The Implementation of a Nutrition Intervention in Food Pantries: The Spirit of SWAP.

Background. Food insecurity, affecting approximately 10% of the U.S. population, with up to 40% or higher in some communities, is associated with higher rates of chronic conditions and inversely associated with diet quality. Nutrition interventions implemented at food pantries are an effective strategy to increase healthy food choices and improve health outcomes for people experiencing food and nutrition insecurity. Supporting Wellness at Pantries (SWAP), a stoplight nutrition ranking system, can facilitate healthy food procurement and distribution at pantries. Purpose. Guided by the RE-AIM Framework, this study assesses the implementation and outcomes of SWAP as nutritional guidance and institutional policy intervention, to increase procurement and distribution of healthy foods in pantries. Method. Mixed-methods evaluation included observations, process forms, and in-depth interviews. Food inventory assessments were conducted at baseline and 2-year follow-up. Results. Two large pantries in New Haven, Connecticut, collectively reaching more than 12,200 individuals yearly, implemented SWAP in 2019. Implementation was consistent prepandemic at both pantries. Due to COVID-mandated distribution changes, pantries adapted SWAP implementation during the pandemic while still maintaining the "spirit of SWAP." One pantry increased the percentage of Green foods offered. Challenges to healthy food distribution are considered. Discussion. This study has implications for policy, systems, and environmental changes. It shows the potential for SWAP adoption at pantries, which can serve as a guide for continued healthy food procurement and advocacy. Maintaining the "spirit of SWAP" shows promising results for food pantries looking to implement nutrition interventions when standard practice may not be possible.

COVID-19 Vaccine Acceptance and Access Among Black and Latinx Communities.

Importance: Black and Latinx communities have faced disproportionate harm from the COVID-19 pandemic. Increasing COVID-19 vaccine acceptance and access has the potential to mitigate mortality and morbidity from COVID-19 for all communities, including those most impacted by the pandemic. Objective: To investigate and understand factors associated with facilitating and obstructing COVID-19 vaccine access and acceptance among Black and Latinx communities. Design, Setting, and Participants: This community-partnered qualitative study conducted semistructured, in-depth focus groups with Black and Latinx participants from March 17 to March 29, 2021, using a secure video conferencing platform. Participants were recruited through emails from local community-based organizations, federally qualified health centers, social service agencies, the New Haven, Connecticut, Health Department, and in-person distribution of study information from community health workers. A total of 8 focus groups were conducted, including 4 in Spanish and 4 in English, with 72 participants from a diverse range of community roles, including teachers, custodial service workers, and health care employees, in New Haven, Connecticut. Data were analyzed from March 17 to July 30, 2021. Main Outcomes and Measures: Interviews were audio-recorded, transcribed, translated, and analyzed using an inductive content analysis approach. Themes and subthemes were identified on the acceptability and accessibility of the COVID-19 vaccine among participants who identified as Black and/or Latinx. Results: Among 72 participants, 36 (50%) identified as Black, 28 (39%) as Latinx, and 8 (11%) as Black and Latinx and 56 (78%) identified as women and 16 (22%) identified as men. Participants described 3 major themes that may represent facilitators and barriers to COVID-19 vaccinations: pervasive mistreatment of Black and Latinx communities and associated distrust; informing trust via trusted messengers and messages, choice, social support, and diversity; and addressing structural barriers to vaccination access. Conclusions and Relevance: The findings of this qualitative study may impact what health care systems, public health officials, policy makers, health care practitioners, and community leaders can do to facilitate equitable uptake of the COVID-19 vaccine. Community-informed insights are imperative to facilitating COVID-19 vaccine access and acceptance among communities hardest hit by the pandemic. Preventing the further widening of inequities and addressing structural barriers to vaccination access are vital to protecting all communities, especially Black and Latinx individuals who have experienced disproportionate death and loss from COVID-19.