Factors Associated with Universal Free School Meal Provision Adoption among US Public Schools.

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Publisher: Elsevier Science Publishers
Document Type: Report
Length: 539 words

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Keywords School meals; Community Eligibility Provision; Food insecurity; Nutrition policy; Implementation Abstract Background The Community Eligibility Provision (CEP) allows high-poverty schools participating in US Department of Agriculture meal programs to offer universal free school meals. Emerging evidence suggests benefits of CEP for student meal participation, behavior, and academic performance. Although CEP became available nationwide in 2014, in school year 2019--2020, one third of eligible schools were not participating. Objective This study evaluates which school, district, and state factors are associated with CEP participation. Design Cross-sectional study comparing CEP-participating with eligible nonparticipating schools to assess the relationship between CEP participation and school, district, and state factors. Participants US public schools eligible for CEP in school year 2017--2018 (n = 42,813). Main Outcome Measures CEP participation. Statistical Analyses Performed Penalized regression variable selection methods to determine which factors contribute information to the model. Generalized logistic regression to predict odds of CEP participation unadjusted and adjusted for each factor in the full sample and in stratified analyses by whether a state was part of the CEP phase-in period (early vs late implementing states). Results In the full sample, adjusted odds of CEP participation were greater in states where CEP had been available longer (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.34, 1.67). In late implementing states, adjusted odds of CEP participation were higher in schools with more students directly certified for free meals (OR in schools with 80%--89% vs 30%--39% directly certified: 19.32; 95% CI, 12.98, 28.76), Title I schools (OR, 1.85; 95% CI, 1.55, 2.21), and urban schools (OR suburban vs urban, 0.46; 95% CI, 0.36, 0.59). Differences by school level, enrollment, district size, student race/ethnicity, and geographic region also existed. Conclusions Findings may help advocates, state agencies, and policymakers understand potential barriers to adoption and guide research exploring effective strategies to promote uptake. Future research should use qualitative and longitudinal designs to explore barriers to adoption, including cost and state and local policies. Author Affiliation: (1) Institute for Research on Poverty, University of Wisconsin-Madison, Madison, WI (2) Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (3) Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD * Address correspondence to: Amelie A. Hecht, PhD, Institute for Research on Poverty, University of Madison-Wisconsin, 1180 Observatory Drive, 3412 William H. Sewell Social Sciences Building, Madison, WI 53706-1320. Article History: Received 4 September 2020; Accepted 22 June 2021 (footnote) STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors. (footnote) FUNDING/SUPPORT Training and research support for AAH was provided by the Johns Hopkins Center for a Livable Future-Lerner Fellowship and the Johns Hopkins Lerner Center for Public Health Promotion. (footnote) AUTHOR CONTRIBUTIONS A. A. H. conceptualized and designed the study, conducted analyses, interpreted findings, drafted the initial manuscript, and reviewed and revised the manuscript. E. A. S. and K. M. P. P. helped conceptualize the study and interpret findings. and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Byline: Amelie A. Hecht, PhD [AAHecht2@wisc.edu] (1,*), Elizabeth A. Stuart, PhD (2), Keshia M. Pollack Porter, PhD, MPH (3)

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Gale Document Number: GALE|A686979912