Household Food Insecurity Is Associated with Parental Perceptions of and Student Participation in School Meals
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Recruitment
2.3. Survey Instrument
2.4. Measures
2.4.1. Parental Perceptions
2.4.2. Student Participation
2.4.3. Food Insecurity
2.4.4. Covariates
2.5. Statistical Analysis
3. Results
3.1. Sample Characteristics
3.2. Parental Perceptions about School Breakfast and Lunch by Food Security Level
3.3. Parental Perceptions about School Meals by Food Security Level
3.4. Association between Food Insecurity and Student Participation in School Meals
4. Discussion
Recommendations for Policy and Practice
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
References
- U.S. Department of Agriculture. Food Security and Nutrition Assistance. Available online: https://www.ers.usda.gov/data-products/ag-and-food-statistics-charting-the-essentials/food-security-and-nutrition-assistance/#:~:text=The%20prevalence%20of%20food%20insecurity,had%20very%20low%20food%20security (accessed on 13 April 2023).
- U.S. Food Security and Nutrition Assistance. Definitions of Food Security. Available online: https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/definitions-of-food-security/ (accessed on 18 April 2023).
- merican Academy of Pediatrics; Council on Community Pediatrics; Committee on Nutrition; Gitterman, B.; Chilton, L.; Cotton, W.; Duffee, J.; Flanagan, P.; Keane, V.; Krugman, S.; et al. Promoting Food Security for All Children. Pediatrics 2015, 136, e1431–e1438. [Google Scholar] [CrossRef] [PubMed]
- Holben, D.; Marshall, M. Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States. J. Acad. Nutr. Diet. 2017, 117, 1991–2002. [Google Scholar] [CrossRef] [PubMed]
- Darmon, N.; Drewnowski, A. Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: A systematic review and analysis. Nutr. Rev. 2015, 73, 643–660. [Google Scholar] [CrossRef] [PubMed]
- Harper, K.; Caulfield, L.; Lu, S.; Mmari, K.; Gross, S. Diet Quality and Contextual Factors Influencing Food Choice among Adolescents with Food Security and Food Insecurity in Baltimore City. Nutrients 2022, 14, 4573. [Google Scholar] [CrossRef] [PubMed]
- Larson, N.; Story, M.; Nelson, M. Neighborhood environments: Disparities in access to healthy foods in the U.S. Am. J. Prev. Med. 2009, 36, 74–81. [Google Scholar] [CrossRef]
- Gosliner, W.; Brown, D.; Sun, B.; Woodward-Lopez, G.; Crawford, P. Availability, quality and price of produce in low-income neighbourhood food stores in California raise equity issues. Public Health Nutr. 2018, 21, 1639–1648. [Google Scholar] [CrossRef] [PubMed]
- Duke, N. Adolescent-Reported Food Insecurity: Correlates of Dietary Intake and School Lunch Behavior. Int. J. Environ. Res. Public Health 2021, 18, 6647. [Google Scholar] [CrossRef]
- Ralston, K.; Treen, K.; Coleman-Jensen, A.; Guthrie, J. Children’s Food Security and USDA Child Nutrition Programs; United States Department of Agriculture: Washington, DC, USA, 2017.
- U.S. Department of Agriculture. The National School Lunch Program Fact Sheet. Available online: https://fns-prod.azureedge.us/sites/default/files/resource-files/NSLPFactSheet.pdf (accessed on 9 October 2023).
- U.S. Department of Agriculture. The School Breakfast Program Fact Sheet. Available online: https://fns-prod.azureedge.us/sites/default/files/resource-files/SBPfactsheet.pdf (accessed on 9 October 2023).
- Cullen, K.; Chen, T. The contribution of the USDA school breakfast and lunch program meals to student daily dietary intake. Prev. Med. Rep. 2016, 5, 82–85. [Google Scholar] [CrossRef] [PubMed]
- Andreyeva, T.; Sun, X. Universal School Meals in the US: What Can We Learn from the Community Eligibility Provision? Nutrients 2021, 13, 2634. [Google Scholar] [CrossRef]
- Bartfeld, J.; Ahn, H. The School Breakfast Program strengthens household food security among low-income households with elementary school children. J. Nutr. 2011, 141, 470–475. [Google Scholar] [CrossRef] [PubMed]
- Marcus, M.; Yewell, K. The Effect of Free School Meals on Household Food Purchases: Evidence from the Community Eligibility Provision. J. Health Econ. 2022, 84, 102646. [Google Scholar] [CrossRef] [PubMed]
- Nord, M.; Romig, K. Hunger in the Summer. J. Child. Poverty 2006, 12, 141–158. [Google Scholar] [CrossRef]
- Huang, J.; Barnidge, E.; Kim, Y. Children Receiving Free or Reduced-Price School Lunch Have Higher Food Insufficiency Rates in Summer. J. Nutr. 2015, 145, 2161–2168. [Google Scholar] [CrossRef] [PubMed]
- Lee, J.; Kubik, M.; Fulkerson, J. Diet Quality and Fruit, Vegetable, and Sugar-Sweetened Beverage Consumption by Household Food Insecurity among 8- to 12-Year-Old Children during Summer Months. J. Acad. Nutr. Diet. 2019, 119, 1695–1702. [Google Scholar] [CrossRef] [PubMed]
- U.S. Department of Agriculture. Community Eligibility Provision. Available online: https://www.fns.usda.gov/cn/community-eligibility-provision (accessed on 20 February 2024).
- Stein, K. Erasing the stigma of subsidized school meals. J. Am. Diet. Assoc. 2008, 108, 1980–1983. [Google Scholar] [CrossRef] [PubMed]
- Turner, L.; Guthrie, J.; Ralston, K. Community eligibility and other provisions for universal free meals at school: Impact on student breakfast and lunch participation in California public schools. Transl. Behav. Med. 2019, 9, 931–941. [Google Scholar] [CrossRef] [PubMed]
- Cohen, J.; Hecht, A.; McLoughlin, G.; Turner, L.; Schwartz, M. Universal School Meals and Associations with Student Participation, Attendance, Academic Performance, Diet Quality, Food Security, and Body Mass Index: A Systematic Review. Nutrients 2021, 13, 911. [Google Scholar] [CrossRef] [PubMed]
- Zuercher, M.D.; Cohen, J.F.W.; Hecht, C.E.; Hecht, K.; Ritchie, L.D.; Gosliner, W. Providing School Meals to All Students Free of Charge during the COVID-19 Pandemic and Beyond: Challenges and Benefits Reported by School Foodservice Professionals in California. Nutrients 2022, 14, 3855. [Google Scholar] [CrossRef]
- Hecht, A.; Olarte, D.; McLoughlin, G.; Cohen, J. Strategies to Increase Student Participation in School Meals in the United States: A Systematic Review. J. Acad. Nutr. Diet. 2023, 123, 1075–1096. [Google Scholar] [CrossRef]
- Ohri-Vachaspati, P. Parental perception of the nutritional quality of school meals and its association with students′ school lunch participation. Appetite 2014, 74, 44–47. [Google Scholar] [CrossRef] [PubMed]
- California Department of Education. Fingertip Facts on Education in California. Available online: https://www.cde.ca.gov/ds/ad/ceffingertipfacts.asp (accessed on 9 October 2023).
- California Department of Education. Selected Statewide Data for the year 2021–2022. Available online: https://dq.cde.ca.gov/dataquest/Cbeds1.asp?FreeLunch=on&cChoice=StatProf1&cYear=2021-22&cLevel=State&cTopic=FRPM&myTimeFrame=S&submit1=Submit (accessed on 3 October 2024).
- Wikipedia. List of economic regions of California. Available online: https://en.wikipedia.org/wiki/List_of_economic_regions_of_California (accessed on 18 October 2023).
- Zuercher, M.D.; Cohen, J.F.W.; Ohri-Vachaspati, P.; Hecht, C.A.; Hecht, K.; Polacsek, M.; Olarte, D.A.; Read, M.; Patel, A.I.; Schwartz, M.B.; et al. Parent perceptions of school meals and how perceptions differ by race and ethnicity. Health Aff. Sch. 2024, 2, qxad092. [Google Scholar] [CrossRef] [PubMed]
- Galloway Research Service. Galloway Research Service. Available online: https://www.gallowayresearch.com/ (accessed on 9 October 2023).
- U.S. Department of Agriculture. School Nutrition and Meal Cost Study—Data Collection Instruments. 2019. Available online: https://www.fns.usda.gov/research/school-meals/nutrition-meal-cost-study (accessed on 3 October 2024).
- Smith, S.; Cunningham-Sabo, L.; Auld, G. Satisfaction of Middle School Lunch Program Participants and Non-Participants with the School Lunch Experience. J. Child. Nutr. Manag. 2015, 39, 2. [Google Scholar]
- Machado, S.S.; Ritchie, L.D.; Thompson, H.R.; Madsen, K.A. The Impact of a Multi-Pronged Intervention on Students’ Perceptions of School Lunch Quality and Convenience and Self-Reported Fruit and Vegetable Consumption. Int. J. Environ. Res. Public Health 2020, 17, 5987. [Google Scholar] [CrossRef] [PubMed]
- U.S. Department of Agriculture. U.S. Household Food Security Survey Module: Six-Item Short Form. 2012. Available online: https://www.ers.usda.gov/media/8282/short2012.pdf (accessed on 3 October 2024).
- U.S. Department of Agriculture. Rural-Urban Commuting Area Codes. Available online: https://www.ers.usda.gov/data-products/rural-urban-commuting-area-codes/ (accessed on 9 October 2023).
- Federal Register. Child Nutrition Programs: Income Eligibility Guidelines. Available online: https://www.federalregister.gov/documents/2021/03/04/2021-04452/child-nutrition-programs-income-eligibility-guidelines (accessed on 9 October 2023).
- Missouri Economic Research and Information Center. Cost of Living Data Series. Available online: https://meric.mo.gov/data/cost-living-data-series (accessed on 9 October 2023).
- U.S. Department of Agriculture. Income Eligibility Guidelines. Available online: https://www.fns.usda.gov/cn/income-eligibility-guidelines (accessed on 9 October 2023).
- Urban Institute. Family Finances—How Do Families with and without Children Differ? 2016. Available online: https://www.urban.org/sites/default/files/publication/79886/2000752-Family-Finances-How-Do-Families-with-and-without-Children-Differ.pdf (accessed on 3 October 2024).
- Bardin, S.; Washburn, L.; Gearan, E. Disparities in the Healthfulness of School Food Environments and the Nutritional Quality of School Lunches. Nutrients 2020, 12, 2375. [Google Scholar] [CrossRef] [PubMed]
- Taber, D.; Chriqui, J.; Powell, L.; Perna, F.; Robinson, W.; Chaloupka, F. Socioeconomic Differences in the Association Between Competitive Food Laws and the School Food Environment. J. Sch. Health 2015, 85, 578–586. [Google Scholar] [CrossRef] [PubMed]
- Turner, L.; Ohri-Vachaspati, P.; Powell, L.; Chaloupka, F. Improvements and Disparities in Types of Foods and Milk Beverages Offered in Elementary School Lunches, 2006–2007 to 2013–2014. Prev. Chronic Dis. 2016, 13, 150395. [Google Scholar] [CrossRef]
- U.S. Department of Agriculture. National School Lunch Program: Participation and Lunches Served. 2023. Available online: https://www.fns.usda.gov/pd/child-nutrition-tables (accessed on 3 October 2024).
- Kendall, A.; Olson, C.; Frongillo, E. Relationship of hunger and food insecurity to food availability and consumption. J. Am. Diet. Assoc. 1996, 96, 1019–1024. [Google Scholar] [CrossRef] [PubMed]
- U.S. Department of Agriculture. Nutrition Standards for School Meals. Available online: https://www.fns.usda.gov/cn/nutrition-standards-school-meals (accessed on 20 April 2023).
- U.S. Department of Agriculture. School Breakfast Program Participation and Meals Served. 2024. Available online: https://fns-prod.azureedge.us/sites/default/files/resource-files/sbsummar-9.pdf (accessed on 3 October 2024).
- Food Research and Action Center. The Reach of School Breakfast and Lunch During the 2021–2022 School Year. 2023. Available online: https://frac.org/wp-content/uploads/The-Reach-of-School-Breakfast-and-Lunch_2023_0308-1.pdf (accessed on 3 October 2024).
- FAO, I.; UNICEF; WFP; WHO. The State of Food Security and Nutrition in the World 2023. Urbanization, agrifood systems transformation and healthy diets across the rural–urban continuum. 2023. Available online: https://openknowledge.fao.org/server/api/core/bitstreams/1f66b67b-1e45-45d1-b003-86162fd35dab/content (accessed on 3 October 2024).
- United Nations, D.o.E.a.S.A. The 17 Goals. Available online: https://sdgs.un.org/goals (accessed on 27 September 2024).
- World Food Programme. How School Meals Contribute to the Sustainable Development Goals: A Collection of Evidence. 2017. Available online: https://documents.wfp.org/stellent/groups/public/documents/communications/wfp290718.pdf?_ga=2.212713110.343412226.1516881548-619828755.1516881548 (accessed on 3 October 2024).
Survey Respondent Characteristics | All (n = 1110) | Food Secure (n = 502) | Food Insecure (n = 608) | p-Value | |||
---|---|---|---|---|---|---|---|
n | % | n | % | n | % | ||
Relationship with the Student | 0.0001 | ||||||
Mother | 954 | 85.9 | 411 | 81.9 | 543 | 89.3 | |
Father | 112 | 10.1 | 72 | 14.3 | 40 | 6.6 | |
Other1 | 44 | 4.0 | 19 | 3.8 | 25 | 4.1 | |
Preferred Language | 0.22 | ||||||
English | 893 | 80.5 | 412 | 82.1 | 481 | 79.1 | |
Spanish | 217 | 19.5 | 90 | 17.9 | 127 | 20.9 | |
Household Size | 0.004 | ||||||
2–3 people | 311 | 28.0 | 139 | 27.7 | 172 | 28.3 | |
4 people | 373 | 33.6 | 193 | 38.5 | 180 | 29.6 | |
5 or more people | 426 | 38.4 | 170 | 33.9 | 256 | 42.1 | |
Participant in SNAP/CalFresh 1 (yes) | 474 | 42.7 | 172 | 34.3 | 302 | 49.7 | 0.0001 |
Student Characteristics | n | % | n | % | n | % | p-value |
School Level | 0.06 | ||||||
Elementary school | 651 | 58.6 | 314 | 62.6 | 337 | 55.4 | |
Middle school/Junior high | 203 | 18.3 | 82 | 16.3 | 121 | 199 | |
High school | 256 | 23.1 | 106 | 21.1 | 150 | 24.7 | |
Student’s Race/Ethnicity | 0.01 | ||||||
Hispanic | 574 | 51.7 | 244 | 48.6 | 330 | 54.3 | |
Non-Hispanic White | 227 | 20.5 | 107 | 21.3 | 120 | 19.7 | |
Asian Asian/American | 94 | 8.5 | 57 | 11.4 | 37 | 6.1 | |
Black/African American | 93 | 8.4 | 45 | 9.0 | 48 | 7.9 | |
Non-Hispanic Other + Multiracial | 122 | 11.0 | 49 | 9.8 | 73 | 12.0 | |
Student’s Gender | 0.46 | ||||||
Female | 453 | 40.8 | 204 | 40.6 | 249 | 41.0 | |
Male | 449 | 40.5 | 211 | 42.0 | 238 | 39.1 | |
Other 2 | 208 | 18.7 | 87 | 17.3 | 121 | 19.9 | |
FRPM classification | 0.0001 | ||||||
Free | 484 | 43.6 | 147 | 29.3 | 337 | 55.4 | |
Reduced-Price | 179 | 16.1 | 79 | 15.7 | 100 | 16.5 | |
Non-Eligible | 447 | 40.3 | 276 | 55.0 | 171 | 28.1 | |
Student Characteristics | Mean | SD3 | Mean | SD | Mean | SD | p-value |
Breakfast participation (days/week) | 2.68 | 1.9 | 2.50 | 1.9 | 2.83 | 1.9 | 0.01 |
Lunch participation (days/week) | 3.44 | 1.8 | 3.38 | 1.8 | 3.49 | 1.8 | 0.33 |
School Breakfast | School Lunch | |||||||
---|---|---|---|---|---|---|---|---|
All (n = 874) | Food Secure (n = 389) | Food Insecure (n = 485) | p-Value | All (n = 1110) | Food Secure (n = 480) | Food Insecure (n = 570) | p-Value | |
% | % 1 | % | % 1 | |||||
Positive or neutral perceptions of school meals | ||||||||
My child usually likes the breakfasts/lunches served at school. | 43.9 | 47.1 | 42.4 | 0.17 | 47.4 | 52.2 | 43.4 | 0.01 |
My child has enough time to eat breakfast/lunch at school. | 47.2 | 50.8 | 45.2 | 0.10 | 54.2 | 61.4 | 47.9 | 0.0001 |
The school breakfast/lunch menu offers meals that are healthy. | 46.1 | 51.8 | 41.8 | 0.003 | 44.0 | 48.7 | 39.2 | 0.002 |
The quality of the school breakfasts/lunches is good. | 39.5 | 43.7 | 36.1 | 0.02 | 36.9 | 39.6 | 34.4 | 0.08 |
My child can get enough food at the school breakfast/lunch to get full. | 44.3 | 51.4 | 38.9 | 0.0001 | 46.0 | 54.0 | 39.3 | 0.0001 |
My child thinks the school breakfasts/lunches taste good. | 44.7 | 49.8 | 40.7 | 0.01 | 39.6 | 44.8 | 35.3 | 0.002 |
Negative perceptions of school meals | ||||||||
My child gets tired of the same foods being served at school breakfast/lunch. | 55.8 | 51.4 | 59.2 | 0.02 | 57.7 | 49.9 | 63.8 | 0.0001 |
I have concerns about the amount of sugar in school breakfasts/lunches. | 35.2 | 36.3 | 34.6 | 0.61 | 34.3 | 32.8 | 36.2 | 0.24 |
My child prefers to eat breakfast at/bring food from home instead of eating the school breakfast/lunch. | 49.0 | 48.8 | 49.5 | 0.83 | 48.7 | 46.0 | 50.6 | 0.15 |
I would prefer my child to eat breakfast at/bring food from home instead of eating the school breakfast/lunch. | 37.5 | 35.1 | 39.3 | 0.21 | 36.7 | 35.7 | 36.9 | 0.69 |
I would prefer my child to have the option to eat school breakfast after the bell. | 47.7 | 41.0 | 53.1 | 0.0001 | - | - | - | - |
All (n = 1050) | Food Secure (n = 480) | Food Insecure (n = 570) | p-Value | |
---|---|---|---|---|
% | % 1 | |||
School meals can save my family money. | 81.6 | 78.5 | 83.3 | 0.05 |
School meals can save my family time since we do not have to prepare breakfast and/or lunch for my child. | 79.2 | 77.8 | 80.1 | 0.36 |
School meals can help to reduce stress for me/my family. | 75.0 | 73.1 | 77.2 | 0.12 |
I think that eating school meals may benefit students academically. | 57.5 | 57.1 | 58.4 | 0.65 |
I believe that school meals are only for children whose families have low incomes. | 17.9 | 15.3 | 20.0 | 0.047 |
My child is (or would be) embarrassed to eat school meals. | 11.7 | 8.3 | 15.0 | 0.001 |
Stratification Variable | Sample | Breakfast Participation (n = 874) | Lunch Participation (n = 1050) | ||||
---|---|---|---|---|---|---|---|
n | β | p-Value | n | β | p-Value | ||
None | All | 874 | 0.13 | 0.002 | 1050 | 0.03 | 0.35 |
School level | Elementary school | 538 | 0.16 | 0.002 | 620 | 0.07 | 0.08 |
Middle school | 164 | −0.003 | 0.98 | 192 | 0.008 | 0.92 | |
High school | 172 | 0.21 | 0.06 | 238 | −0.02 | 0.79 | |
FRPM Eligibility | Free | 391 | 0.05 | 0.43 | 457 | −0.03 | 0.53 |
Reduced-price | 143 | 0.09 | 0.39 | 168 | −0.06 | 0.51 | |
Non-eligible | 340 | 0.19 | 0.01 | 425 | 0.11 | 0.04 |
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Zuercher, M.D.; Cohen, J.F.W.; Hecht, C.A.; Hecht, K.; Orta-Aleman, D.; Olarte, D.A.; Chapman, L.E.; Read, M.; Ritchie, L.D.; Gosliner, W. Household Food Insecurity Is Associated with Parental Perceptions of and Student Participation in School Meals. Nutrients 2024, 16, 3375. https://doi.org/10.3390/nu16193375
Zuercher MD, Cohen JFW, Hecht CA, Hecht K, Orta-Aleman D, Olarte DA, Chapman LE, Read M, Ritchie LD, Gosliner W. Household Food Insecurity Is Associated with Parental Perceptions of and Student Participation in School Meals. Nutrients. 2024; 16(19):3375. https://doi.org/10.3390/nu16193375
Chicago/Turabian StyleZuercher, Monica D., Juliana F. W. Cohen, Christina A. Hecht, Kenneth Hecht, Dania Orta-Aleman, Deborah A. Olarte, Leah E. Chapman, Margaret Read, Lorrene D. Ritchie, and Wendi Gosliner. 2024. "Household Food Insecurity Is Associated with Parental Perceptions of and Student Participation in School Meals" Nutrients 16, no. 19: 3375. https://doi.org/10.3390/nu16193375
APA StyleZuercher, M. D., Cohen, J. F. W., Hecht, C. A., Hecht, K., Orta-Aleman, D., Olarte, D. A., Chapman, L. E., Read, M., Ritchie, L. D., & Gosliner, W. (2024). Household Food Insecurity Is Associated with Parental Perceptions of and Student Participation in School Meals. Nutrients, 16(19), 3375. https://doi.org/10.3390/nu16193375