Position of the Society for Nutrition Education and Behavior: The Importance of Emergency-Related Food and Nutrition Education Before, During, and After a Disaster.

It is the position of the Society for Nutrition Education and Behavior that for effective recovery from and resilience to disasters, it is essential that impacted individuals and communities have access to safe, nutritious, and culturally and contextually appropriate foods and beverages, and receive emergency-related food and nutrition education before, during, and after a disaster. Despite the increasing number, duration, and intensity of disasters worldwide, there is relatively limited guidance for research, policy, and practice about addressing the emergency-related food and nutrition needs of affected populations. Although nutrition emergencies tend to be understudied, emerging efforts are working to advance food and nutrition security during disaster response and recovery.

Dietary Outcomes of a Multilevel, Multicomponent, Cluster Randomized Obesity Intervention in 6 Native American Communities in the Upper Midwest and Southwest United States.

Background: Impacts of colonization on dietary intake have led to high rates of obesity and noncommunicable diseases among Native American adults. Multilevel, multicomponent (MLMC) interventions may improve dietary intake.

Objectives: To assess the impact of a MLMC obesity intervention, OPREVENT2 (Obesity Prevention and Evaluation of InterVention Effectiveness in NaTive North Americans 2; clinicaltrials.

Journey to Promoting Structural Change for Chronic Disease Prevention: Examining the Processes for Developing Policy, Systems, and Environmental Supports in Native American Nations.

Background: Obesity and chronic disease rates continue to be disproportionally high among Native Americans (NAs) compared with the US general population. Policy, systems, and environmental (PSE) changes can address the root causes of these health inequalities by supporting access to healthy food and physical activity resources.

Objective: We aim to describe the actors and processes involved in developing PSE changes supporting obesity prevention in NA Nations.

Individual- and household-level factors associated with fruit, vegetable, and dietary fiber adequacy among Native American adults in 6 reservation communities.

This study utilized baseline data collected in 2017 from the OPREVENT2 trial, which included 540 Native Americans in six Midwest and Southwest reservation communities. The objective was to identify correlates of fruit, vegetable, and dietary fiber adequacy among participants 18-75 years old who self-identified as the main food purchaser or preparer in their household. Mean daily servings of fruits and vegetables and grams of dietary fiber were quantified based on a 30-day semi-quantitative food frequency questionnaire.

Exposure to a Multilevel, Multicomponent Obesity Prevention Intervention (OPREVENT2) in Rural Native American Communities: Variability and Association with Change in Diet Quality.

The OPREVENT2 obesity prevention trial was a multilevel multicomponent (MLMC) intervention implemented in rural Native American communities in the Midwest and Southwest U.S. Intervention components were delivered through local food stores, worksites, schools, community action coalitions, and by social and community media.

Nationwide Assessment of SNAP Online Purchasing Pilot State Communication Efforts During the COVID-19 Pandemic.

Objective: To conduct a nationwide assessment of communication by participating states and Washington DC about the Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot expansion.

Design: Systematic coding of official communication from state and DC SNAP administrating agencies.

Participants: Forty-six states and DC approved to participate in the pilot as of October 2020 (n = 47).

Perceived barriers and facilitators to participating in the North Carolina Healthy Food Small Retailer Program: a mixed-methods examination considering investment effectiveness.

Objective: The North Carolina Legislature appropriated funds in 2016-2019 for the Healthy Food Small Retailer Program (HFSRP), providing small retailers located in food deserts with equipment to stock nutrient-dense foods and beverages. The study aimed to: (1) examine factors facilitating and constraining implementation of, and participation in, the HFSRP from the perspective of storeowners and (2) measure and evaluate the impact and effectiveness of investment in the HFSRP.

Design: The current analysis uses both qualitative and quantitative assessments of storeowner perceptions and store outcomes, as well as two innovative measures of policy investment effectiveness.

Feeding Children and Maintaining Food Service Operations during COVID-19: A Mixed Methods Investigation of Implementation and Financial Challenges.

The United States Department of Agriculture (USDA) National School Lunch and Breakfast Programs are critical for the health and food security of U.S. schoolchildren, but access to these programs was disrupted by COVID-19 pandemic-related school closures in spring 2020.

Qualitative perspectives of the North Carolina healthy food small retailer program among customers in participating stores located in food deserts.

Background: The North Carolina Healthy Food Small Retailer Program (NC HFSRP) was established through a policy passed by the state legislature to provide funding for small food retailers located in food deserts with the goal of increasing access to and sales of healthy foods and beverages among local residents. The purpose of this study was to qualitatively examine perceptions of the NC HFSRP among store customers.

Methods: Qualitative interviews were conducted with 29 customers from five NC HFSRP stores in food deserts across eastern NC.

USDA Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Vendor Criteria: An Examination of US Administrative Agency Variations.

The food retail environment has been directly linked to disparities in dietary behaviors and may in part explain racial and ethnic disparities in pregnancy-related deaths. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), administered by the United States Department of Agriculture, is associated with improved healthy food and beverage access due to its requirement for minimum stock of healthy foods and beverages in WIC-eligible stores. The selection and authorization criteria used to authorize WIC vendors varies widely from state to state with little known about the specific variations.

A four-year observational study to examine the dietary impact of the North Carolina Healthy Food Small Retailer Program, 2017-2020.

Background: The North Carolina (NC) Healthy Food Small Retailer Program (HFSRP) was passed into law with a $250,000 appropriation (2016-2018) providing up to $25,000 in funding to small food stores for equipment to stock healthier foods and beverages. This paper describes an observational natural experiment documenting the impact of the HFSRP on store food environments, customers' purchases and diets.

Methods: Using store observations and intercept surveys from cross-sectional, convenience customer samples (1261 customers in 22 stores, 2017-2020; 499 customers in 7 HFSRP stores, and 762 customers in 15 Comparison stores), we examined differences between HFSRP and comparison stores regarding: (1) change in store-level availability, quality, and price of healthy foods/beverages; (2) change in healthfulness of observed food and beverage purchases ("bag checks"); and, (3) change in self-reported and objectively-measured (Veggie Meter®-assessed skin carotenoids) customer dietary behaviors.

Food Insecurity Among College Students: An Analysis of US State Legislation Through 2020.

Many US college students experience food insecurity (FI). Given most students are excluded from receiving federal nutrition assistance, additional efforts are needed to alleviate student FI. This perspective discusses proposed and enacted state statutes, resolutions, and bills addressing college FI to date, which range in depth, breadth, and success.

Feeding Students During COVID-19-Related School Closures: A Nationwide Assessment of Initial Responses.

Objective: To conduct a nationwide assessment of child nutrition administrative agencies' responses to meal service provision during coronavirus disease 2019-related school closures.

Design: Systematic coding of government websites (February-May 2020) regarding school meal provision in all 50 US states and the District of Columbia, 5 US territories, and the US Department of Interior Bureau of Indian Education.

Participants: All US jurisdictions (N = 57).

A Model Depicting the Retail Food Environment and Customer Interactions: Components, Outcomes, and Future Directions.

The retail food environment (RFE) has important implications for dietary intake and health, and dramatic changes in RFEs have been observed over the past few decades and years. Prior conceptual models of the RFE and its relationships with health and behavior have played an important role in guiding research; yet, the convergence of RFE changes and scientific advances in the field suggest the time is ripe to revisit this conceptualization. In this paper, we propose the Retail Food Environment and Customer Interaction Model to convey the evolving variety of factors and relationships that convene to influence food choice at the point of purchase.

Healthy Food Retail during the COVID-19 Pandemic: Challenges and Future Directions.

Disparities in dietary behaviors have been directly linked to the food environment, including access to retail food outlets. The Coronavirus Disease of 2019 (COVID-19) pandemic has led to major changes in the distribution, sale, purchase, preparation, and consumption of food in the United States (US). This paper reflects on those changes and provides recommendations for research to understand the impact of the pandemic on the retail food environment (RFE) and consumer behavior.

Addressing College Food Insecurity: An Assessment of Federal Legislation Before and During Coronavirus Disease-2019.

Research conducted before coronavirus disease-2019 illustrated high rates of food insecurity among college students. The pandemic has likely increased student food insecurity because of factors like unemployment and closure of campus resources, and many students cannot access federal food assistance because of long-standing student restrictions. This perspective reviews federal legislation on college food insecurity introduced in the 116th legislative session (2019-2020) immediately before coronavirus disease-2019 in the US, as well as pandemic-related stimulus bills and their implications for future policies and practice.

Strengthening national nutrition research: rationale and options for a new coordinated federal research effort and authority.

Background: The US faces remarkable food and nutrition challenges. A new federal effort to strengthen and coordinate nutrition research could rapidly generate the evidence base needed to address these multiple national challenges. However, the relevant characteristics of such an effort have been uncertain.

Food System Workers are the Unexpected but Under Protected COVID Heroes.

Coronavirus disease 2019 (COVID-19) poses an occupational health risk to food system workers including farmers/producers, grocery store workers, emergency food system staff and volunteers (e.g., food pantry workers), and others.