Professional Networks Among Rural School Food Service Directors Implementing the Healthy, Hunger-Free Kids Act

ABSTRACT Purpose/Objectives This study was designed to explore the professional networks of rural school food service directors (FSD), the resources they use for implementing the Healthy, Hunger-free Kids Act of 2010 (HHFKA), and their needs for information and support to continue to implement successfully. Methods Rural FSD participated in an in-depth telephone interview (n = 67) and an online survey (n = 57). The interview asked respondents about the resources and support they used and still needed to assist with implementing the HHFKA changes, while the online survey focused on professional networks and communication among FSD. The interviews were analyzed by thematic coding, while descriptive statistics were used to summarize survey data. Results Respondents reported making extensive use of professional networks by communicating with FSD in other districts. They both sought and gave advice during this communication, and the topic discussed most frequently was implementation of HHFKA requirements. Mapping of network nodes showed that networks of communication were often geographically bound. Respondents reported using a variety of resources to implement the HHFKA and disclosed that they often relied on their colleagues in other districts for support. Self-identified needs included staffing support, additional networking opportunities, and technology support. Perceived support varied and several responses indicated that rural FSD feel isolated when implementing the HHFKA requirements. Applications to Child Nutrition Professionals Rural FSD would benefit from enhanced professional networks that are tailored to their needs and constraints. It may be the case that rural schools need more support overall because existing challenges make HHFKA implementation more difficult than in larger, urban, or better-funded school districts

The Secondhand Effects of College Drinking: The Need For Media Relations

Heavy episodic drinking can lead to significant harmful effects for the drinker and others. Rates of heavy alcohol use on college campuses have remained high, despite increased educational interventions. This study examines the coverage of the negative consequences of drinking among college students. This content analysis looks at coverage from1996-2006 in 32 major US newspapers. Of the total 255 articles, 209 covered at least one negative consequence of college drinking. Consequences were framed as individual in nature and did not acknowledge the impact on other individuals and institutions. Those related to damage to self were covered most often in newspapers from this time period, appearing in nearly every article that mentioned a negative consequence. Damage to others and damages to institutions were mentioned very infrequently. In addition, in 2006, damages to self outnumbered damages to others 4:1 and damages to institutions 10:1. While a range of negative consequences of heavy episodic drinking are covered, the most common harm covered is death, which is severe but highly unlikely. Coverage of more commonly occurring negative consequences were far less frequent. Coverage varied by region and was not consistent with where the greatest college drinking problems are found. The focus on individual harms and particularly those that are uncommon could lead readers to inaccurately perceive the issue as episodic and unrelated to environmental determinants. The study concludes that public relations and public health professionals can use media advocacy to work with the media to illuminate the secondhand impact of episodic drinking beyond those affecting the drinker

Rural School Food Service Director Perceptions on Voluntary School Meal Reforms

This mixed-method study examined rural U.S. food service directors' perceptions of and experiences with voluntary school meal programs, which have the potential to improve school nutrition but have not been widely adopted in rural areas of the United States. Little is known about how rural food service directors perceive these programs. Interview and survey instruments examined how rural food service directors characterize barriers and facilitators to participation in voluntary school meal programs like farm-to-school and school garden programs. Rural school food service directors participated in a semistructured telephone interview (n=67) and an online survey (n=57). We defined rural school districts by the most rural locale codes (as categorized by the National Center for Education Statistics) in a midsized Midwestern state. Quantitative data were analyzed using descriptive statistics. We analyzed qualitative responses using thematic coding. The qualitative analysis revealed that directors had little experience with these programs and perceived these programs to be very challenging to implement. Issues common to rural school districts were a very small staff, lack of concrete knowledge about how these programs work, and lack of access to local producers and chefs. These findings underscore the need to consider the unique situation of rural schools when promoting voluntary school meals reform programs. We make recommendations about adopting and adapting these voluntary programs to better fit the reality of rural areas

CDC Healthcare and Public Perceptions of Immunizations (HaPPI) Survey Collaborative

The overall objective of this collaboration between the Centers for Disease Control and Prevention, University of Iowa, and RAND Corporation is the conduct surveys with healthcare providers and the general public to help inform the vaccination recommendations of CDC's Advisory Committee on Immunization Practices (ACIP)

Intersectoral cooperation to increase HPV vaccine coverage: an innovative collaboration between Managed Care Organizations and state-level stakeholders

In order to reduce disparities in human papillomavirus (HPV) vaccine coverage, intersectoral approaches are needed to reach vulnerable populations, including Medicaid enrollees. This manuscript describes a collaboration between Medicaid Managed Care Organizations (MCOs), the American Cancer Society, and a state health department in a Midwestern state to address HPV vaccination. Qualitative interviews (n = 11) were conducted via telephone with key stakeholders from the three participating organizations using an interview guide designed to capture the process of developing the partnership and implementing the HPV-focused project. Interviews were transcribed and coded using thematic analysis. Interviewees described motivation to participate, including shared goals, and facilitators, like pooled resources. They cited barriers, such as time and legal challenges. Overall, interviewees reported that they believed this project is replicable. Conducting this project revealed the importance of shared vision, effective communication, and the complementary resources and experiences contributed by each organization. Valuable lessons were learned about reaching the Medicaid population and groundwork was laid for future efforts to serve vulnerable populations and reduce health disparities. This work has significant implications for other organizations seeking to partner with large nonprofits, state health departments, MCOs, or others, and the lessons learned from this project could be translated to other groups working to improve vaccination rates in their communities

The Relationship between Political, Economic, Social, and Cultural Vulnerability and Food Insecurity among Adults Aged 50 Years and Older

Individuals experience food insecurity when they worry about or have limited access to nutritious foods. Food insecurity negatively impacts older adults’ health. Social exclusion is a theoretical framework describing how unequal access to rights, resources, and capabilities results in political, economic, social, and cultural vulnerability, which leads to health disparities. We used the Health and Retirement Study to cross-sectionally examine associations between vulnerability and experiencing food insecurity in adults 50 years and older using the social exclusion framework. We tested the association between experiencing food insecurity and indicators of political, economic, social, and cultural vulnerability using logistic regression controlling for demographic and health-related factors. Analyses were performed with all respondents and sub-group of respondents with incomes less than 400% of the federal poverty level (FPL). Assets (OR = 0.97 in both samples), income (OR = 0.85, 0.80 in 400% FPL sub-sample), perceived positive social support from other family (OR = 0.86, 0.84 in 400% FPL sub-sample), and perceived everyday discrimination (OR = 1.68, 1.82 in 400% FPL sub-sample) were significantly associated with food insecurity. Perceived positive social support from spouses, children, or friends and U.S. citizenship status were not significantly associated with food insecurity. Further research is needed to define and measure each dimension of vulnerability in the social exclusion framework. Interventions and policies designed to prevent food insecurity should address these vulnerabilities

Predictors of rural driver self-reported passing behaviors when interacting with farm equipment on the roadway

Background: Crashes involving farm equipment (FE) are a major safety concern for farmers as well as all other users of the public road system in both rural and urban areas. These crashes often involve passenger vehicle drivers striking the farm equipment from behind or attempting to pass, but little is known about drivers’ perceived norms and self-reported passing behaviors. The objective of this study is to examine factors influencing drivers' farm equipment passing frequencies and their perceptions about the passing behaviors of other drivers. Methods: Data were collected via intercept surveys with adult drivers at local gas stations in two small rural towns in Iowa. The survey asked drivers about their demographic information, frequency of passing farm equipment, and perceptions of other drivers' passing behavior in their community and state when approaching farm equipment (proximal and distal descriptive norms). A multinomial logistic regression model was used to estimate the relationship between descriptive norms and self-reported passing behavior. Results: Survey data from 201 adult drivers showed that only 10% of respondents considered farm equipment crashes to be a top road safety concern. Respondents who perceived others passing farm equipment frequently in their community were more likely to report that they also frequently pass farm equipment. The results also showed interactions between gender and experience operating farm equipment in terms of self-reported passing behavior. Conclusions/implications: Results from this study suggest local and state-level norms and perceptions of those norms may be important targets for intervention to improve individual driving behaviors around farm equipment

Lessons Learned From Human Papillomavirus Vaccination to Increase Uptake of Adolescent COVID-19 Vaccination

Uptake of COVID-19 vaccination among adolescents has been low and highly variable across the United States. As of July 2021, the most recently available national data, 42% of adolescents ages 12–17 had received at least one dose of the COVID-19 vaccine, but that percentage varied widely from state to state. Low vaccination rates threaten to prolong the pandemic and pose a health risk to unvaccinated adolescents as well as their families and social networks. To promote COVID-19 vaccinations for adolescents, it will be valuable to explore lessons learned about human papillomavirus (HPV) vaccination in this population. In this commentary, we outline the similarities between the HPV and COVID-19 vaccines and offer three recommendations that can be applied to efforts for adolescent COVID-19 vaccination promotion and delivery