USDA-Funded Summer Feeding Programs and Key Child Health Outcomes of Public Health Importance: A Rapid Review [Internet]

Excerpt

Background: The Nutrition Evidence Systematic Review (NESR) team, housed in the Center for Nutrition Policy and Promotion, Food and Nutrition Service (FNS), U.S. Department of Agriculture (USDA), specializes in conducting food- and nutrition-related reviews using rigorous, protocol-driven methodology. To inform Federal communication, research, and program guidance, the Office of Policy Support (OPS), FNS, USDA requested that the NESR team conduct a rapid review to answer the following question: What is the relationship between participation in USDA-funded summer feeding programs and food security, food sufficiency, diet quality, food acceptance, and weight-related outcomes?

Methods: The NESR team developed a protocol in collaboration with the review sponsor, the OPS Special Nutrition Research and Analysis Division team. The intervention or exposure of interest was USDA-funded summer feeding programs, including all types of models (e.g., Summer Food Service Program (SFSP), Seamless Summer Option (SSO), and electronic benefit), and USDA-funded multi-component summer programs with a food provision component in school-aged children and adolescents. The comparators were different types of summer feeding programs, including non-USDA funded programs, and no participation in a summer feeding program. The outcomes were food security, food sufficiency, diet quality, food acceptance, and weight-related outcomes in school-aged children and adolescents. All studies had to be conducted in the United States.

The NESR librarian conducted a comprehensive search for literature published between January 2000 and August 2020, which identified an existing narrative review on the same topic that covered literature published through April 2018. The review sponsor and NESR team decided to build upon this existing review and update its conclusions, if needed. To verify all relevant literature was captured by the existing review, as well as to capture literature published since its completion, two NESR analysts independently screened all results from the original, comprehensive search conducted by the NESR librarian.

NESR analysts compared the list of articles included during screening with the reference list from the existing review, and those not included in or published since the existing review were included in this rapid review. One NESR analyst extracted data from each study, and a second analyst verified all critical data. A single analyst assessed risk of bias with verification by a second analyst.

Results: Evidence included in this rapid review and findings from an existing narrative review provided the foundation for the following summary statement:

Summary statement:

Findings from this rapid review suggest USDA-funded summer feeding programs may benefit child food security and diet quality, and both in-person food provision and electronic benefit transfer formats appear beneficial.

Initial findings suggest multi-component interventions that include a feeding program may have a beneficial impact on summer weight gain prevention. However, further research is needed to determine the effects of USDA-funded summer feeding program participation on weight-related outcomes.

Summary of the evidence:

Few relevant articles have been published since the existing review. Six articles met inclusion criteria for this rapid review: four randomized controlled trials, one uncontrolled before-and-after study, and one prospective cohort study. Conducted primarily in lower income populations, studies found a beneficial impact of program participation on rates of food security. Findings were less consistent for diet quality and weight-related outcomes, but they tended to show beneficial changes in response to program participation, as well. More research in these areas could bolster the ability to draw conclusions about program effectiveness.