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Background: The purpose of this study was to assess the school breakfast environment in rural Appalachian schools to inform school environment intervention and policy change. Methods: A total of 4 rural schools with fourth- and fifth-grade students in East Tennessee were assessed. A cross-sectional descriptive examination of the school food environment where food service managers submitted school menus, production sheets, and vendor bid sheets as part of the dietary data collection protocol for a school-based nutrition intervention study. The school breakfast environment was characterized in terms of calories, fat, saturated fat, and fiber from foods served on a per person basis using menus entered into Nutrient Data Systems for Research and production sheets for amounts of each food item served. Food items were grouped by the meal components of the School Breakfast Program (SBP) and ranked according to the items served most frequently. Results: Total fat provided slightly less than half the calories (43%); 15% of calories were from saturated fat. The top-ranked foods for each meal component were biscuits, sausage, 2% milk, orange juice, and gravy. Conclusions: Results suggest that clearer policies or regulations for the SBP are warranted to support policy efforts to promote childhood health. These should include technical assistance and provision of resources for school food service managers to provide low-fat meal options. Further research is needed to determine whether what is offered at school breakfast is actually consumed and how that might affect children's weight because of the high fat content. (Contains 2 tables.)

Objectives, We examined changes in meal selection by patrons of university food-service operations when nutrition labels were provided at the point of selection. Methods. We used a quasi-experimental, single-group, interrupted time-series design to examine daily sales before, during, and after provision of point-of-selection nutrition labels. Piecewise linear regression was employed to examine changes in the average energy content of entrees and a paired t test was used to detect differences in sales across the periods. Results. The average energy content of entrees purchased by patrons dropped immediately when nutrition labels were made available at point of selection and increased gradually when nutrition information was removed. There was no significant change in number of entrees sold or in revenues between the 2 periods. Conclusions. Use of nutrition labels reduced the average energy content of entrees purchased without reducing overall sales. These results provide support for strengthening the nutrition labeling policy in food-service operations. (Am J Public Health. 2009;99:2001-2005. doi: 10.2105/AJPH.2008.153205)

Food insecurity has been associated with diverse developmental consequences for U.S. children primarily from cross-sectional studies. We used longitudinal data to investigate how food insecurity over time related to changes in reading and mathematics test performance, weight and BMI, and social skills in children. Data were from the Early Childhood Longitudinal Study-Kindergarten Cohort, a prospective sample of -21,000 nationally representative children entering kindergarten in 1998 and followed through 3rd grade. Food insecurity was measured by parent interview using a modification of the USDA module in which households were classified as food insecure if they reported [greater than or equal to] 1 affirmative response in the past year. Households were grouped into 4 categories based on the temporal occurrence of food insecurity in kindergarten and 3rd grade. Children's academic performance, height, and weight were assessed directly. Children's social skills were reported by teachers. Analyses examined the effects of modified food insecurity on changes in child outcomes using lagged, dynamic, and difference (i.e., fixed-effects) models and controlling for child and household contextual variables. In lagged models, food insecurity was predictive of poor developmental trajectories in children before controlling for other variables. Food insecurity thus serves as an important marker for identifying children who fare worse in terms of subsequent development. In all models with controls, food insecurity was associated with outcomes, and associations differed by gender. This study provides the strongest empirical evidence to date that food insecurity is linked to specific developmental consequences for children, and that these consequences may be both nutritional and nonnutritional. KEY WORDS: * food insecurity * child development * overweight * academic * longitudinal

The purpose of this qualitative study is to elucidate how food insecurity affects diabetes self-management among adults with type 2 diabetes mellitus (T2DM). Eleven persons with T2DM who screened as food insecure were recruited from a patient pool of a healthcare system in South Carolina. Interview recordings were transcribed, blinded, and imported into NVivo. Participant ages ranged from 36 to 66 years, and included nine women, and seven African American participants. Three major themes emerged: (1) coping with food insecurity; (2) strategies used to manage T2DM within the context of food insecurity; and (3) receiving unrealistic advice from providers. [ABSTRACT FROM AUTHOR]

Food systems students can benefit from a critically reflective, anti-oppressive, and culturally responsive classroom. In this paper, we share 37 students' reflections on their experiences in two such courses. Qualitative analysis was done in NVIVO to identify emergent themes. Students connected personal experiences of trauma, oppression, grief, as well as nourishment, resistance, and self – care to food systems case study themes. Students' reflections demonstrated how anti-oppressive and culturally responsive practices created inclusive and safe spaces for students to grapple with complex issues and share vulnerable personal experiences that deepened their learning. [ABSTRACT FROM AUTHOR]

Cultural frames, or myths we use to communicate, shape how we understand social problems, such as child hunger. In 48 interviews, we identified metaphors and myths, such as "the poor will always be with you," "meat product," and "butterfly effects" that point to cultural frames of child hunger. Three different frames were identified – the welfare state, the free market, and the resilience and resistance frame. Speakers used frames to communicate different types of social responsibility for hunger. Understanding which frames we invoke with our stories may allow for more effective collaborative action to end child hunger. [ABSTRACT FROM AUTHOR]

Eliminating childhood hunger and supporting households in need of food are US policy priorities, because food insecurity in the US remains elevated postrecession. The objective of this study was to bring a systems science lens to the issue of childhood food security. We used a qualitative systems mapping process (a “soft” systems science approach) to develop and describe a systems framework for childhood food security using a visual map. A first step was accomplished through convening a facilitated expert workshop in which we developed the systems map shown here. The systems map contains information on the sectors (e.g., government, private etc.), actors (e.g., children, caregivers, etc.), programs and policy levers (e.g., food and nutrition assistance programs, public goods and services, etc.), and flows (e.g., money, food, social support, etc.) pertinent to childhood food security. Situated at the center of the map is the interrelationship of competing demands and resources for caregivers and children. We use the systems map to discuss how qualitative and quantitative systems science techniques can be applied to further advance childhood food security research by defining a research agenda. The present article serves as a call to action to invest in systems science research on childhood food security. [ABSTRACT FROM AUTHOR]

Objectives: In 2014, 30% of African-American households with children had low or very low food security, a rate double that of white households with children. A household has low food security if its members experience food shortages and reductions in food quality attributable to a lack of household resources or access and very low food security if its members also experience reductions in food intake and disrupted eating patterns. Households that are either low or very low food secure are known collectively as food insecure. We examined the association between the severity of household food insecurity and reports of lifetime racial discrimination among a sample of food-insecure African-American households in South Carolina. Design: Data were collected from 154 African-American respondents. Food insecurity was measured using the US Department of Agriculture's Household Food Security Survey Module. Lifetime racial discrimination was measured using the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV). We used logistic regression to test the association between severity of food insecurity (low vs. very low food secure), PEDQ-CV score and PEDQ-CV subscales. All models were adjusted for demographic and socioeconomic variables. Results: A one-unit increase in the frequency of lifetime racial discrimination was associated with a 5% increase in the odds of being very low food secure (odds ratio (OR) 1.05, P < .05). More reports of discrimination that were stigmatizing or devaluing (OR 1.16, P < .05), took place at a workplace or school (OR 1.15, P < .05) or were threatening or aggressive (OR 1.39, P < .05) increased the odds of being very low food secure. More reports of racial discrimination that were excluding or rejecting did not significantly increase the odds of being very low food secure (OR 1.07, P > .05). Conclusions: Severity of household food insecurity is associated with lifetime racial discrimination among African-American households in South Carolina. [ABSTRACT FROM AUTHOR]

This article explores how parents and school personnel perceived and experienced parental involvement at a school serving a low-income mainly black population. The first author recorded detailed field notes (n=70) and conducted in-depth interviews with parents (n=20) and school personnel (n=20) over a three-year period. Despite rhetoric of inclusion, the school’s policies and practices restricted parents to predetermined and acceptable roles of parental involvement. Ideologies of colorblind racism undergirded school policies and practices, thereby maintaining current social hierarchies of white privilege and racial minority disadvantage. This colorblind approach to parental involvement created barriers to the development of authentic relationships and, therefore, the development of a positive, mutual, and respectful relationship between student families and school personnel. Naming racism and recognizing its impact on the school environment are important first steps towards change. School staff and teachers must be willing to interrogate their participation in maintaining social hierarchies. [ABSTRACT FROM AUTHOR]

Food insecurity affects one fifth of U.S. households with children and tends to be associated with low income, minority race/ethnicity, and low educational attainment—difficult groups to recruit to population-based studies. We present successful recruitment strategies and participation data after enrolling 544 participants encompassing 3 food security categories from 4 types of food venues throughout South Carolina. Eligible persons were most likely to participate if they had lower food security, lived in an urban area, and were recruited over the phone. In multivariate logistic models, participation predictors were screening mode and recruitment site, with the highest yield at family-oriented emergency food assistance sites. [ABSTRACT FROM PUBLISHER]