Right to food in the Chilean constitution: legal, social and nutritional elements for a proposal

Background: The Human Right to Food is not incorporated in the Chilean Constitution. Aim: To identify the legal, social, and nutritional elements for its incorporation into the new Constitution, and to draft a text proposal for the constituent discussion. Material and Methods: Descriptive and qualitative study on the perceptions of experts and key actors of the food chain in Chile. The sample was for convenience and included civil society, academia, international organizations, parliamentarians, food traders and producers, and national and local authorities (n = 26). The research team, previously trained and standardized, applied semi-structured online surveys, which were recorded and transcribed. Through an inductive approach, a thematic analysis was carried out using the Atlas.ti 9.0 software. Results: Eighty-one percent of the interviewees were in favor of the Constitutional incorporation of the Right to Food. According to interviews, a constitutional text was proposed considering the characteristics of adequate, healthy, safe, and nutritious foods. Also, the food items must be available, physically and economically accessible, and culturally relevant. A guaranteed citizen participation, food sovereignty, food security, and environmental sustainability must be considered. Conclusions: The high prevalence of malnutrition due to excess, poor diet, and food insecurity during the COVID-19 pandemic, and a current Constitution that does not explicitly guarantee physical and economic access to food, establish a factual and normative background that justifies the incorporation of this right in a new Constitution.

Association of mobile health (mHealth) use with health status and COVID-19-related concerns by people with mobility impairments.

PURPOSE: Mobile health (mHealth) technology has increased dramatically in the wake of the pandemic. Less research has focused on people with mobility impairing (PMI) disabilities. This study determined the prevalence of mHealth use among PMI adults during the COVID-19 escalation and examines demographic, health and COVID-19 concerns correlates. METHODS: PMI adults (N = 304) completed an online survey investigating mHealth use and COVID-19 concerns related to food access in June of 2020. Smartphone and mHealth use were measured with an adapted version of the survey used in the Pew Internet & American Life project. Descriptive and multivariable analyses were conducted to determine associations of demographics, health status, and COVID-19 concerns with mHealth use. About two-thirds (N = 201) of the sample were mHealth users (owned a smartphone and engaged in health-promoting behaviors with the smartphone; e.g., sought online information, tracked health behaviors, used patient portals). RESULTS: Having hypertension was associated with higher mHealth use, and having higher COVID-19 concerns about food access was associated with higher mHealth use. Those who used mHealth were also more engaged with smartphone apps for communication, services, and entertainment. Only the association between educational attainment and mHealth use remained significant after adjusting for other covariates in multivariable logistic regression models. DISCUSSION: PMIs continue to need support in the use of mHealth technology to help maximize access to potentially important tools for rehabilitation and health management. There is a need to continue to investigate mHealth and its applications for people with disabilities.Implications for RehabilitationMany people with mobility impairing disabilities may be missing opportunities for mHealth rehabilitation and healthcare.COVID-19 has widened existing gaps in access and use of mHealth technology among people with mobility impairing disabilities.Focused education is needed to help people with disabilities exploit the full range of services of their smartphones to increase access to care, social connectivity, and other important goods and services to enhance rehabilitation and health management.

Caregivers' Perceived Impact of WIC's Temporary Cash-Value Benefit (CVB) Increases on Fruit and Vegetable Purchasing, Consumption, and Access in Massachusetts.

Responding to the COVID-19 pandemic, the American Rescue Plan (2021) allowed state agencies of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) the option of temporarily increasing the Cash-Value Benefit (CVB) for fruit and vegetable (FV) purchases. To examine the impact of this enhancement on WIC caregiver experience, the MA WIC State Office invited 4600 randomly selected MA WIC caregivers to complete an online survey (February-March 2022). Eligible adults had at least one child, had been enrolled at least a year, and were aware of the increase. Of those who opened the screener (n = 545), 58.9% completed it (n = 321). We calculated the frequencies of reporting increased FV outcomes and tested whether responses differed by race/ethnicity, market access, and food security. Most caregivers perceived the CVB increase to benefit FV purchasing (amount and quality, 71.0% and 55.5%), FV consumption (offered to children and personally consumed, 70.1% and 63.2%), and satisfaction with the WIC food package (37.1% reported improved satisfaction, pre- vs. post-increase). Probability of reporting improved outcomes was not found to differ by race/ethnicity, market access, or food security. CVB increases may pose important implications for dietary behaviors and satisfaction with WIC. Policymakers should consider making this increase permanent.

P056 Challenges and Successes of a Pediatric Produce Prescription Program During COVID-19

A large pediatric clinic in Flint, Michigan, a low-income, urban community, implemented a fruit and vegetable prescription program for youth to address enduring challenges with food access and food insecurity. Approximately 18 months after this prescription program was introduced, the State of Michigan issued a "stay home, stay safe" executive order in response to the COVID-19 pandemic. This study sought to investigate perceived changes to access and utilization of fruit and vegetable prescriptions as well as general changes in the food environment that resulted from the pandemic and related executive order. Data were collected using semi-structured telephone interviews with caregivers of children (8-18 years of age) who received at least one fruit and vegetable prescription. Interview recordings were transcribed verbatim for textual analysis. Using thematic analysis, qualitative data was examined to identify patterns across transcripts and formulate common themes. Interviews concluded when data saturation was reached. Fifty-six caregivers participated in interviews (mean age, 41.3 ± 10.3 years). The majority were female (91%), African American (70%), and residents of Flint (75%). Four recurrent themes, centered around changes in the food environment resulting from COVID-19, emerged: produce prescription access and utilization;food access constraints;food shopping adjustments;and food insecurity stress. The current study highlights stark ramifications of COVID-19, particularly among vulnerable families, many of whom were at elevated risk for food insecurity and hunger prior to the pandemic. Perceived consequences of COVID-19 included increased anxiety related to food shopping and food insecurity alongside challenges with access and utilization of a fruit and vegetable prescription program as pediatric clinics moved to virtual healthcare visits and farmers' markets closed. Michigan Health Endowment Fund

P002 Access to Fresh Produce and Low-Fat Food Products in SNAP-Eligible Virginians During COVID-19

Consuming fresh produce and low-fat food products is desirable to maintain a healthy diet. Restrictions from the COVID-19 pandemic resulted in disruptions in the food supply and difficulties in access to fresh produce and low-fat products. To assess food access to fresh produce and low-fat products among SNAP-eligible Virginians during COVID-19. An online Qualtrics cross-sectional survey was conducted with SNAP-eligible Virginians aged 18 and older in November-December 2020. Survey questions included socio-demographic information and questions about access to, and quality of, fresh produce and low-fat products within the respondents' neighborhoods. Descriptive statistics were computed in SPSS. Of 973 survey responses, 228 (23.4%) respondents reported difficulties accessing fresh produce;215 (22.1%) difficulty accessing fresh produce of high quality;and 233 (23.9%) issues with breadth of produce selection. By contrast, 184 (19.0%) respondents reported difficulty accessing low-fat products and 184 respondents (19.0%) reported issues with breadth of low-fat product selection. Severe difficulties in accessing both fresh produce and low-fat products were noted in Southwest and Eastern Virginia. Overall, one-quarter of survey respondents reported challenges with accessing produce. While we did not assess changes because of COVID-19 specifically, efforts to support access to nutritious options is a critical component of promoting food security and community food security. These results can inform and tailor coordinated programs that include nutrition education programs and policy, systems, and environmental change initiatives. Follow-up research is warranted to determine ongoing challenges with food access among adults and households with lower incomes. USDA Virginia Cooperative Extension Supplemental Nutrition Assistance Program-Education, Virginia Department of Social Services (SNAP)

O01 Optimizing a Theoretical Framework for Virtual Nutrition Education Programs for Adolescents With Autism Spectrum Disorder

Adolescents with autism spectrum disorder (ASD) demonstrate more problematic eating behaviors and unhealthy dietary patterns than their neurotypical peers. As the COVID-19 pandemic has resulted in a continued need for virtual interventions, a tailored framework to guide virtual nutrition education programs for this population is warranted. To optimize a theoretical framework based on empirical data from a virtual nutrition education intervention study for adolescents with ASD. This is a secondary analysis of qualitative data collected from a pre-post intervention study with 27 adolescents with ASD aged 12-21 years. Six adolescent focus groups (n = 12) and 21 parent interviews were conducted after the intervention. The initial framework based on social cognitive theory (SCT) was applied to a virtual nutrition education intervention, BALANCE (Bringing Adolescent Learners Nutrition and Culinary Education), that consisted of eight weekly sessions. The framework had 6 domains (ASD-related Barriers, SCT Constructs, Environmental Context, Eating Habits, Other Lifestyle Behaviors, and Health Outcomes) and 21 constructs. Focus group and interview data were analyzed for emergent themes, and the framework was refined based on key findings. Emergent themes that were overlooked in the initial framework development included that adolescents improved 'Self-regulation';parents particularly liked that children's 'Autonomy and independence' were encouraged;and 'Family support' for healthy eating increased, e.g., parents teaching their children how to prepare food themselves, after participating in BALANCE. The optimized framework included 3 new constructs based on these results: Self-regulation, Autonomy, and Supportive Social Environment, which can be well-explained with self-determination theory (SDT). The findings suggest that future versions of the BALANCE intervention should incorporate SDT constructs to improve adolescents' intrinsic motivation to make healthy food choices. The optimized framework can be used to inform future virtual nutrition education programs for this population. University of South Florida College of Public Health.