Early care and education (ECE) providers play a critical role in supporting infant and young child feeding (IYCF) practices for US children. This systematic review synthesizes literature on IYCF interventions and curricula for training ECE providers.
Method
Searches were conducted across 5 databases. Eligible studies were published in the US in English through April 2024. Studies addressed infant feeding in ECE and policies, practices, or training related to breastfeeding practices in ECE.
Results
Fourteen studies were identified. Most IYCF training was in the context of obesity prevention. Training approaches included multimodal education, online platforms, opportunities for peer learning and support, ongoing technical assistance, and external motivators to encourage and sustain practices.
Discussion
Effective training approaches embedded ongoing external supports and motivators (e.g., the availability of technical support or refresher training and direct support and coaching via phone calls, emails, and on-site visits). A barrier was ECE providers’ perception of human milk feeding training as irrelevant outside the context of infant care. Research limitations included a lack of comparison groups in testing interventions and vague dose exposure and assessment definitions.
Conclusions and Implications
A centralized repository could advance national scale-up. Findings suggest external stakeholders with authority, acting as champions, increase implementation of supportive human milk feeding practices in IYCF training.
{"title":"Systematic Review of Human Milk Feeding Practices and Policies in Infant and Young Child Feeding Trainings for Early Care and Education Providers","authors":"Kathryn Wouk PhD, MS, IBCLC , Jessica Bridgman MPH, RDN, LDN , Daina Huntley MPH, CHES , Cinya Brand MPH, CHES , Natsumi Koyama MPH , Stacy Torian MLIS, MA , Aunchalee E.L. Palmquist PhD, IBCLC","doi":"10.1016/j.jneb.2025.05.198","DOIUrl":"10.1016/j.jneb.2025.05.198","url":null,"abstract":"<div><h3>Introduction</h3><div>Early care and education (ECE) providers play a critical role in supporting infant and young child feeding (IYCF) practices for US children. This systematic review synthesizes literature on IYCF interventions and curricula for training ECE providers.</div></div><div><h3>Method</h3><div>Searches were conducted across 5 databases. Eligible studies were published in the US in English through April 2024. Studies addressed infant feeding in ECE and policies, practices, or training related to breastfeeding practices in ECE.</div></div><div><h3>Results</h3><div>Fourteen studies were identified. Most IYCF training was in the context of obesity prevention. Training approaches included multimodal education, online platforms, opportunities for peer learning and support, ongoing technical assistance, and external motivators to encourage and sustain practices.</div></div><div><h3>Discussion</h3><div>Effective training approaches embedded ongoing external supports and motivators (e.g., the availability of technical support or refresher training and direct support and coaching via phone calls, emails, and on-site visits). A barrier was ECE providers’ perception of human milk feeding training as irrelevant outside the context of infant care. Research limitations included a lack of comparison groups in testing interventions and vague dose exposure and assessment definitions.</div></div><div><h3>Conclusions and Implications</h3><div>A centralized repository could advance national scale-up. Findings suggest external stakeholders with authority, acting as champions, increase implementation of supportive human milk feeding practices in IYCF training.</div></div>","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 10","pages":"Pages 943-961"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jneb.2025.09.001
Lauren Haldeman PhD (Editor in Chief)
{"title":"Building Healthier Communities Through Online Nutrition Education","authors":"Lauren Haldeman PhD (Editor in Chief)","doi":"10.1016/j.jneb.2025.09.001","DOIUrl":"10.1016/j.jneb.2025.09.001","url":null,"abstract":"","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 10","pages":"Page 901"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jneb.2025.06.009
Stephanie L. Silveira PhD , Sarah E. Deemer PhD , EvaClaire Synkowski MS
Objective
Test an intervention promoting fruit and vegetable (F&V) intake among persons with multiple sclerosis.
Methods
The study was a prepost single group clinical trial in which weeks 1–4 included daily logging into an application to report attainment of 800 g F&V goal, F&V variety, and reading of educational content. In weeks 4–8, participants only logged F&V goals and variety (NCT05712408). Primary measures included feasibility, acceptability, and change in diet behavior measured using Healthy Eating Index scores, metabolic health biomarkers, body composition, cognition, and multiple sclerosis symptoms. A paired sample t test and Wilcoxon signed rank test were conducted to assess efficacy outcomes of interest.
Results
Fourteen participants completed the study, and all rated the overall program as excellent or good. Analyses indicated significant positive changes in Healthy Eating Index Total (P = 0.001), vegetable (P = 0.04), fruit (P = 0.004), and whole fruit (P = 0.01) component scores, blood glucose (P = 0.04), and mental health-related quality of life (P = 0.03).
Conclusions and Implications
This study provides evidence regarding the feasibility, acceptability, and preliminary efficacy of an online diet program promoting F&V intake among persons with multiple sclerosis.
{"title":"Feasibility, Acceptability, and Preliminary Efficacy of an Online Diet Intervention for Promoting Fruit and Vegetable Intake Among Persons With Multiple Sclerosis","authors":"Stephanie L. Silveira PhD , Sarah E. Deemer PhD , EvaClaire Synkowski MS","doi":"10.1016/j.jneb.2025.06.009","DOIUrl":"10.1016/j.jneb.2025.06.009","url":null,"abstract":"<div><h3>Objective</h3><div>Test an intervention promoting fruit and vegetable (F&V) intake among persons with multiple sclerosis.</div></div><div><h3>Methods</h3><div><span>The study was a prepost single group clinical trial in which weeks 1–4 included daily logging into an application to report attainment of 800 g F&V goal, F&V variety, and reading of educational content. In weeks 4–8, participants only logged F&V goals and variety (NCT05712408). Primary measures included feasibility, acceptability, and change in diet behavior measured using Healthy Eating Index scores, metabolic health biomarkers, body composition, cognition, and multiple sclerosis symptoms. A paired sample </span>t test<span> and Wilcoxon signed rank test were conducted to assess efficacy outcomes of interest.</span></div></div><div><h3>Results</h3><div>Fourteen participants completed the study, and all rated the overall program as excellent or good. Analyses indicated significant positive changes in Healthy Eating Index Total (<em>P</em> = 0.001), vegetable (<em>P</em> = 0.04), fruit (<em>P</em> = 0.004), and whole fruit (<em>P</em><span> = 0.01) component scores, blood glucose (</span><em>P</em><span> = 0.04), and mental health-related quality of life (</span><em>P</em> = 0.03).</div></div><div><h3>Conclusions and Implications</h3><div>This study provides evidence regarding the feasibility, acceptability, and preliminary efficacy of an online diet program promoting F&V intake among persons with multiple sclerosis.</div></div>","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 10","pages":"Pages 980-988"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jneb.2025.06.014
Natalie Vallone RD , Nia I. Bodrick MD , Jasmine H. Kaidbey MS , Mariana F. Grilo MPH , Shaleen Arora BS , Adam Dawer BS , Natasha Kumar BS , Jaiden Bluth , Natalie Lueders MPH , Jennifer M. Sacheck PhD , William H. Dietz PhD , Karen A. McDonnell PhD , William D. Evans PhD , Allison C. Sylvetsky PhD
Objective
Develop a multilevel intervention to reduce sugary drink intake and increase water intake among African American children in Washington, DC.
Design
Qualitative interviews and surveys with pediatricians, children, and their parents. Three key phases of intervention development guided the research: (1) pediatrician (n = 6) feedback on the "Decreasing Children’s Sugar Intake through Pediatricians and Social Marketing" intervention concept, (2) initial feedback from children (n = 10) and parents (n = 7) on intervention concept, branding and messaging content, and (3) additional feedback from children (n = 7) and parents (n = 6) on the revised branding and messaging content.
Setting
Pediatric primary care clinic in an underresourced area of Washington, DC.
Participants
Pediatricians, children aged 11–14 years seen at the clinic, and their parents.
Main Outcome Measures
Feedback on the intervention concept and prototype content.
Analysis
Thematic analysis for qualitative data and descriptive statistics for survey responses.
Results
All 3 key informant groups expressed enthusiasm for the intervention concept. Key suggestions included incorporating incentive-based challenges and suggestions for alternative beverages. Feedback on branding and messaging was primarily related to enhancing aesthetics and improving the relatability of the content.
Conclusions and Implications
Formative research informed the development of a "Decreasing Children’s Sugar Intake through Pediatricians and Social Marketing" intervention plan, which will be pilot-tested for feasibility and acceptability.
{"title":"Formative Research to Develop DC-SIPS: A Multilevel Intervention to Reduce Sugary Drink Intake and Promote Water Intake Among Black Youth in Washington, DC","authors":"Natalie Vallone RD , Nia I. Bodrick MD , Jasmine H. Kaidbey MS , Mariana F. Grilo MPH , Shaleen Arora BS , Adam Dawer BS , Natasha Kumar BS , Jaiden Bluth , Natalie Lueders MPH , Jennifer M. Sacheck PhD , William H. Dietz PhD , Karen A. McDonnell PhD , William D. Evans PhD , Allison C. Sylvetsky PhD","doi":"10.1016/j.jneb.2025.06.014","DOIUrl":"10.1016/j.jneb.2025.06.014","url":null,"abstract":"<div><h3>Objective</h3><div>Develop a multilevel intervention to reduce sugary drink intake and increase water intake among African American children in Washington, DC.</div></div><div><h3>Design</h3><div>Qualitative interviews and surveys with pediatricians, children, and their parents. Three key phases of intervention development guided the research: (1) pediatrician (n = 6) feedback on the \"Decreasing Children’s Sugar Intake through Pediatricians and Social Marketing\" intervention concept, (2) initial feedback from children (n = 10) and parents (n = 7) on intervention concept, branding and messaging content, and (3) additional feedback from children (n = 7) and parents (n = 6) on the revised branding and messaging content.</div></div><div><h3>Setting</h3><div>Pediatric primary care clinic in an underresourced area of Washington, DC.</div></div><div><h3>Participants</h3><div>Pediatricians, children aged 11–14 years seen at the clinic, and their parents.</div></div><div><h3>Main Outcome Measures</h3><div>Feedback on the intervention concept and prototype content.</div></div><div><h3>Analysis</h3><div>Thematic analysis for qualitative data and descriptive statistics for survey responses.</div></div><div><h3>Results</h3><div>All 3 key informant groups expressed enthusiasm for the intervention concept. Key suggestions included incorporating incentive-based challenges and suggestions for alternative beverages. Feedback on branding and messaging was primarily related to enhancing aesthetics and improving the relatability of the content.</div></div><div><h3>Conclusions and Implications</h3><div>Formative research informed the development of a \"Decreasing Children’s Sugar Intake through Pediatricians and Social Marketing\" intervention plan, which will be pilot-tested for feasibility and acceptability.</div></div>","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 10","pages":"Pages 909-922"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jneb.2025.06.017
Eliza Short PhD, RDN , Ji Li MS , James P. Selig PhD , Kelsey Bounds BS , Alexandra Diaz-Cruz MD , Brett Rowland MA , Holly C. Felix PhD, MPA , Krista Langston MBA , Pearl A. McElfish PhD, MBA, MS , Christopher R. Long PhD
Objective
This study evaluated differences in diet quality across multiple racial/ethnic groups with type 2 diabetes (T2D) experiencing food insecurity.
Design
Cross-sectional. Bilingual (English/Spanish, English/Marshallese) community health workers used a multiple-pass approach to collect 3 24-hour dietary recalls via phone.
Setting
Food pantries in Arkansas.
Participants
Eighty-three adult food pantry clients with T2D (hemoglobin A1c ≥ 7.0%) experiencing food insecurity and self-identified race/ethnicity of Hispanic (39%), Marshallese Pacific Islander (i.e., Marshallese) (35%), or White (26%).
Main Outcome Measure
Diet quality (Healthy Eating Index [HEI]-2015).
Analysis
Differences in diet quality scores by race/ethnicity were evaluated using one-way analysis of variance; Turkey-Kramer tests for pairwise comparisons assessed diet quality differences among Hispanic, Marshallese, and White participants. A food-level analysis identified top food categories contributing to diet quality.
Results
Diet quality was 71.7 ± 12.7 (mean ± standard deviation) among Hispanic, 56.9 ± 14.1 among Marshallese, and 45.9 ± 14.1 among White participants. Hispanic participants had a significantly higher HEI-2015 score than Marshallese (mean difference, 14.9 [95% confidence interval (CI), 6.6–23.2]; P < 0.001) and White (mean difference, 25.9 [95% CI, 16.9–34.8]; P < 0.001) participants. Marshallese participants had a significantly higher HEI-2015 score than White participants (mean difference, 11.0 [95% CI, 1.8–20.1]; P = 0.01).
Conclusions and Implications
Designers of nutrition-focused interventions may consider tailoring food and education around high and low diet quality component scores that vary across racial/ethnic groups (e.g., including culturally appropriate fruits/vegetables) to improve T2D management.
{"title":"Diet Quality Among Community Members With Diabetes and Food Insecurity in Northwest Arkansas: Comparison Across 3 Racial/Ethnic Groups","authors":"Eliza Short PhD, RDN , Ji Li MS , James P. Selig PhD , Kelsey Bounds BS , Alexandra Diaz-Cruz MD , Brett Rowland MA , Holly C. Felix PhD, MPA , Krista Langston MBA , Pearl A. McElfish PhD, MBA, MS , Christopher R. Long PhD","doi":"10.1016/j.jneb.2025.06.017","DOIUrl":"10.1016/j.jneb.2025.06.017","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated differences in diet quality across multiple racial/ethnic groups with type 2 diabetes (T2D) experiencing food insecurity.</div></div><div><h3>Design</h3><div>Cross-sectional. Bilingual (English/Spanish, English/Marshallese) community health workers used a multiple-pass approach to collect 3 24-hour dietary recalls via phone.</div></div><div><h3>Setting</h3><div>Food pantries in Arkansas.</div></div><div><h3>Participants</h3><div>Eighty-three adult food pantry clients with T2D (hemoglobin A1c ≥ 7.0%) experiencing food insecurity and self-identified race/ethnicity of Hispanic (39%), Marshallese Pacific Islander (i.e., Marshallese) (35%), or White (26%).</div></div><div><h3>Main Outcome Measure</h3><div>Diet quality (Healthy Eating Index [HEI]-2015).</div></div><div><h3>Analysis</h3><div>Differences in diet quality scores by race/ethnicity were evaluated using one-way analysis of variance; Turkey-Kramer tests for pairwise comparisons assessed diet quality differences among Hispanic, Marshallese, and White participants. A food-level analysis identified top food categories contributing to diet quality.</div></div><div><h3>Results</h3><div>Diet quality was 71.7 ± 12.7 (mean ± standard deviation) among Hispanic, 56.9 ± 14.1 among Marshallese, and 45.9 ± 14.1 among White participants. Hispanic participants had a significantly higher HEI-2015 score than Marshallese (mean difference, 14.9 [95% confidence interval (CI), 6.6–23.2]; <em>P</em> < 0.001) and White (mean difference, 25.9 [95% CI, 16.9–34.8]; <em>P</em> < 0.001) participants. Marshallese participants had a significantly higher HEI-2015 score than White participants (mean difference, 11.0 [95% CI, 1.8–20.1]; <em>P</em> = 0.01).</div></div><div><h3>Conclusions and Implications</h3><div>Designers of nutrition-focused interventions may consider tailoring food and education around high and low diet quality component scores that vary across racial/ethnic groups (e.g., including culturally appropriate fruits/vegetables) to improve T2D management.</div></div>","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 10","pages":"Pages 932-942"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jneb.2025.06.007
Samantha M. Sundermeir PhD, MS, RDN , Mika Matsuzaki PhD, MPH, MS , Angela Zhang MPH , Jane C. Obi MPH , Joel Gittelsohn PhD, MS , Megan R. Winkler PhD, RN
Objective
To characterize the overall availability, price, and promotional placement of food and beverage products at dollar stores and explore differences in the food environment by neighborhood racial composition in Atlanta, Georgia.
Methods
A cross-sectional assessment of the food environment was conducted at 25 dollar stores. Measures included availability, affordability, and promotion of fresh produce, salty snacks, sweet snacks, sugar-sweetened beverages (SSBs), and water. Store neighborhoods were categorized as majority-Black (MB) or non-majority-Black (NMB) neighborhoods using American Community Survey data. Kruskal Wallis and chi-square tests (test of independence) were used to test for differences across neighborhood racial composition.
Results
Only 2 stores sold fresh produce, whereas all offered and most promoted sweet snacks, salty snacks, and SSBs. Compared with NMB neighborhoods, prices for SSBs and salty snacks were significantly lower in MB neighborhoods (P < 0.05).
Conclusions and Implications
The dollar store food environment lacks fresh produce and comprises largely unhealthy food options. Findings suggest dollar stores in MB neighborhoods may provide lower prices for unhealthy food and beverages.
{"title":"Characterizing the Consumer Food Environment of Dollar Stores and Exploring Differences by Neighborhood Racial Composition","authors":"Samantha M. Sundermeir PhD, MS, RDN , Mika Matsuzaki PhD, MPH, MS , Angela Zhang MPH , Jane C. Obi MPH , Joel Gittelsohn PhD, MS , Megan R. Winkler PhD, RN","doi":"10.1016/j.jneb.2025.06.007","DOIUrl":"10.1016/j.jneb.2025.06.007","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the overall availability, price, and promotional placement of food and beverage products at dollar stores and explore differences in the food environment by neighborhood racial composition in Atlanta, Georgia.</div></div><div><h3>Methods</h3><div>A cross-sectional assessment of the food environment was conducted at 25 dollar stores. Measures included availability, affordability, and promotion of fresh produce, salty snacks, sweet snacks, sugar-sweetened beverages (SSBs), and water. Store neighborhoods were categorized as majority-Black (MB) or non-majority-Black (NMB) neighborhoods using American Community Survey data. Kruskal Wallis and chi-square tests (test of independence) were used to test for differences across neighborhood racial composition.</div></div><div><h3>Results</h3><div>Only 2 stores sold fresh produce, whereas all offered and most promoted sweet snacks, salty snacks, and SSBs. Compared with NMB neighborhoods, prices for SSBs and salty snacks were significantly lower in MB neighborhoods (<em>P</em> < 0.05).</div></div><div><h3>Conclusions and Implications</h3><div>The dollar store food environment lacks fresh produce and comprises largely unhealthy food options. Findings suggest dollar stores in MB neighborhoods may provide lower prices for unhealthy food and beverages.</div></div>","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 10","pages":"Pages 972-979"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jneb.2025.06.016
Victor O. Olayemi , Rachel A. Liebe PhD, MPH , Elena L. Serrano PhD , Chanit’a Holmes PhD , George Davis PhD , Sarah A. Misyak PhD, MPH
Objective
This study examined the impact of the Eating Smart, Being Active curriculum within the Expanded Food and Nutrition Education Program (EFNEP) on participants’ food security and identified the pathways influencing food security to enhance program effectiveness.
Design
Cross-sectional, quantitative secondary data.
Participants
Two hundred adult EFNEP participants who completed the required preprogram and postprogram surveys during fiscal years 2022 and 2023.
Main Outcome Measure(s)
Food security, food resource management, and food safety.
Analysis
Descriptive statistics summarized participants’ characteristics. Paired t tests evaluated preprogram and postprogram changes. Path analysis was conducted using structural equation modeling to test hypothesized relationships between improvements in EFNEP domains and participants’ food security.
Results
While all EFNEP domains (nutrition behaviors, physical activity behaviors, food safety, and food resource management) showed significant improvements, only 51.5% of participants reported improved food security after program participation. Improvements in food resource management and food safety contributed to improved food security (β = 0.33 and β = 0.28, respectively; P < 0.001).
Conclusions and Implications
The findings suggest a need to integrate explicit food security strategies beyond these areas to further enhance postprogram food security improvements.
{"title":"The Association Between Changes in Food Security and Core Aspects of EFNEP Programming: A Path Analysis","authors":"Victor O. Olayemi , Rachel A. Liebe PhD, MPH , Elena L. Serrano PhD , Chanit’a Holmes PhD , George Davis PhD , Sarah A. Misyak PhD, MPH","doi":"10.1016/j.jneb.2025.06.016","DOIUrl":"10.1016/j.jneb.2025.06.016","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined the impact of the <em>Eating Smart, Being Active</em> curriculum within the <em>Expanded Food and Nutrition Education Program</em> (EFNEP) on participants’ food security and identified the pathways influencing food security to enhance program effectiveness.</div></div><div><h3>Design</h3><div>Cross-sectional, quantitative secondary data.</div></div><div><h3>Participants</h3><div>Two hundred adult EFNEP participants who completed the required preprogram and postprogram surveys during fiscal years 2022 and 2023.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Food security, food resource management, and food safety.</div></div><div><h3>Analysis</h3><div>Descriptive statistics summarized participants’ characteristics. Paired t tests evaluated preprogram and postprogram changes. Path analysis was conducted using structural equation modeling to test hypothesized relationships between improvements in EFNEP domains and participants’ food security.</div></div><div><h3>Results</h3><div>While all EFNEP domains (nutrition behaviors, physical activity behaviors, food safety, and food resource management) showed significant improvements, only 51.5% of participants reported improved food security after program participation. Improvements in food resource management and food safety contributed to improved food security (β = 0.33 and β = 0.28, respectively; <em>P</em> < 0.001).</div></div><div><h3>Conclusions and Implications</h3><div>The findings suggest a need to integrate explicit food security strategies beyond these areas to further enhance postprogram food security improvements.</div></div>","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 10","pages":"Pages 923-931"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jneb.2025.06.001
Juliana F.W. Cohen ScD, RD , Monica D. Zuercher PhD , Dania Orta-Aleman PhD , Leah E. Chapman PhD , Christina A. Hecht PhD , Kenneth Hecht LLB , Punam Ohri-Vachaspati PhD, RD , Deborah A. Olarte PhD, RD , Anisha I. Patel MD , Michele Polacsek PhD , Marlene B. Schwartz PhD , Lorrene D. Ritchie PhD, RD , Wendi Gosliner DrPH, RD
Objective
To examine the impact of deimplementing universal free school meal (UFSM) policies on school food authorities (SFAs) vs continuing UFSM with state-level policies.
Design
Cross-sectional study.
Participants
A total of 941 SFAs in 8 US states with and without UFSM policies completed a survey during the spring of 2023.
Main Outcome Measures
The SFA survey assessed school meal participation rates, foodservice revenues, staffing needs, administrative burdens, and student stigma and meal debt.
Analyses
Chi-square tests (Test of homogeneity) and generalized estimating equation regression models clustering by state were used to examine differences by UFSM status (deimplementing vs continuing), adjusting for school demographic characteristics.
Results
Compared with SFAs in states that continued UFSM, deimplementation of UFSM was associated with reported declines in school meal participation and foodservice revenues (73% reported declines with deimplementation vs 15% with UFSM policies; P < 0.001), as well as increases in school meal debt (76% vs 5%; P < 0.001) and stigma for students from low-income households (26% vs 5%; P < 0.001). States that deimplemented UFSM reported lower foodservice staffing challenges, potentially because of the lower participation rates.
Conclusions and Implications
Overall, the results of this study suggest that deimplementing UFSM is adversely impacting SFAs and students. Policies to reimplement UFSM could help reduce stigma and meal debt, as well as provide more students access to healthy meals and better nutrition. Strategies to support states with UFSM—including more ways to address current staffing challenges/shortages—are needed.
目的：研究取消普遍免费校餐政策对学校食品管理机构（SFAs）的影响与继续实施普遍免费校餐政策对州一级政策的影响。设计：横断面研究。参与者：在2023年春季，美国8个州共有941个SFAs完成了一项调查，这些州有或没有UFSM政策。主要结果衡量指标：SFA调查评估了学校供餐参与率、餐饮服务收入、人员需求、行政负担、学生污名和供餐债务。分析：使用卡方检验（同质性检验）和按州聚类的广义估计方程回归模型来检查unfsm状态（取消与继续）的差异，并根据学校人口统计学特征进行调整。结果：与继续实施统一管理政策的州的SFAs相比，废除统一管理政策与学校供餐参与和餐饮服务收入的下降有关(73%的人报告说废除了统一管理政策，而15%的人报告说废除了统一管理政策；P < 0.001)，以及学校膳食债务的增加(76% vs 5%；P < 0.001)和对低收入家庭学生的污名(26% vs 5%；P < 0.001)。取消unfsm的州报告说，餐饮服务人员配备方面的挑战较低，可能是因为参与率较低。结论和意义：总的来说，本研究的结果表明，取消统一管理对学生和学生产生了不利影响。重新实施联合管理方案的政策可以帮助减少耻辱和膳食债务，并为更多学生提供健康膳食和更好的营养。需要采取战略支持各州实施ufsm，包括采取更多方法解决当前的人员配备挑战/短缺问题。
{"title":"Impact of Deimplementing Universal Free School Meals: School Food Authority Perspectives","authors":"Juliana F.W. Cohen ScD, RD , Monica D. Zuercher PhD , Dania Orta-Aleman PhD , Leah E. Chapman PhD , Christina A. Hecht PhD , Kenneth Hecht LLB , Punam Ohri-Vachaspati PhD, RD , Deborah A. Olarte PhD, RD , Anisha I. Patel MD , Michele Polacsek PhD , Marlene B. Schwartz PhD , Lorrene D. Ritchie PhD, RD , Wendi Gosliner DrPH, RD","doi":"10.1016/j.jneb.2025.06.001","DOIUrl":"10.1016/j.jneb.2025.06.001","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the impact of deimplementing universal free school meal (UFSM) policies on school food authorities (SFAs) vs continuing UFSM with state-level policies.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Participants</h3><div>A total of 941 SFAs in 8 US states with and without UFSM policies completed a survey during the spring of 2023.</div></div><div><h3>Main Outcome Measures</h3><div>The SFA survey assessed school meal participation rates, foodservice revenues, staffing needs, administrative burdens, and student stigma and meal debt.</div></div><div><h3>Analyses</h3><div>Chi-square tests (Test of homogeneity) and generalized estimating equation regression models clustering by state were used to examine differences by UFSM status (deimplementing vs continuing), adjusting for school demographic characteristics.</div></div><div><h3>Results</h3><div>Compared with SFAs in states that continued UFSM, deimplementation of UFSM was associated with reported declines in school meal participation and foodservice revenues (73% reported declines with deimplementation vs 15% with UFSM policies; <em>P <</em> 0.001), as well as increases in school meal debt (76% vs 5%; <em>P</em> < 0.001) and stigma for students from low-income households (26% vs 5%; <em>P</em> < 0.001). States that deimplemented UFSM reported lower foodservice staffing challenges, potentially because of the lower participation rates.</div></div><div><h3>Conclusions and Implications</h3><div>Overall, the results of this study suggest that deimplementing UFSM is adversely impacting SFAs and students. Policies to reimplement UFSM could help reduce stigma and meal debt, as well as provide more students access to healthy meals and better nutrition. Strategies to support states with UFSM—including more ways to address current staffing challenges/shortages—are needed.</div></div>","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 10","pages":"Pages 902-908"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.jneb.2025.07.004
Adrienne Markworth MA
{"title":"Flourishing Through Change: Centering Purpose, Connection, and Community","authors":"Adrienne Markworth MA","doi":"10.1016/j.jneb.2025.07.004","DOIUrl":"10.1016/j.jneb.2025.07.004","url":null,"abstract":"","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 9","pages":"Page 807"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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