Assessing the Implementation of US Programs and Policies for the Prevention of Food Insecurity and Obesity in Schools

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The hunger safety net plays an important role in helping to alleviate hunger for the one in five US children who experiences food insecurity. Historically, food assistance programs have focused on ensuring that children have sufficient access to calories and not necessarily the nutritional quality of food provided. However, in response to the coexistence of food insecurity and the risk of obesity within the same populations, there is a growing emphasis on aligning food security and obesity prevention initiatives by simultaneously promoting food access and nutrition. Strategic design and implementation of policy and program interventions that address both food insecurity and nutrition for children are therefore imperative to make certain that the food being provided does not contribute to health disparities. Alignment of food security and nutrition initiatives can also make better use of limited public health resources for maximum benefits to health outcomes. The proposed project considers how to improve the implementation of initiatives for child nutrition and food security in schools. Aim 1 quantifies the relationship between implementation supports (e.g., training and equipment) and school meal quality using a nationally representative sample of schools. This work explores whether better implementation supports for assisting schools in adoption of the nutrition standards for meals associated with the Healthy, Hunger-Free Kids Act of 2010 resulted in improved nutritional quality of meals. Using a nationally representative sample of public schools, aim 2 gathers information on an understudied, yet widely used, program to address food insecurity in schools: weekend backpack programs. These programs provide income-eligible students with food to take home on Fridays; however, they were not designed based on scientific evidence and the existing evidence-base for impact on food security and nutrition is extremely limited. This work will collect information on weekend backpack programs including data on prevalence, nutritional quality and other characteristics to determine if implementation factors are associated with more nutritious offerings. Findings may help to identify ways to improve program design, implementation and nutritional impact. Aim 3 will explore potential disparities in the nutritional quality of weekend backpack program contents by US region, urbanicity, and poverty-level. This work will determine if certain populations may be at disproportionate risk for participating in low quality programs that could contribute to poor nutrition and health disparities. Findings may help to promote equitable adoption of programs. The research will be achieved through committed mentorship of my sponsors, guidance from my dissertation advisory committee, and ample educational resources from the institutional environment and beyond. I will also participate in training and education through courses, seminars, meetings, webinars, and conferences.