Food recovery and produce distribution as a system strategy for increasing access to healthy food among populations experiencing food insecurity: lessons for post-pandemic planning.

Using data from an intercept survey of 428 adults who received free surplus produce at five distribution sites and qualitative data from 15 interviews with site personnel, we examined facilitators (e.g. community partnerships, coalition support) and challenges (e.g. limited refrigerated storage, lack of transportation infrastructure) to operating a food recovery and distribution program in Los Angeles County. Overall, this food system intervention appeared to fill an unmet need for recipients, nearly 80% of whom were food insecure and 60% visited a site several months/year or monthly. For many living in this county's underserved communities, this effort was instrumental in increasing access to healthy food before and during the COVID-19 pandemic. To sustain/expand this program's reach, local governments and food assistance programs should provide greater coordination and oversight, and invest more resources into this food recovery and distribution infrastructure.

Food Insecurity Screening in Safety-Net Clinics in Los Angeles County: Lessons for Post-Pandemic Planning.

INTRODUCTION: Food insecurity is a major public health problem in the United States which was exacerbated by the COVID-19 pandemic. We used a multi-method approach to understand barriers and facilitators to implementing food insecurity screening and referrals at safety net health care clinics in Los Angeles County before the pandemic. METHODS: In 2018, we surveyed 1013 adult patients across eleven safety-net clinic waiting rooms in Los Angeles County. Descriptive statistics were generated to characterize food insecurity status, attitudes toward receiving food assistance, and use of public assistance programs. Twelve interviews with clinic staff explored effective and sustainable approaches to food insecurity screening and referral. RESULTS: Patients welcomed the opportunity to access food assistance in the clinic setting; 45% preferred discussing food issues directly with the doctor. Missed opportunities to screen for food insecurity and refer patients to food assistance were identified at the clinic level. Barriers to these opportunities included: competing demands on staff and clinic resources, difficulty establishing referral pathways, and doubts surrounding data. DISCUSSION: Integrating food insecurity assessment in clinical settings requires infrastructure support, staff training, clinic buy-in, and more coordination and oversight from local government, health center entities, and public health agencies.

Increasing Surplus Food Redistribution to Improve Food Access Through a Partnership Between Public Health and a Technology-Based Company.

Redistributing surplus food that would otherwise be discarded represents a viable strategy both for increasing food access and for addressing climate change. This study describes a public-private partnership that scaled such an effort in Los Angeles County. Public health worked with a technology-based company to introduce a mobile app that connected various traditional (e.g., food pantries) and non-traditional (e.g., businesses with surplus food, food rescue organizations, community-based organizations that work in low-income communities) organizations with a countywide surplus food redistribution process. In 11 months, 50 food businesses participated, a total of 43,900 pounds of food were recovered, and surplus food was delivered to 34 community sites, serving 28,400 meals. Lessons from the experience suggest that mobile app use was a key component of the redistribution effort, and that diverting food waste while increasing food access, with a priority towards obtaining food of high nutritional value, was both feasible and practical. It has previously been shown that reducing food loss and waste by at least 50% in the food service sector could help reduce energy use and greenhouse gas emissions.

MyPlate and urban low-income Asian Americans in the United States: a study to improve nutrition education.

This study describes barriers to using the MyPlate visual as a resource for communicating dietary recommendations to Asian American participants of a federally funded nutrition education program. To identify potential barriers to using MyPlate, an interdisciplinary team collected quantitative (n = 349) and qualitative (n = 40) data via a cross-sectional survey and a series of focus group interviews with convenience samples of Cambodian, Filipino, Japanese, Chinese, Vietnamese, and Korean adult participants of a nutrition education class in downtown Los Angeles. Findings showed that 13.2% of the participants ate meals only on a plate, 30.7% were accustomed to eating only refined grains like white rice, and 22.4% did not customarily make half their meals to consist of fruits and vegetables. Food customs, preference, and taste vary across these subgroups. The heterogeneity and complexity of dietary practices among Asian subgroups suggest a need to better tailor nutrition education resources for use in these populations.

Lessons learned from implementing the Supplemental Nutrition Assistance Program Education Small Corner Store Project in Los Angeles County.

As part of the federal Supplemental Nutrition Assistance Program Education (SNAP-Ed) in Los Angeles County (LAC), corner store conversions (CSCs) were an integral part of a broader, more coordinated effort to improve nutrition and to prevent obesity in low-income populations. To date, little is known about this experience in LAC. The present study addresses this gap by describing lessons learned from implementing the SNAP-Ed Small Corner Store Project (SCSP) in this region. The project, which began in 2013, sought to scale CSCs in underserved communities of LAC, employing behavioral economics (e.g., prominently displaying healthy foods at checkout aisles or using in-store signage to promote healthy options) to encourage patron selection of healthier food items. Results from an assessment of the SCSP suggest that for CSCs to do well, careful considerations should be given to factors such as time (e.g., amount of staff time dedicated to the effort), staff capacity (e.g., # staff available to assist), and available resources that can be leveraged (e.g., support from community-based organizations). For some stores, inadequate food distribution or a lack of capital improvement infrastructure (e.g., refrigeration for fresh produce/storage of excess food that can be repurposed) were key barriers that required additional funding. Although local efforts that incentivize small businesses to undergo CSCs may initially nudge store owners to participate, increasing overall consumer demand for healthier food products (i.e., so as to help maintain sales volume) remains a key to sustaining store conversions long after SNAP-Ed resources are gone.