“Let’s Use This Mess to Our Advantage”: Calls to Action to Optimize School Nutrition Program beyond the Pandemic

Abstract

School nutrition programs mitigate food insecurity and promote healthy eating by offering consistent, nutritious meals to school-aged children in communities across the United States; however, stringent policy guidelines and contextual challenges often limit participation. During COVID-19 school closures, most school nutrition programs remained operational, adapting quickly and innovating to maximize reach. This study describes semi-structured interviews with 23 nutrition directors in North Carolina, which aimed to identify multi-level contextual factors that influenced implementation, as well as ways in which the innovations during COVID-19 could translate to permanent policy and practice change and improve program reach. Interviews were conducted during initial school closures (May–August 2020) and were deductively analyzed using the Social Ecological Model (SEM) and Consolidated Framework for Implementation Research (CFIR). Analysis elicited multiple relevant contextual factors: director characteristics (motivation, leadership style, experience), key implementation stakeholders (internal staff and external partners), inner setting (implementation climate, local leadership engagement, available resources, structural characteristics), and outer setting (state leadership engagement, external policies and incentives). Findings confirm the strength and resilience of program directors and staff, the importance of developing strategies to strengthen external partnerships and emergency preparedness, and strong support from directors for policies offering free meals to all children.

Predictors of Participation in the U.S. Department of Agriculture Summer Meal Programs: An Examination of Outreach Strategies and Meal Distribution Methods During COVID-19

“…In previous research, both participants and sponsors underscored the utility of the USDA's COVID-19 regulatory waivers. Sponsors liked the increased flexibility 23 , 24 , 25 and the ability to innovate to reach more participants. 9 , 19 Families highlighted the importance of being able to pick up multiple meals in a grab-and-go setting as they decided to participate in the program.…”

Challenges and Opportunities for Equity in US School Meal Programs: A Scoping Review of Qualitative Literature Regarding the COVID-19 Emergency

“…Some of these challenges aligned with those described in prior research on summer meal programs, but were amplified by the pandemic: limited awareness of/dissatisfaction with the program, inconvenient times for families, lack of transportation, stigma, and limited options for religious conventions or dietary needs [37,38,41,46,49,53]. Pandemic-specific challenges included supply chain issues (i.e., being unable to receive the variety of foods obtained in the past), limited communication to families about how and where to access meals, and excessive waste [37][38][39]41,[45][46][47][49][50][51][52]54] Authors described how supply chain issues exacerbated family dissatisfaction-in one study, families reported stopping the use of the school meal programs because their kids refused to eat the food provided [53]. Parents in one study reported on a variety of ways that communication could have been more equitable (e.g., signage in multiple languages, more mail notifications for households without reliable Internet) [49].…”

“…In one study, food service directors noted that they knew parents were more likely to be able to pick up meals in the evenings and over the weekend, but it was too expensive to staff in the off-hours because the union required them to pay overtime [40]. Additionally, both food service directors and families described challenges mitigating fears around disease transmission and the physical safety of both staff and families when receiving food from distribution sites [35,[39][40][41][42][43]47,50,51].…”

“…Other operational challenges included staff burnout, staff illness, limited volunteer capacity, and staff feeling underappreciated [38,40,42,[45][46][47]50]; difficulty predicting participation numbers, particularly as a result of competition with other nearby food distribution programs and federal programs such as Pandemic EBT (a USDA food assistance financial benefit issued to families to support buying groceries during the COVID-19 pandemic) [38][39][40]46,47,50,52]; financial deficits resulting from increased operational costs and unpredictable participation numbers [40,41,47,50]; and food safety concerns, such as maintaining the cold chain with deliveries [43]. Food service directors also described challenges related to the USDA waivers, such as lack of adequate resources or knowledge to implement the waivers and a lack of communication from federal and state agencies [39,42,48,[50][51][52]54].…”

“…These waivers enabled delivery of meals to homes or other easy to reach locations (e.g., parks, parking lots, homeless shelters, bus stops) in previously inaccessible community areas, providing meals through "grab and go" systems, and offering multiple days' worth of food at one time at no cost to all children. Importantly, food service directors in included studies noted that the waivers enabled them to prioritize reach to high-risk subgroups, including families with transportation limitations and low-income families who lived in areas that were not normally eligible to have a site nearby or geographically difficult to access [8,39,41,50]. In one study, parents appreciated being able to access any site within a city if they wanted to, both for convenience during working hours or to reduce stigma of being seen by neighbors [50].…”