Qualitative Study of Participation Facilitators and Barriers for Emergency School Meals and Pandemic Electronic Benefits (P-EBT) in an Urban Setting during COVID-19
Abstract
:1. Introduction
2. Materials and Methods
2.1. Research Design
2.2. Semi-Structured Interviews
2.3. Statistical Analysis
3. Results
3.1. Participant Information
3.2. Thematic Focus Group Findings on Participation in Grab-and-Go Meals
3.2.1. Communication as a Facilitator to Participation in Grab-and-Go Meals
3.2.2. Communication as a Barrier to Participation in Grab-and-Go Meals
3.2.3. Logistics as a Facilitator to Grab-and-Go Participation
3.2.4. Logistics as a Barrier to Grab-and-Go Participation
3.2.5. Meal Appeal as a Facilitator to Grab-and-Go Participation
3.2.6. Meal Appeal as a Barrier to Grab-and-Go Participation
3.2.7. Personal Circumstances as a Facilitator to Grab-and-Go Participation
3.2.8. Personal Circumstances as Barriers to Grab-and-Go Participation
3.3. Pandemic Electronic Benefit Payments Facilitators and Barriers to Participation
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Grab n Go Recruitment Form based on Recruitment Script
- 1.
- Email*
- 2.
- Are you a parent of a NYC Public School (K-12) student who has ever received * school food (grab ‘n go) during the pandemic (since March 2020)? *Mark only one oval.YesNoOther: ___
- 3.
- Please enter your preferred name (first and last) *
- 4.
- What is your preferred salutation *Mark only one oval.
- o
- Ms.
- o
- Mrs.
- o
- Mr.
- o
- None
- o
- Other:
- 5.
- Please enter your cell phone number *
- 6.
- Is it OK for us to contact you by texts? *Mark only one oval.
- o
- Yes
- o
- No
- 7.
- What is the best way to contact you? (check all that apply) *Check all that apply.
- o
- Email
- o
- Phone
- o
- Other:
- 8.
- When would be best to call you ABOUT the study (will take ~15–20 min, the 1 h focus group will be another time)? *Check all that apply.Any time 8 a.m.–10 a.m. 10 a.m.–12 p.m. 12 p.m.–2 p.m. 2 p.m.–5 p.m. 5 p.m.–8 p.m.Any day is OK
- o
- Sunday
- o
- Monday
- o
- Tuesday
- o
- Wednesday
- o
- Thursday
- o
- Friday
- o
- Saturday
- 9.
- How did you hear about this study? *Check all that apply.
- o
- Community Food Advocates
- o
- Lunch 4 Learning
- o
- Instagram
- o
- Facebook
- o
- Friends/family
- o
- Other:
Appendix B. NY Parents Demographics Survey
- 1.
- What is the NYC Community School District for your youngest child who is school-aged? (1–32 and 75)
- 2.
- How many children do you have in each of the following age groups?
- ○
- Younger than Pre-K
- ○
- Pre-K–5th grade
- ○
- 6th–8th grade
- ○
- 9th–12th grade
- ○
- Beyond high school
- 3.
- How many children in your home use the school meals program in the following time periods?
Before the pandemic | ▼ 1 … 10 or more |
16 March–June 2020 | ▼ 1 … 10 or more |
Summer 2020 | ▼ 1 … 10 or more |
September 2020–Present | ▼ 1 … 10 or more |
- 4.
- Which meals have your children received from the school meals program? (Check all that apply)
Breakfast | Lunch | Dinner | Unsure | |
Before the pandemic | ⚬ | ⚬ | ⚬ | ⚬ |
16 March–June 2020 | ⚬ | ⚬ | ⚬ | ⚬ |
Summer 2020 | ⚬ | ⚬ | ⚬ | ⚬ |
September 2020–Present | ⚬ | ⚬ | ⚬ | ⚬ |
- 5.
- How many days a week were your children typically getting school meals during the following time periods? (Check all that apply)
Before the pandemic | ▼ 1 … 5 |
16 March–June 2020 | ▼ 1 … 5 |
Summer 2020 | ▼ 1 … 5 |
September 2020–Present | ▼ 1 … 5 |
- 6.
- What has made it harder for your children to get school meals since the pandemic started? (Check all that apply)My job (e.g., my hours, responsibilities, …) made it difficult to leave.
- ○
- Pick-up place was hard to get to or inconvenient.
- ○
- I have safety concerns about COVID.
- ○
- I have to take care of my kids or other family members.
- ○
- The food was the same a lot of the time.
- ○
- The food was unappealing or not something my child would normally eat.
- ○
- Other: ________________________________________________________________
- 7.
- What would make it easier for your children to get school meals now? (Check all that apply)
- ○
- Being able to pick up multiple days of meals at one time
- ○
- Having additional help with my kids
- ○
- Serving more variety of foods
- ○
- Serving foods that my kid likes to eat more
- ○
- Having more convenient times for pick-up
- ○
- More communication about the meals
- ○
- Other: ________________________________________________________________
- 8.
- In addition to school meals, since schools have shut down, how else have you obtained food for your children? (Check all that apply)
- ○
- Food pantries
- ○
- SNAP
- ○
- WIC
- ○
- Get the Good Stuff
- ○
- Health Bucks
- ○
- Buying groceries with personal earnings or savings
- ○
- Take-outs from restaurants
- ○
- Community fridges
- ○
- Other _________________________________________________________________
- 9.
- “We worried whether our food would run out before we got money to buy more.” Was that often, sometimes, or never true for your household?
Often True | Sometimes True | Never True | Don’t Know | |
Before the pandemic | ⚬ | ⚬ | ⚬ | ⚬ |
16 March–June 2020 | ⚬ | ⚬ | ⚬ | ⚬ |
Summer 2020 | ⚬ | ⚬ | ⚬ | ⚬ |
September 2020–Present | ⚬ | ⚬ | ⚬ | ⚬ |
- 10.
- “The food that we bought just didn’t last, and we didn’t have money to get more.” Was that often, sometimes, or never true for your household?
Often True | Sometimes True | Never True | Don’t Know | |
Before the pandemic | ⚬ | ⚬ | ⚬ | ⚬ |
16 March–June 2020 | ⚬ | ⚬ | ⚬ | ⚬ |
Summer 2020 | ⚬ | ⚬ | ⚬ | ⚬ |
September 2020–Present | ⚬ | ⚬ | ⚬ | ⚬ |
- 11.
- About how many cups of fruit (including 100% fruit juice) did your youngest child who is school aged eat or drink every day?1 cup of fruit could be:1 small apple1 large banana1 large orange8 large strawberries1 medium pear2 large plums32 seedless grapes1 cup (8 fl oz) 100% juice1/2 cup dried fruit
Daily Cups of Fruit Before the pandemic 16 March–June 2020 Summer 2020 September 2020–Present About how many cups of vegetables (including 100% vegetable juice) did your youngest child who is school aged eat or drink every day?1 cup of vegetables could be:3 broccoli spears (5” long)1 cup cooked leafy greens2 cups lettuce or raw greens12 baby carrots1 medium potato1 large sweet potato1 large ear of corn1 large raw tomatoes2 large celery stalksDaily cups of vegetables Before the pandemic 16 March–June 2020 Summer 2020 September 2020–Present These last few questions are about you.
- 12.
- What is your occupation?_________________________________________________________________
- 13.
- Do you identify as Hispanic/Latinx?
- ○
- Yes
- ○
- No
- 14.
- What is your race?
- ○
- African American/Black
- ○
- Mixed or Multiracial
- ○
- Asian
- ○
- Native American or Pacific Islander
- ○
- White
- ○
- Other
- 15.
- What is your age?_________________________________________________________________
- 16.
- What is your gender?_________________________________________________________________
- 17.
- What language do you primarily speak at home?_________________________________________________________________
- 18.
- Would you be willing to be contacted for future research?
- ○
- Yes
- ○
- No
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Survey (n = 126) | Focus Groups (n = 101) | p-Value | |
---|---|---|---|
Gender Female | 119 (94.4%) | 97 (96.0%) | 0.014 |
Age <35 35–39 40–44 45–49 50+ Unknown | 34 (27.0%) 32 (25.4%) 33 (26.2%) 15 (11.9%) 11 (8.7%) 1 (0.8%) | 24 (23.8%) 26 (25.7%) 27 (26.7%) 14 (13.9%) 9 (8.9%) 1 (1.0%) | 0.109 |
Occupation Unemployed/ Retired/Disabled Homemaking Office/White-Collar Education Blue-collar Healthcare Government Other/Unknown | 24 (19.0%) 21 (16.7%) 21 (16.7%) 15 (11.9%) 12 (9.5%) 9 (7.1%) 4 (3.2%) 20 (15.9%) | 22 (21.8%) 19 (18.8%) 16 (15.8%) 12 (11.9%) 8 (7.9%) 8 (7.9%) 3 (3.0%) 13 (12.9%) | 0.007 |
Race/Ethnicity Hispanic/Latino Non-Hispanic Black Non-Hispanic White Asian Mixed/Other/Unknown | 52 (41.3%) 44 (34.9%) 14 (11.1%) 10 (7.9%) 6 (4.8%) | 40 (39.6%) 39 (38.6%) 10 (9.9%) 9 (8.9%) 3 (3.0%) | 0.503 |
Home language English Spanish Other | 106 (86.2%) 12 (9.8%) 5 (4.0%) | 86 (88.7%) 9 (9.3%) 3 (3.0%) | 0.449 |
Borough/Community school district of the youngest child Brooklyn The Bronx Manhattan Queens Staten island Special Education 1 Unknown | 38 (29.9%) 31 (24.4%) 23 (18.1%) 17 (13.4%) 6 (4.7%) 4 (3.1%) 8 (6.3%) | 33 (32.7%) 25 (24.8%) 18 (17.8%) 16 (15.8%) 3 (3.0%) 4 (4.0%) 2 (2.0%) | 0.602 |
Families with children in age group 2 Younger than Pre-K Pre-K–5th grade 6th–8th grade 9th–12th grade Beyond high school | 19 (15.2%) 94 (75.2%) 39 (31.2%) 44 (35.2%) 11 (8.8%) | 11 (10.9%) 74 (73.3%) 33 (32.7%) 37 (36.6%) 10 (9.9%) | 0.008 |
Themes: | Communication | Logistics | Meal Appeal | Personal Circumstances |
---|---|---|---|---|
Facilitating Communication Subthemes: | Facilitating Logistics Subthemes: | Facilitating Meal Appeal Subthemes: | Facilitating Personal Circumstances Subthemes: | |
Facilitators |
|
|
|
|
Barrier Communication Subthemes: | Barrier Logistics Subthemes: | Barrier Meal Appeal Subthemes: | Barrier Personal Circumstances Subthemes: | |
Barriers |
|
|
|
|
Communication | Subtheme Topics | Focus Groups | Selected Quotes |
---|---|---|---|
Facilitating Communication Subthemes | Multiple methods of school communication | 92% | “My school made a flyer and a PC [parent coordinator], sent it out numerous times to come pick up the grab-in go. And then she also explained, you know, the timing of the grab and go at the PTA meeting. So yeah, they were good at giving out the news…” |
Mass media promotion | 64% | “[Mayor] DeBlasio said it one time and then that’s when I started getting it. I heard it on the news.” ”I would say the advertisements on television. I would see meals for children advertisements online as well.” | |
Informal Support | 52% | “Well, I’m a parent coordinator, and, uh, I speak to the other parent coordinators from the schools in our district… we kind of help each other out, because it’s the time for our families to be able to help everyone out not just our families in our school, it’s our community. So, like, our school, if we’re having a food pantry day, we’ll advertise it for our families, and we’ll advertise it for the community, but we also share it with the other schools so that they can send their families over as well. And vice versa.” | |
School & meal signage | 40% | “They put the sign up outside [of the school]” “The signage on the school. People walk by all the time, so I think that is important. Especially with the pandemic, a-lot of people weren’t out, so if there is a big banner outside the school, people tend to take notice.” | |
Number of groups mentioning communication as a facilitator | 24 out of 25 focus groups | 96% |
Communication | Subtheme Topics | Focus Groups | Selected Quotes |
---|---|---|---|
Barriers Communication Subthemes | Unclear menu choices | 60% | “I had to question [the available options], ‘Well, that’s not what ---that wasn’t on the menu?’ And then I had to hear, ‘Well, that’s what they gave us today…[or]that’s what—that’s what’s left.’” |
Inadequate signage/ communication | 48% | “There’s no signage on the school. I only know that I can go there to pick up the food when we did pick it up was because I Google everything. I look. I search. I make sure to find out where the, the information is. So, from my end, our school is … a total lack of communication. There’s no signage on the doors. There’s no message from the school leadership like, ‘hey, the school’s closing…, you can pick up at this time…, you can pick up breakfast…, if you need extra.’ There’s just absolutely crickets on it from our school.” | |
Inadequate marketing | 36% | “From my school, there’s been a lack of communication from the leadership in the school as per what time we can pick up the food. Like what the other parents said, if it closes, where can you get it?” | |
Inadequate two-way communication | 28% | ”They don’t give you no information… I Googled, [my child’s school] giving meals.’ And, it pops up. Yes. Then I went onto the Board of Ed, and I saw the listing there... But, they just didn’t say nothing to us.” “… one of my schools was one of the first ones have signs up. But again, it was only in English. So, the neighborhood is a mix of, you know, Spanish, Asian. There are Caucasians. But the language was only… only one language. So, you know, the neighborhood is very diverse. You need to have it in multi language”s. | |
Number of groups mentioning communication as a barrier | 19 out of 25 focus groups | 76% |
Logistics | Subtheme Topics | Focus Groups | Selected Quotes |
---|---|---|---|
Facilitating Logistics Subthemes | Location Accessibility | 84% | “It’s within walking distance of the apartment.” “It’s easy because it’s just right down the block.” “It’s easier for [my daughter] and more convenient to just go across the street, go to the school, pick up a lunch, and, and eat it, instead of also waiting for me to come home and cook for her.” |
Bonus Resources | 60% | “They gave out resources … anytime you went and got a meal, they usually had a paper that they handed you that told you about other resources. They also gave out masks at one time.” ”I know, some schools, some places that were also giving feminine products as well. Yeah, with a lot, you know, you could pick up feminine products. You could, like she said [get] the masks, some gloves.” | |
Bulk Pickup | 52% | “[It’s easy for me since] I have three kids, and we’re picking up breakfast- because … they give us breakfast and lunch at the same time, which I love.” | |
Number of groups mentioning logistics as a facilitator | 22 out of 25 focus groups | 88% |
Logistics | Subtheme Topics | Focus Groups | Selected Quotes |
---|---|---|---|
Barriers Logistics Subthemes | Location Limitations | 68% | “I’m not walking 7 blocks just to get peanut butter & jelly when I can make it at home.” “The school that was offering food was close to 10 blocks away from me or so.” [Meant to imply she was not going to travel that far for meals.] |
Limited Hours | 64% | On the challenge of getting the meals right before class starts for multiple children: “I have 10 kids. …once we have the grab-and-go, I just give everybody their breakfast… and they eat while they’re on the tablet. …some of the teachers would be like, you know, “Don’t eat!” Or, “Stop eating!” But, they don’t understand, like, what’s going on in your house—it’s so hectic to serve a breakfast, you know -- on the breakfast table—when we have school at 8:30 a.m. That is like, really hard!” | |
Limited Bulk Pickup | 48% | “Well, I think that having it [bulk] delivered would, would help a lot.” “Um…actually, I didn’t have a good experience with getting food because I do have a large family. I have a household of seven. Umm…so they would limit me to only taking three meals, sometimes…just 3 meals for 3 people.” | |
Lack of Supervision | 32% | “I felt like it wasn’t supervised. And, you know, it was a little chaotic. And the second time I went to pick up, and it was just like, not safe, or I didn’t feel safe, because the other people were too close. …my child was like, ‘Oh, I don’t want to stand here. It’s too many people.’” | |
Number of groups mentioning logistics as a barrier | 22 out of 25 focus groups | 80% |
Meal Appeal | Subtheme Topics | Focus Groups | Selected Quotes |
---|---|---|---|
Facilitating: Meal Appeal Subthemes | Types of options available | 36% | “I really loved the breakfast and milk and fruit and veggies.” “My kids’ picky, but he eats it.” “When they started doing hot lunches, that helped out a lot too, because it was more of a lot of variety. And then, it was like, the lunch, the fruit, the snack, which was great.” “As much as there really wasn’t a large selection of things, that probably would have been the same things that I would have packed for [my children] and sent them with to school.” |
Nutritional quality | 28% | “My child eats a lot more vegetables because of the school food.” “They were fresh. I heard some complaints that at some places they were stale, but they were fresh—they were accommodating, and it was pretty well balanced. There was the fruit, there was juice, there was milk, and there was also a snack…like a granola bar or like a pack of apples. So, I think…that was pretty good.” | |
Number of groups mentioning meal appeal as a facilitator | 15 out of 25 focus groups | 60% |
Meal Appeal | Subtheme Topics | Focus Groups | Selected Quotes |
---|---|---|---|
Barriers Meal Appeal Subthemes | Limited Variety & Inconsistent Options | 88% | “We’ll strictly get sandwiches. We get nothing else. It’s either peanut butter, cheese- strict American cheese on whole wheat bread and that’s it…” “I’m seeing pictures of other schools’ [grab-and-go] lunch, it was nothing compared with what I saw here in front of my building. It was like,’ Why are we not having the same thing?’ ‘What’s going on here?’ I don’t want to play the discrimination card, but it was like what’s going on?” |
Insufficient Food Items & Limited Selections for Special Diets | 80% | From a parent needing kosher options, with a teenage son: “I was very disappointed because it was always like hummus, crackers, and… I was just like, ‘this is not a meal, it’s more like snacks to me.” | |
Unappealing Meals | 72% | “The containers that these vegetables come in, they are not well sealed. So, then they will spill onto whatever fruits [that’s in] there, the sandwiches … and then [my children] just don’t want to eat it. … then the cheese melts into the turkey, and mine don’t eat cheese, so I’m there peeling off, trying to scrape it off and then the bread doesn’t work so it’s just um, the lack of options.” “It looked like, ‘be thankful we’re giving you something to eat, you know? We’re in the middle of a pandemic, you should be grateful!’ That was the message I got from it.” | |
Number of groups mentioning meal appeal as a barrier | 22 out of 25 focus groups | 88% |
Personal Circumstances | Subtheme Topics | Focus Groups | Selected Quotes |
---|---|---|---|
Facilitating Personal Circumstances Subthemes | Informal Support | 52% | “I got lucky. My son’s high school (school in Brooklyn)—actually when the pandemic started, they gave us all vouchers to have food delivered directly to our house.” |
Addresses Basic Needs | 44% | On the fact that her middle school sons were constantly hungry and needing the meals: “If the house was made of gingerbread, I probably wouldn’t have a house.” ”[Grab-and-go meals] provided some sort of normalcy, if you will, for, especially for my older one because it was a school lunch, right, it’s what she was accustomed to seeing during lunch time. I was gonna get milk. I was gonna get a fruit. I was gonna get something else to eat and vegetable that I wasn’t going to touch. So for her at the very beginning, it helped a little bit with ‘Okay, I have class, I have lunch, I have class.” | |
School Personnel Rapport | 36% | On a privileged friendship at the school, “I have a friend there. And I say, ‘Send me a text’…, I say, ‘Y’all have salad today?’ And then when I’m coming back from washing, I’ll pick it up.” | |
Number of groups mentioning personal circumstances as a facilitator | 21 out of 25 focus groups | 84% |
Personal Circumstances | Subtheme Topics | Focus Groups | Selected Quotes |
---|---|---|---|
Barriers Personal Circumstances Subthemes | Food & Excess Packaging Waste Avoidance | 68% | “An overkill of packaging.” “Literally, it was like the big gallon plastic bag filled with food... and this is a very pervasive issue in our society, in our city.” |
Family & Work Responsibilities | 68% | “Since my child has ASD, it was very hard at the beginning to take him out, just because it was hard for him to even wear a face covering.” “It was hard, because sometimes our kids, sometimes have disability that may not allow them to be able to go outside, because they might be in a wheelchair or different things. | |
Miscellaneous Challenges | 52% | “I mean, the whole point of COVID is, you know, to stay remote and not to be outside in public and you’re making us go every day. It kind of defeats the purpose.” “I’m of on the sixth floor. I got asthma, COPD, diabetes. I got a lot of health issues. I cannot be going out much every single day, you know?” On navigating getting the meals if your child is in a wheelchair: “It was hard.” | |
Number of groups mentioning personal circumstances as a barrier | 22 out of 25 focus groups | 88% |
P-EBT Themes | Subtheme Topics | Focus Groups | Selected Quotes |
---|---|---|---|
P-EBT Facilitators | Helpful funding | 56% | On helpfulness: “Yeah, … that P-EBT thing did help, because I have a child that… [has] a feeding tube that can’t eat normal food, so they require baby food.” On increased autonomy: “That P-EBT card helps a lot because … At least you’re able to control what you’re buying… When you were able to find the sale… you were able to get the fresh fruits. … you were able to get the fresh vegetable.” On the relief of getting the funds when times were grim, “For me, it was extremely beneficial because my husband was the only one qualified for unemployment. …. when it hit, I was like … ‘Where did this money come from? [extremely animated] God? [laughing] It was really… it was like a weight lifted. It was a relief because it was at a time, where we were all kinds of panicking.” |
Allows flexibility | 40% | ||
Easy to use | 32% | ||
Increased autonomy | 32% | ||
Ability to purchase food online | 16% | ||
Combination with other resources | 12% | ||
Number of groups mentioning facilitators for using P-EBT | 20 out of 25 focus groups | 80% | |
P-EBT Barriers | Administrative issues | 52% | On confusion over not receiving benefits: “I haven’t gotten mine. But I did email, um, I did email, and there’s, they’re gonna give it. They’re gonna send it in the month. I just don’t know how much is the amount? Okay? But, I did get in contact with somebody. They, say [that] they put it in a card that was [from] 2016. They just said they were gonna send me another one. And that was like two weeks ago.” |
Lack of information | 40% | ||
Late arrival | 24% | ||
Lack of support | 16% | ||
Confusion of P-EBT with SNAP | 8% | ||
Number of groups mentioning barriers for using P-EBT | 15 out of 25 focus groups | 60% |
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Cadenhead, J.W.; McCarthy, J.E.; Nguyen, T.T.T.; Rodriguez, M.; Koch, P.A. Qualitative Study of Participation Facilitators and Barriers for Emergency School Meals and Pandemic Electronic Benefits (P-EBT) in an Urban Setting during COVID-19. Nutrients 2022, 14, 3358. https://doi.org/10.3390/nu14163358
Cadenhead JW, McCarthy JE, Nguyen TTT, Rodriguez M, Koch PA. Qualitative Study of Participation Facilitators and Barriers for Emergency School Meals and Pandemic Electronic Benefits (P-EBT) in an Urban Setting during COVID-19. Nutrients. 2022; 14(16):3358. https://doi.org/10.3390/nu14163358
Chicago/Turabian StyleCadenhead, Jennifer W., Julia E. McCarthy, Thanh Thanh T. Nguyen, Michelle Rodriguez, and Pamela A. Koch. 2022. "Qualitative Study of Participation Facilitators and Barriers for Emergency School Meals and Pandemic Electronic Benefits (P-EBT) in an Urban Setting during COVID-19" Nutrients 14, no. 16: 3358. https://doi.org/10.3390/nu14163358