The relationship between community food environment around schools and student meal participation: the role of school CEP participation status.

Background: Despite the many benefits of school meals, not all students participate. One reason students may not participate in school meals is because they instead purchase breakfast or lunch from food outlets located around schools that mostly carry unhealthy items. This study examined whether school participation in the Community Eligibility Provision (CEP), which allows qualifying schools to serve free meals to all students, moderated the association between the community food environment around schools and student meal participation.

The association between unhealthy dietary behaviors and participation in the Supplemental Nutrition Assistance Program (SNAP): No evidence in support of the self-selection hypothesis.

Supplemental Nutrition Assistance Program (SNAP) participants tend to have unhealthier dietary consumption compared to eligible non-participants. It has been suggested, though never empirically tested, that individuals who enroll in SNAP may have unhealthy diets prior to program participation. Using a longitudinal cohort study design, we examined the association between low-income adults' SNAP participation status and prior dietary behaviors to test the argument that individuals with unhealthier dietary consumption self-select into SNAP.

Emergency Free School Meal Distribution During the COVID-19 Pandemic in High-Poverty Urban Settings.

Background: The coronavirus disease 2019 pandemic triggered nationwide school closures in March 2020, putting millions of children in the United States who were reliant on subsidized school meals at risk of experiencing hunger. In response, the US Department of Agriculture mobilized the Summer Food Service Program and Seamless Summer Option program to provide emergency free school meals. There is a need to investigate the effectiveness of these programs in covering underresourced communities during the pandemic.

Food Environments Within and Outside of Schools Play a Critical Role in Curtailing the Rise in Obesity among School-Aged Children over Time.

Background: Sound evidence for effective community-based strategies is needed to curtail upward trends in childhood obesity in the United States (US).

Objectives: The aim of the study was to assess the association between school and community food environments and the prevalence of obesity over time.

Methods: Data were collected from K-12 schools in 4 low-income New Jersey cities in the US.

The relationship between changes in neighborhood physical environment and changes in physical activity among children: a prospective cohort study.

Background: Physical activity (PA) is associated with positive health outcomes over the entire life course. Many community-based interventions that promote PA focus on implementing incremental changes to existing facilities and infrastructure. The objective of this study was to determine if such upgrades were associated with increases in children's PA.

Improvements in School Food Offerings over Time: Variation by School Characteristics.

The 2010 Healthy, Hunger-Free Kids Act (HHFKA) improved the nutritional quality of food served in schools. This longitudinal study examined school food offerings over time from school year 2010-11 to 2017-18 in public schools (n = 148) in four New Jersey cities. Six food indices were used to assess the number of healthy and unhealthy items offered as part of the National School Lunch Program (NSLP), in vending machines, and à la carte (i.

Differential Associations Between Changes in Food Environment and Changes in BMI Among Adults Living in Urban, Low-Income Communities.

Background: Food environments can contribute to excess weight gain among adults, but the evidence is mixed.

Objectives: This longitudinal study investigated the associations between changes in the food environment and changes in BMI in adults and whether changes in the food environment differentially impact various subgroups.

Methods: At 2 time points, BMI was calculated using self-reported height and weight data from 517 adults (mean age, 41 years) living in 4 New Jersey cities.

Schools' Participation in the Community Eligibility Provision Affects Students' Receipt of Emergency Benefits during the COVID-19 Pandemic.

Pandemic Electronic Benefits Transfer (P-EBT) benefits were intended for families of school children who lost access to free or reduced-price school meals (FRPMs) during the COVID-19 pandemic-related school closures. In high-poverty communities, all students from schools participating in the Community Eligibility Provision (CEP) were automatically eligible for P-EBT benefits; in non-CEP schools, only students already participating in FRPMs-for which their parents submitted an individual application-were eligible for P-EBT benefits. Using publicly available data from 105 K-12 public schools located in 4 sizeable low-income New Jersey (NJ) cities, this study investigated the association between school CEP participation status and the reach of P-EBT benefits for eligible students.

Impact Of The New Jersey COVID-19 Temporary Emergency Reciprocity Licensure Program On Health Care Workforce Supply.

New Jersey's COVID-19 Temporary Emergency Reciprocity Licensure program provided temporary licenses to more than 31,000 out-of-state health care practitioners. As one of the first COVID-19 hot spots in the US, New Jersey is uniquely positioned to provide insights on enabling an out-of-state health care workforce through temporary licensure to address critical, ongoing concerns about health care workforce supply. In January 2021 we surveyed New Jersey temporary licensees.

Active commuting to school: A longitudinal analysis examining persistence of behavior over time in four New Jersey cities.

Evidence suggests that healthy behaviors initiated during childhood may continue over time. The objective of this study was to determine whether active commuting to/from school (ACS) at baseline predicted continued ACS at follow-up two to five years later. Two cohorts of households with 3-15 year-olds in four low-income New Jersey cities were randomly sampled and followed for two to five year periods between 2009 and 2017.

Do Parental Perceptions of the Nutritional Quality of School Meals Reflect the Food Environment in Public Schools?

(1) Background: It is unknown whether parents' perception of school meals, a determinant of student meal participation, align with the nutritional quality of meals served in schools. This study compares the healthfulness of foods offered in schools with parental perception of school meals at those same schools. (2) Method: Parents were asked to rate the healthfulness of school meals at their child's school.

Evidence That Changes in Community Food Environments Lead to Changes in Children's Weight: Results from a Longitudinal Prospective Cohort Study.

Background: Strategies to improve the community food environment have been recommended for addressing childhood obesity, but evidence substantiating their effectiveness is limited.

Objective: Our aim was to examine the impact of changes in availability of key features of the community food environment, such as supermarkets, small grocery stores, convenience stores, upgraded convenience stores, pharmacies, and limited service restaurants, on changes in children's body mass index z scores (zBMIs).

Design: We conducted a longitudinal cohort study.

Parental Perceptions of the Nutritional Quality of School Meals and Student Meal Participation: Before and After the Healthy Hunger-Free Kids Act.

Objectives: To examine (1) parental perceptions of school meals and (2) student meal participation before and after the implementation of the Healthy Hunger-Free Kids Act (HHFKA).

Design: Data were collected from telephone surveys of 2 independent cross-sectional panels in New Jersey (2009-2010 and 2016-2017).

Participants: Households with children aged 7-18 years (pre-HHFKA: n = 1,027; post-HHFKA: n = 324).

Healthier school food and physical activity environments are associated with lower student body mass index.

School food and physical activity (PA) environments can influence children's dietary and physical activity behaviors. However, evidence on whether school environment is associated with students' weight status is less definitive. In this study, we examined the association between students' body mass index (BMI) and measures of school food and PA environments.

The Special Supplemental Nutrition Program for Women, Infants, and Children Spillover Effect: Do Siblings Reap the Benefits?

Background: Participation in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) among 0- to 5-year-old children is associated with healthier diets. Extension of dietary benefits to older, age-ineligible children (5-18 years old) residing in WIC households has not been fully investigated.

Objective: Examine the association between household WIC participation and dietary behaviors of age-ineligible children.

The Policy and Practice Legacy of the New Jersey Medicaid ACO Demonstration Project.

The New Jersey Medicaid Accountable Care Organization (ACO) Demonstration was created with a unique combination of features regarding ACO geography, involvement of managed care organizations (MCOs), and shared savings parameters. Ultimately, the Demonstration did not lead to a sustainable accountable care financing model and shared savings were deemphasized. Instead, the ACOs evolved into community health coalitions focused on coordinating and enhancing a wide range of activities in partnership with state government, private health systems, community leaders, and MCOs.

Community food environment moderates association between health care provider advice to lose weight and eating behaviors.

Patients who receive weight loss advice from a health care provider (HCP) are more likely to eat healthy. The food environment affects eating behaviors. This study explored how the community food environment may moderate the relationship between HCP advice to lose weight and eating behaviors.

Healthy Food Access in Low-Income High-Minority Communities: A Longitudinal Assessment-2009-2017.

Disparities in healthy food access are well documented in cross-sectional studies in communities across the United States. However, longitudinal studies examining changes in food environments within various neighborhood contexts are scarce. In a sample of 142 census tracts in four low-income, high-minority cities in New Jersey, United States, we examined the availability of different types of food stores by census tract characteristics over time (2009-2017).

Accuracy of Parent-Measured and Parent-Estimated Heights and Weights in Determining Child Weight Status.

This cohort study assesses whether parent measurements of children’s height and weight are more accurate than their respective estimates for determining weight status and how both compare with professionally measured data.

School Food and Physical Activity Environment: A Longitudinal Analysis of Four School Districts in New Jersey.

Purpose: Exposures to favorable environments in childhood, including those in schools, are associated with healthy habits among children. In this study, we developed a series of indices aimed at measuring students' exposure to different dimensions of the school food and physical activity (PA) environment. We implemented these indices to investigate how different aspects of the school food and PA environment changed over time and examined their correspondence with known changes in relevant policies and programs.

Participation in the Supplemental Nutrition Assistance Program and Dietary Behaviors: Role of Community Food Environment.

Background: The United States Department of Agriculture's Supplemental Nutrition Assistance Program (SNAP) is the country's largest nutrition assistance program for low-income populations. Although SNAP has been shown to reduce food insecurity, research findings on the diet quality of program participants are inconsistent.

Objective: This study evaluated whether the community food environment is a potential moderator of the association between SNAP participation and eating behaviors.

Predicted Impact of the Food and Drug Administration's Menu-Labeling Regulations on Restaurants in 4 New Jersey Cities.

Objectives: To determine the proportion of restaurants that will be required to post calorie information under the Food and Drug Administration's menu-labeling regulations in 4 New Jersey cities.

Methods: We classified geocoded 2014 data on 1753 restaurant outlets in accordance with the Food and Drug Administration's guidelines, which will require restaurants with 20 or more locations nationwide to post calorie information. We used multivariate logistic regression analyses to assess the association between menu-labeling requirements and census tract characteristics.

Competencies for engaging high-needs patients in primary care.

Background: Patients who heavily utilize hospitals and emergency departments frequently have complex needs requiring services spanning medical, behavioral, and social service sectors. This study identifies essential competencies for caring for high-needs patients and highlights their importance to primary care delivery.

Methods: Transcripts of in-depth interviews with 30 clinical and administrative staff at 23 complex care programs across the United States were analyzed using standard qualitative techniques.

Impact of the 2010 US Healthy, Hunger-Free Kids Act on School Breakfast and Lunch Participation Rates Between 2008 and 2015.

Objectives: To evaluate National School Lunch Program (NSLP) and School Breakfast Program (SBP) participation over a 7-year period before and after the implementation of the 2010 Healthy, Hunger-Free Kids Act (HHFKA), which required healthier school lunch options beginning in school year (SY) 2012-2013 and healthier school breakfast options beginning in SY2013-2014.

Methods: Data were gathered from low-income, high-minority public schools in 4 New Jersey cities. We conducted longitudinal analyses of annual average daily participation (ADP) in school meals among enrolled students overall and among those eligible for free or reduced-price meals.

Patterns of food and physical activity environments related to children's food and activity behaviors: A latent class analysis.

Relationships between food and physical activity (PA) environments and children's related behaviors are complex. Latent class analyses derived patterns from proximity to healthy and unhealthy food outlets, PA facilities and parks, and counts of residential dwellings and intersections. Regression analyses examined whether derived classes were related to food consumption, PA, and overweight among 404 low-income children.