all water, during the intervention. Signage alone may not be enough to impact healthy beverage purchasing, and signage should be paired with other promotional components to increase healthy beverage purchases in convenience stores. [ABSTRACT FROM AUTHOR]

Australia has a hidden but growing problem with household food insecurity, revealing the failure of conventional food infrastructures to support human flourishing. Disruptions to employment and livelihoods due to pandemic lockdowns have exacerbated household food insecurity, evincing the uneven geography of food access in countries globally, including Australia. Increasing demand for food relief had been observed prior to the COVID‐19 pandemic and has been met by food relief providers, which we consider as infrastructures of care addressing growing levels of hunger. This paper reveals COVID‐19's many impacts on the food relief sector across Metropolitan Sydney, New South Wales. It analyses both a questionnaire of food relief providers in 2022 and media articles, social media posts, reports, and websites. It provides much‐needed insights into the impacts of pandemic lockdowns on the demand for food, interruptions to food provisioning, changes to food supply, and alterations made to suppliers' ways of operating. Those insights show how infrastructures of care are place‐based, responsive, dynamic, and constrained by caring capacities. Such insights are increasingly important for understanding infrastructural failures, documenting the real extent of household food insecurity, and challenging dominant discourses of Australia as a food‐secure nation. [ABSTRACT FROM AUTHOR]

To examine the associations between food insecurity and health, access to care, affordability of care, financial burden of care, and financial hardships among US adults during the COVID-19 pandemic and examine whether the associations were less pronounced among adults with safety nets. We conducted a retrospective longitudinal cohort study using the 2020–2021 Medical Expenditure Panel Survey. Linear probability models were used to assess the associations between food insecurity in one year and the outcomes of interest in the following year while adjusting for baseline characteristics. We performed the analyses for the entire population and then conducted stratified analyses for adults with and without Supplemental Nutrition Assistance Program (SNAP) benefits or Medicaid coverage. Compared with food-secure adults, food-insecure adults were 9.1 percentage points less likely to report life satisfaction and 9.9, 10.2, and 13.2 percentage points more likely to experience delays in getting medical care, postpone or forgo medical care because of cost, and struggle with paying medical bills. Food-insecure adults were 30.4, 27.2, and 23.5 percentage points more likely to face challenges in affording necessities, paying utility bills, and meeting rent or mortgage payments on time than food-secure adults. Notably, the strengths of these associations were attenuated among adults with SNAP benefits or Medicaid coverage. Food insecurity was associated with poor health, limited access to and affordability of care, and a greater financial burden of care among US adults during the pandemic. Nevertheless, safety net programs can play a critical role in alleviating adverse consequences. [ABSTRACT FROM AUTHOR]

Objective: Referral to social and health services is a core process of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). We evaluate the feasibility and acceptability of a referral innovation implemented at two New York City WIC sites. This program aimed to improve retention by increasing WIC's perceived value by addressing unmet needs of WIC families. The two main components were needs assessment via conversation and a closed-loop referral process for WIC families with children aged 6–9 months and 18–21 months. Design: Referral outcomes from Unite Us and program data were tracked and assessed using descriptive univariate analyses. We conducted 29 in-depth interviews with caregivers and six focus groups with WIC and CBO staff. Qualitative data were analyzed using thematic framework analysis. Results: From February 2020 through January 2021, 1,675 WIC caregivers participated in a conversation about their family's needs. Four hundred sixty-one caregivers were referred to at least one service. 95 received services or benefits. In interviews, caregivers viewed referrals to other services positively but were not aware WIC could address needs holistically. In focus groups, WIC staff liked the conversation script but highlighted barriers to making referrals. CBO partners valued network participation as it increased their reach to new families. Conclusions and Implications: Our approach facilitated targeted referrals for WIC participants. It is an acceptable enhancement of the WIC referral process with potential to strengthen WIC as a community provider. Significance: What is Already Known on this Subject?: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides nutrition education, nutrition supplementation, breastfeeding support, and referrals, and is associated with improved health outcomes for participating families. What does this Study Add?: This manuscript describes the approach of and stakeholder perspectives on a novel approach to referral-making at one WIC agency. This innovation aimed to improve the existing process with closed-loop coordination through an online referral platform. The study adds to the limited research on WIC referral processes in general. [ABSTRACT FROM AUTHOR]