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Principal Investigator: Felice Le-Scherban
Organization: DREXEL UNIVERSITY
Fiscal Year: 2024
Award: $619,860
Funding agency: National Institute of Diabetes and Digestive and Kidney Diseases
PROJECT SUMMARY Nearly 14% of US households with children were food insecure before the start of the
COVID-19 crisis, and this number increased dramatically during the pandemic. Food insecurity (FI)—
inadequate access to enough food for every person in a household to live an active, healthy life—threatens
critical early childhood growth and can put children at risk for poor short- and long-term health. FI is also a
major source of inequity among children: compared to white households with children, Black households are 3
times as likely and Latinx households over twice as likely to experience FI. The degree to which household FI
impacts children’s diet and weight may vary depending on caregivers’ shielding behaviors (e.g., skipping meals
to prioritize feeding their children), characteristics of the neighborhoods where families live (e.g., healthy food
access), and participation in food assistance programs.
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is an important
evidence-based program that supports equitable child health by providing families with children aged 0–4
access to nutritionally and developmentally appropriate foods and counseling. However, only half of those who
are eligible for WIC participate; among those who do participate, nonredemption or partial redemption of the
monthly benefit is common. Maximizing the effectiveness of this cornerstone food assistance program requires
understanding the multilevel factors that influence families’ participation and use of the benefit.
The goal of the proposed exploratory sequential mixed-methods study is to inform implementation of
WIC and other food assistance policies by analyzing how household FI is associated with weight trajectories
among young children, and how this association is modified by neighborhood environment and public food
assistance programs. We will accomplish this goal through the following specific aims:
Aim 1: Conduct in-depth qualitative focus groups with caregivers with low incomes to investigate families’ food
purchasing, feeding practices, and food insecurity during the COVID-19 crisis and economic recovery,
including recent changes in WIC and neighborhood characteristics.
Aim 2: Assess whether FI at age 2 to 36 months predicts weight gain trajectories to age 3 and 6 years before
and after onset of the COVID-19 crisis.
Aim 3: Assess interactions between FI and (focus group-identified) neighborhood environments in early life as
predictors of child weight gain trajectories to age 3 and 6 years before and after onset of the COVID-19 crisis.
We will integrate qualitative and quantitative findings in an integrative report to inform WIC program
recommendations to best support families’ healthy feeding choices and children’s healthy growth in the context
of multilevel contributing factors. The evidence we produce can be used to improve WIC implementation to
support families with young children in metropolitan areas long-term and in times of crisis.
Terms: <0-11 years old><Affect><Age><American><Area><Behavior><Black><Black race><Breast Feeding><Breast fed><Breastfed><Breastfeeding><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Care Givers><Caregivers><Certification><Characteristics><Child><Child Care><Child Youth><Child health equity><Childhood><Children (0-21)><Children's Hospital><Communities><Complex><Counseling><Data><Data Analyses><Data Analysis><Decrease disparity><Development><Diet><Economics><Effectiveness><Electronic Health Record><Electronics><Eligibility><Eligibility Determination><Environment><Evidence based program><Family><Fats><Fatty acid glycerol esters><Focus Groups><Food><Food Access><Food Assistance Programs><Food Packaging><Generalized Growth><Goals><Growth><Health><Health Food><Health behavior and outcomes><Household><Individual><Inequity><Infant><Integrated Delivery Systems><Intervention><Intervention Strategies><Latine><Latinx><Life><Link><Low income><Lower disparity><Methods><Modeling><Modernization><Mothers><Neighborhoods><Nutrient><Nutritional><Office Visits><Outcome><Patients><Pediatric Hospitals><Persons><Philadelphia><Policies><Postpartum Period><Protocol Screening><Puericulture><Recommendation><Recovery><Reporting><Research><Restaurants><Risk><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Schools><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Source><Special Supplemental Nutrition Program for Women, Infants, and Children><Statistical Data Analyses><Statistical Data Analysis><Statistical Data Interpretation><Survey Instrument><Surveys><System><Time><Tissue Growth><WIC><WIC program><Weight><Weight Gain><Weight Increase><Woman><Women, Infants and Children (WIC)><aged><ages><body weight gain><body weight increase><community violence><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><cost><data interpretation><developmental><diets><disparate effect><disparate impact><disparate result><disparity reduction><early childhood><economic><electronic><electronic device><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><evidence base><experience><family influence><family support><feeding><flexibility><flexible><food insecurity><fruits and vegetables><healthy food><healthy weight><improved><inequitable effect><inequitable impact><inequitable outcome><innovate><innovation><innovative><interventional strategy><kids><metropolitan><mitigate disparity><neighborhood violence><nutritious><obesity risk><ontogeny><outcome disparities><outcome inequality><outcome inequity><outreach><overweight child><overweight childhood><pandemic><pandemic disease><pediatric><physician office visit><post-partum><pregnant><programs><reduce disparity><reduction in disparity><risk for obesity><risk of obesity><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><statistical analysis><sugar><unequal effect><unequal impact><unequal outcome><violence against communities><weights><wt gain><youngster>