SEARCHSYSTEMATIC_REVIEWpublic health, nutrition

systematic_review·public health, nutrition, pediatrics, systematic review, epidemiology·PMC10490348

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

Nutrients · 7 authors, 7 centres

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TL;DR

This scoping review synthesized qualitative evidence on the implementation of US emergency school meal programs during the COVID-19 pandemic.

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This scoping review synthesized 21 qualitative and mixed-methods studies on US emergency school meal programs during COVID-19 school closures. The review used the Getting to Equity (GTE) framework to analyze how programs adapted to distribute meals. The review notes that data were most robust for reducing deterrents, while evidence on improving social and economic resources was limited. Limitations include the exclusive focus on qualitative data and the rapid study design during the pandemic. The implications suggest these insights can inform policy to optimize budgets, increase equitable reach, and improve access during future out-of-school times.

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systematic_review

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public health

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AI pipeline

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ORIGINAL PAPER

PMC10490348

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

Nutrients

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ABSTRACT

The emergency school meals program provided free meals to children in the United States (US) during COVID-19-related school closures. This scoping review aims to synthesize the existing qualitative empirical evidence published between March 2020 and January 2023 on the operations and utilization of emergency school meal programs during the pandemic. Qualitative, US-based peer-reviewed literature was collected from three sources: (1) parent review of all federal nutrition assistance programs; (2) systematic search of four databases; and (3) manual search of grey literature. Identified scientific articles and grey literature reports ( n = 183) were uploaded into Covidence and screened for duplicates and inclusion/exclusion criteria. Our final sample included 21 articles/reports, including 14 mixed methods and seven qualitative-only projects. Articles spanned all U.S. states. Articles had similar research questions to understand school meals and/or general food access during COVID-19, with an emphasis on long-term policy implications. Hybrid deductive/inductive analytic coding was used to analyze data, utilizing domains from the Getting to Equity Framework (GTE). GTE considers multi-level factors that influence nutrition behavior while centering more equitable pathways to improve nutrition security and reduce adverse health. Findings were sorted into two categories: operational challenges during the pandemic and solutions to address inequities in school meal distribution during and after the pandemic, particularly during school closures such as summers or future emergencies. Key challenges related to supply chain issues, safety, and balancing families’ needs with limited staff capacity. Programs addressed equity by (a) reducing deterrents through federally issued waivers and increased communications which allowed the serving of meals by programs to families who previously did not have access, (b) building community capacity through collaborations and partnerships which allowed for increased distribution, and (c) preparing and distributing healthy options unless barriers in supply chain superseded the effort. This review highlights the importance of emergency school meal programs and provides insights into addressing challenges and promoting equity in future out-of-school times. These insights could be applied to policy and practice change to optimize program budgets, increase reach equitably, and improve access to nutritious meals among populations at highest risk for nutrition insecurity.

CITATION EXPORT

Kaitlyn Harper, Bree Bode, Kritika Gupta et al.. Challenges and Opportunities for Equity in US School Meal Programs: A Scoping Review of Qualitative Literature Regarding the COVID-19 Emergency. Nutrients. (2023). https://doi.org/10.3390/nu15173738

AUTHORS

7 · 7 CENTRES

Kaitlyn Harper, Bree Bode, Kritika Gupta, Ally Terhaar, Aysegul Baltaci, Yuka Asada, Hannah Lane

1Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21218, USA
2Michigan Fitness Foundation, Lansing, MI 48906, USA
3Department of Nutrition & Hospitality Management, University of Mississippi, Oxford, MS 38677, USA
4Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63103, USA
5Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
6Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60607, USA
7Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC 27708, USA; [email protected]

EDITOR / REVIEWER

Amanda N. Szabo-Reed