"Let's Use This Mess to Our Advantage": Calls to Action to Optimize School Nutrition Program beyond the Pandemic.

School nutrition programs mitigate food insecurity and promote healthy eating by offering consistent, nutritious meals to school-aged children in communities across the United States; however, stringent policy guidelines and contextual challenges often limit participation. During COVID-19 school closures, most school nutrition programs remained operational, adapting quickly and innovating to maximize reach. This study describes semi-structured interviews with 23 nutrition directors in North Carolina, which aimed to identify multi-level contextual factors that influenced implementation, as well as ways in which the innovations during COVID-19 could translate to permanent policy and practice change and improve program reach. Interviews were conducted during initial school closures (May-August 2020) and were deductively analyzed using the Social Ecological Model (SEM) and Consolidated Framework for Implementation Research (CFIR). Analysis elicited multiple relevant contextual factors: director characteristics (motivation, leadership style, experience), key implementation stakeholders (internal staff and external partners), inner setting (implementation climate, local leadership engagement, available resources, structural characteristics), and outer setting (state leadership engagement, external policies and incentives). Findings confirm the strength and resilience of program directors and staff, the importance of developing strategies to strengthen external partnerships and emergency preparedness, and strong support from directors for policies offering free meals to all children.

Dietary Diversity, Food Security, and Body Image among Women and Children on San Cristobal Island, Galapagos.

OBJECTIVES: We conducted a study of the food environment and nutritional status among women and children living on a Galapagos Island. Anthropometric and body silhouette data give insight into body size perceptions for women and their young children. We frame our findings in the context of the nutrition transition. METHODS: A convenience sample was recruited via word-of-mouth for in-depth interviews and assessments of household food security, dietary intake, anthropometrics, and body image. Interviews took place in 2011 on San Cristobal Island, one of four inhabited islands in the Galapagos archipelago. Twenty women with children between the ages of one and six participated, all permanent residents of San Cristobal Island. RESULTS: Most women (60%) reported limited availability of fresh produce due to an unreliable food supply shipped from mainland Ecuador. Despite reported food insecurity in our sample (55%), more than half of the children (55%) experienced high dietary diversity measured by 24 h recall. Women tended to report less dietary diversity than their children, which may be linked to a stated desire to be thinner. Eighty percent of children were classified as normal weight, while 75% of women were overweight or obese. Conclusions for Practice: Results provide an initial survey of the food landscape on one Galapagos Island. By combining qualitative interviews with indicators of nutritional status, the narrative data allow an interpretation of issues of food security, dietary intakes, dietary diversity, and body size. This study forms the basis for a larger examination of these issues in the Galapagos islands.