A Program Evaluation of Cartersville City Schools’ Summer Meal Program Pubblico

Abstract

Background: Youth food insecurity remains a prevalent public health issue. Inadequate diets among children can lead to health outcomes such as poorer mental health, reduce cognitive performance, and a greater risk of future chronic diseases. School meal programs are one intervention strategy to combat youth food insecurity via provision of fully or partially subsided meals. Due to food inaccessibility in summer months, the Summer Meal Program has recently gained traction in combatting this seasonal youth food insecurity. With a 50% utilization rate of free and reduced school meals and a sponsor of the Summer Meal Program, Cartersville Georgia’s school system is primed for public health evaluation of their implementation strategy effectiveness.

Methods: A program evaluation was conducted using process and outcome evaluation design components to determine reach, barriers and facilitators of program participation, and effect of the program on families with children. The mixed methods evaluation included qualitative interviews with 18 purposively sampled participating caregivers and an online survey targeting 178 households of which 25 responded, representing 69 participating children. Feedback from Cartersville City Schools’ Nutrition Director was also incorporated to provide program specific data and potential explanatory data.

Results: Cartersville serves about 25% of its student population during the summer months. Key themes from interview data included importance of multi-contact communication methods and stakeholder engagement to increase awareness of program; temporality, route adequacy, and use of stakeholders as an implementation strategy to encourage greater reach and accessibility; use of social strategies to improve utilization of program; and impact of program beyond nutrition. Summer meals were perceived as a benefit to the local community in both datasets.

Conclusions: Cartersville’s multi-modal implementation strategy for meal dissemination makes it a strong Summer Meal Program sponsor school by effective use of school and delivery locations, mobile vans, and church distribution sites. Recommendations to mitigate program participation barriers are designed to address inadequate communication, encourage program acceptability, increase reach, and increase utilization efficiency.

Table of Contents

Introduction………………………………………………………..…1

Problem Statement……………………………………………..……3

Purpose Statement……………………………………………………3

Objectives……………………………………………………………...3

Significance…………………………………………………………....3

Comprehensive Literature Review……………………..............4

United States Food Security………………………………...........4

Youth Food Insecurity……………………………………..............4

Understanding youth food insecurity etiology……………...….6

Community-based youth food insecurity interventions.…..…9

School Meal Programs…………………………………….............11

Summer Food Service Programs…………………….…….........14

Mobile Meals Strategy…………………………………………...…16

Cartersville Summer Meals Program ……………………...…..17

Methods…………………………………………………………..….. 19

Introduction……………………………………………………..……19

Population……………………………………………………………19

Research Design……………………………………………………..20

Procedures and Data Analysis Plans……………..…….……….21

Instruments………………………………………………..…...……25

Limitations……………………………………………………..……..25

Results………………………………………………………….….….27

Introduction………………………………………………………..…27

Qualitative Findings…………………………….…………….……27

Program Awareness……………………………………...………...27

Acceptability ………………………………………………....…….28

Program Accessibility …………………………………….…..…28

Delivery Route Adequacy…………………………...........……28

Transportation and Work…………………………........……....29

Faith-Based support…………………………………………...….29

Staff Environment…………………………………………..….…30

Social Strategies to Improve Program Utilization…………..30

Preventing Food Waste………………………………............…30

Social Media………………………………………............………31

Phone Calendars…………………………………...........………..31

Impact of Program Beyond Nutrition…………………………..31

Quantitative Findings………………………………………………33

Demographics……………………………………………………..33

Food Security Status……………………………………………....34

Reach…………………………………………………………....…...34

Program Adequacy……………………………………………...….35

Program Outcomes on Child Diet……………………….……...38

Discussion, Conclusions, and Recommendations……….......39

Introduction …………………………………………………………39

Reach……………………………………………………………………39

Barriers and Facilitators …………………………………………..40

Program Outcomes………………………………………….………43

Strengths and limitations………………………………………...43

Public Health Implications…………………………………………44

Conclusion…………………………………………………………...45

Appendices…………………………………………………………..46

Appendix A…………………………………………………………….46

Appendix B…………………………………………………………….48

Appendix C…………………………………………………………….49

References……………………………………………………………. .56

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health
Parola chiave	Mobile meals Summer meals Program evaluation Process evaluation Youth food insecurity Pediatric health Food insecurity Outcome evaluation
Committee Chair / Thesis Advisor	Amy Webb-Girard, Emory University
Committee Members	Christina Nichols, Cartersville City Schools

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